Care Home: Nairn Close - Orkney Close

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What the care home does well Each house is well furnished and homely which means that people have a comfortable place to live. Bedrooms were decorated and furnished to a good standard; they contained personal possessions, photographs and other effects. Orkney Close has been completely refurbished and the people who live there have only recently returned to their home Throughout the visit to each house, staff were observed to offer help where needed and in such a way that maintained independence, dignity and safety. People are supported to gain access to advice from health professionals where they need it so their health needs can be met. At the time of the inspection, the people who use this service were on their holidays from college and the day services that they attend. It was evident that the service has made provision for this free time in providing the opportunity to participate in their interests and preferences both within and outside of the service. There is both a complaints policy and an adult protection policy in place. Staff were aware of how people with limited verbal communication make their needs known. At the time of this inspection we had received no complaints. There is a good system in place with regard to the appointment of staff. Records seen show that references are always obtained, and staff are not appointed prior to safety checks being undertaken. The number of staff on duty enables the needs of the people living there to be met. The home has both male and female staff reflecting the gender make up of those who live there. People are supported to keep in touch with their families and friends so that they do not lose relationships that are important to them. What has improved since the last inspection? What the care home could do better: The home needs to continue with the redecoration program, ensuring all parts of each house are maintained to a high standard. Staff training should include Safeguarding and Whistle Blowing. This will ensure that staff take the appropriate action if there are any allegations orsuspicion of abuse, and will equip staff to meet the needs of people living in the home whilst carrying out their work safely. There should be no gaps in people`s care plans or risk assessments. In particular there is a need to ensure that guidance is in place for staff to monitor peoples skin condition and the use of listening devices. CARE HOME ADULTS 18-65 Nairn Close - Orkney Close 2 Nairn Close Nuneaton Warwickshire CV10 7LG Lead Inspector Julie McGarry Unannounced Inspection 12th August 2008 09:00 Nairn Close - Orkney Close DS0000004360.V369603.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 Nairn Close - Orkney Close DS0000004360.V369603.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. Nairn Close - Orkney Close DS0000004360.V369603.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Nairn Close - Orkney Close Address 2 Nairn Close Nuneaton Warwickshire CV10 7LG 02476 353399 02476 344357 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) FCH - Housing and Care Maxine Farrell Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Nairn Close - Orkney Close DS0000004360.V369603.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th July 2006 Brief Description of the Service: 2 Nairn Close and 9 Orkney Close are part of FCH Friendship Housing and Care. The home provides two separate living environments each for three people with a learning disability. The houses are in close proximity to each other and function as two separate units although staff work across both houses. Each house provides the people who live there with single bedroom accommodation, a bathroom and toilet facility, lounge, kitchen and dining room. A downstairs bedroom facility is available at each house, which at 9 Orkney Close includes an en-suite shower and toilet facility. There is also a conservatory at 9 Orkney Close. There is limited but sufficient parking to the front of each house with enclosed gardens and patio areas to the rear. The properties are in an established residential area of the town of Nuneaton, close to local shops and on a bus route to the town centre. Nairn Close - Orkney Close DS0000004360.V369603.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 2 star. This means the people who use this service experience good quality outcomes. This Key Inspection was unannounced; it was undertaken over one day on the 12th August 2008. The home is comprised of two houses in close proximity to each other. Each house offers accommodation to three people. This inspection was carried out to establish the outcomes for people living in the home, and to confirm whether they are protected from harm. The pre fieldwork inspection record was completed, as well as a site visit to the home, during which time staff members, people living in the home and the acting manager were spoken with. A completed annual quality assurance assessment was received from the service prior to the inspection along with five surveys completed by the people who live there, and one survey from a member of staff. Due to the communication needs of the people who live at this service, staff provided support to those who live there in completing the surveys. Some of the people who live at this service have communication needs and rely on staff support to recognise and respond to their needs and wishes. The acting manager was present throughout the inspection. At the time of the last inspection there was a manager in post, however she is currently off work ill and the acting manager was running the service with support from the Care Business Manager. Policies, procedures and care records were examined. Staff records, environmental checks and risk assessments were also read. They have been reviewed since the last inspection and the service has met the requirement set out at the last inspection. During the inspection, the care of two people who live in the home was examined in detail. This included, reading assessments, care plans, and other documentation, observing care offered to them and that staff have necessary skills to care for them. This is part of a process known as ‘case tracking’, where evidence is matched to outcomes for the people who live in the home. Specific elements of one other person’s care were also looked at to see if the outcomes are good. The inspector ate lunch at the home and was able to observe practices, and how staff interacted with individuals. Generally the people who live at this home live in safe, well -maintained and comfortable environment that promotes their independence. Bedrooms were decorated and maintained to a good standard meeting the requirements at the last inspection. Nairn Close - Orkney Close DS0000004360.V369603.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The home needs to continue with the redecoration program, ensuring all parts of each house are maintained to a high standard. Staff training should include Safeguarding and Whistle Blowing. This will ensure that staff take the appropriate action if there are any allegations or Nairn Close - Orkney Close DS0000004360.V369603.R01.S.doc Version 5.2 Page 7 suspicion of abuse, and will equip staff to meet the needs of people living in the home whilst carrying out their work safely. There should be no gaps in people’s care plans or risk assessments. In particular there is a need to ensure that guidance is in place for staff to monitor peoples skin condition and the use of listening devices. 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. Nairn Close - Orkney Close DS0000004360.V369603.R01.S.doc Version 5.2 Page 8 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 Nairn Close - Orkney Close DS0000004360.V369603.R01.S.doc Version 5.2 Page 9 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, and 5. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their representatives have the information needed to decide if the home can meet their needs. They have their needs assessed and a contract that clearly tells them about the service they will receive. EVIDENCE: The home has a Service User Guide and Statement of Purpose in place. The acting manager informs us that these documents are being reviewed and the service is planning to transfer the information onto a DVD so they are in formats that are user friendly to the people who live there and prospective residents. The home needs to ensure that the information provided to prospective residents details information about weekly fees and other costs. There are currently no vacancies at the home. The service needs to ensure that their registration details are displayed in a public place within the home. Two files of people who live at the home were viewed and both contained contracts / tenancy agreements for their stay there. As no new people have moved to live at the home since the last inspection, the pre assessment process was not examined as part of this inspection. Nairn Close - Orkney Close DS0000004360.V369603.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 and 9. Quality in this outcome area is Good This judgement has been made using available evidence including a visit to this service. The outcomes for people who use this service are good and people are supported to make everyday choices so that they can exercise some control over their daily lives. Care plans and risk assessments are completed in detail to describe people’s individual needs to ensure that they receive the care and support that they require in a consistent manner. EVIDENCE: Care plans of two residents were examined. These were good in providing detailed guidelines for staff in supporting residents the people who live there. In partnership with ‘The Loft’ (Local Authority: Adult, Health and Community Services), family and the people who live at the home, Person Centred Plans are being developed for the people who live there. The home has one Person Centred Plan fully completed, and referrals have been made for others who live there to also have Person Centred Plans. The acting manager informs us that Nairn Close - Orkney Close DS0000004360.V369603.R01.S.doc Version 5.2 Page 11 existing care plans/ tenant profiles are currently being reviewed to a new format, however on the day of the inspection this was not available for us to view as these details are held on the computer and staff were not able to access the appropriate files. Risk management and recording remains good at this home. Records showed a detailed understanding of each person’s individual needs and risks and how staff need to respond to minimise the risk occurring. For example, one person has swallowing difficulties, the risk assessment guides staff in how to minimise the risk of choking for this person. At lunchtime, staff were following these guidelines. The inspector met with all of the people living at the home. One person ‘case tracked’ was able to verbally communicate their views and satisfaction with their lifestyle. This person was able to tell the inspector about the range of activities offered to them, and opportunities they have in going to college and doing courses of their choice. Another person told us that they enjoy a range of sports and the home has supported them to participate in the Special Olympics. Staff were seen supporting other people to make choices who were unable to verbally communicate. Comments made by people living there included ‘staff are very nice’ and ‘I like living here’. People at the home were observed to freely walk around and make decisions for themselves about their lunch, what they wanted to do that day and staff were seen to respond to those with communication difficulties to ensure their needs were met. For example, one person wanted to go out at short notice and the home was equipped with staff to support this person to do what they wanted to do. Another person was experiencing toothache and staff made arrangements for that person to be taken to the dentist. Comments by staff and the acting manager demonstrated a detailed knowledge of people’s care needs. Staff were able to illustrate examples of good care practices. For instance, staff were able to discuss the safe practices they follow to ensure that one person with swallowing difficulties is able to enjoy food and drink with minimal risk to their wellbeing. There is a designated key worker system to promote continuity of care and support to the people who live there. The people who live at the home are involved in the planning of their care through regular key worker meetings. From discussion with staff and peoples care plans, it was evident that people are encouraged to maintain and develop their independence. On the day of the inspection all people at the home were seen to offered choices and asked their views and wishes on how to spend the day. Staff hold meetings with the people who live there regularly to make decisions about menu choices and activities preferences. Care plans and daily records Nairn Close - Orkney Close DS0000004360.V369603.R01.S.doc Version 5.2 Page 12 also detailed information on promoting peoples independent living skills through such activities as planned cooking sessions. For the people who live here who have communication difficulties, staff were observed communicating effectively and respectfully. One member of staff spoke to a person whilst helping them into their wheelchair, explaining what help they were providing and asking the person to lift their feet so the footplates should go in place. Nairn Close - Orkney Close DS0000004360.V369603.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,,15,16 and 17. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. People are supported to make choices about their life style, and supported to develop life skills. Social, educational, and recreational activities meet individuals’ expectations. EVIDENCE: Daily records were looked at which showed that most people through the year attend college or go to day centres through the week. In the evenings and at weekends, people are supported to participate in a range of activities including swimming, keep fit classes, shopping, achieving gateway awards, participating in the Special Olympics, going to the stables and kennels. One person who likes gardening is supported to go to work at a garden centre twice a week. People spoken to told us about their interest and hobbies and confirmed that they are able to do a range of activities through the year. On the day if the inspection, one person spoken to said that they like to spend their time in their room in the evenings to watch certain TV programs, they told us that they Nairn Close - Orkney Close DS0000004360.V369603.R01.S.doc Version 5.2 Page 14 were able to do so. We were also told of planned holidays in September to the south of England, and people had brochures of the places they had planned to visit. One person has a dedicated worker who comes into the home twice a week to help enable them to achieve their personal goals and interests. This includes going fishing, golfing and going to a local fire station. Mealtimes are relaxed and unhurried. A lunchtime meal was observed and staff were seen to give assistance where needed and in such a way that maintained individuals dignity and safety. People had a choice of where to eat their meals, at the dining table or in front of the television. The lunchtime meals were very well presented and appeared appetizing. Due to the needs of the people who live there, they require staff support to make any meals / snacks. Menus were sampled to establish that a balanced and varied diet is provided that meets peoples’ needs and preferences. A range of food had been offered including Sunday roasts and other traditional English and Indian dishes that reflect the cultural needs of people living in the home. Some of the people maintain links with their family. There was evidence in care plans that people’s needs with regard to keeping in touch with friends and relatives had been recorded. Staff have recorded individuals religious preferences. There are records to show how people are supported to practice their chosen faith. For example, one person likes to go to church and they are supported to do so every Sunday. Staff are also supporting another person to meet their cultural needs through the cooking of Indian foods and listening to Indian music. One person living at the home is going to the Friendship’s First Key Customer Conference in September. This is a consultation event in relation to the organisation’s future and they will be able to express their views about how the service is meeting their needs or how improvements can be made. Nairn Close - Orkney Close DS0000004360.V369603.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 and 20. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Records that describe individual’s health and medication needs are not always completed in detail to describe how those needs should be met, however staff have a good understanding of how to offer care and support to each person. EVIDENCE: Residents were all smart in their appearance, their clothes were clean and fresh and appropriate to their individual lifestyle and needs. Staff were heard to compliment people on their choice of clothing and appearance. Residents receive personal support in the way they prefer and require as evidenced through observations during the inspection, discussions with staff and examination of records. For example, on each morning of the visits not all residents were up and dressed. Residents arose at varying times and made choices about where to have breakfast and what they wished to eat. As at previous inspections, care plans looked at continued to evidence that people have ready access to a GP and other health professionals locally including, consultants, dentists, speech and language therapists, opticians and chiropodists. Nairn Close - Orkney Close DS0000004360.V369603.R01.S.doc Version 5.2 Page 16 The information in the care plans are well organised and guide new staff about how people’s care support is to be provided. For example, one care plan states how support needs to be provided to one person who can become anxious after the bus journey from college. Another care plan states that another person can also experience anxiety at times, guidelines for each person differs showing that staff tailor their care practices to meet individual needs considering peoples individual differences. Discussions with existing staff and the deputy manager illustrated that staff are providing good care and sensitive support and have a good understanding of people’s needs. Care plans are being regularly reviewed and updated to reflect any changing needs of the people who live there. Further work must however be undertaken to ensure documents are completed in full and dated to ensure records evidence needs are current and are being appropriately managed; for example, records show that one person has a listening device in their room at night as they have epilepsy. There is no care plan in place to show that this is happening with the consent of the person. Should the individual be unable to give their consent, staff should discuss this with other professionals to ensure a multi disciplinary approach is taken. This is good practice to ensure the needs of the person are being met whilst ensuring privacy and dignity of that person is respected. Another person has fragile skin and can bruise easily, staff need to ensure that the care plan and risk assessment are in place to provide guidance to staff to monitor for bruises and what action they need to take should bruises been seen. As with care planning, risk assessment processes and documentation are appropriate, reviewed and generally reflect people’s needs and capabilities. A suitable lockable cabinet is in place for the safe storage of medication at the home. The cabinet was well ordered and not overstocked. All medication looked at was correct and audits could be easily made. The home currently carries no controlled drugs that would necessitate any special storage and recording arrangements. There are no drugs that need to be stored in the fridge. Information supplied by the home prior to the inspection states ‘all service users have a financial risk assessment which details what support is needed to manage their finances’. The home keeps a float of peoples’ monies. This is held securely in the homes’ safe. Two individuals financial records and money were checked. The money held matched the records. Receipts were evident to show items that were purchased. Nairn Close - Orkney Close DS0000004360.V369603.R01.S.doc Version 5.2 Page 17 There are a range of policies and procedures in place relating to administration, covert practices, training and disposal of medication in each individual’s medication folder. Nairn Close - Orkney Close DS0000004360.V369603.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. There are procedures in place to listen and respond to peoples’ concerns and complaints and safeguard them from the risk of harm. EVIDENCE: The annual quality assurance assessment and records seen during this visit showed that there had been no complaints made about the home since the last inspection. The service has recently carried out a questionnaire to relatives of those who live at the home. All comments made were positive, with one relative commenting that this is ‘home for home’. Two people spoken to at the home said that they would ‘speak to staff’ if they were unhappy about living at the home. There is a complaints leaflet available at the home however it is in the form of a standardised leaflet produced by the organisation. The people who live at the service would benefit from the complaints leaflet being reviewed and produced in a user-friendlier format. There is a detailed complaints procedure available in the home to guide staff. Staff development records showed that the majority of staff had completed National Vocational Qualifications (NVQ) or Learning Disability Award Framework (LDAF) training, which includes sessions in safeguarding vulnerable adults. The home has a safeguarding policy in place. Two staff on duty Nairn Close - Orkney Close DS0000004360.V369603.R01.S.doc Version 5.2 Page 19 confirmed that they had seen the Safeguarding and whistle blowing procedures and one said they had been provided with training and the other received training at a previous job but not at this service. Both members of staff could explain the procedures in relation to complaints, safeguarding and whistle blowing and a training certificate was seen in one staff file as verification of this. The people who live there would benefit from all staff being trained and informed of complaints procedures and safeguarding procedures. There have been no safeguarding concerns at the home since the last inspection. Nairn Close - Orkney Close DS0000004360.V369603.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 30 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. People live in a clean, safe and comfortable environment that meets their individual needs. EVIDENCE: A tour of both houses and gardens was carried out on the day of the inspection. Each house is located in close proximately to the other and people, who live there, can freely visit the other house. People who live at Orkney Close have only recently returned to their home as it was completely refurbished. One person living there commented on their satisfaction of the new décor stating that they ‘like the home like this’. One bedroom in Orkney House is quite small, however it comprises and en-suite bathroom as it is downstairs. An Occupational Therapy assessment has been recently carried out for this person, as they require support to get into and out of bed. The assessment showed that appropriate support could be provided to this person in their room. Nairn Close - Orkney Close DS0000004360.V369603.R01.S.doc Version 5.2 Page 21 The acting manager informed us that carpets in the stairs and hallway at Nairn Close are due to be replaced following the recent replacement of the front door. Staff need to put paper towels in the communal toilets that are used by residents and staff to dry their hands as this will ensure good infection control practices. Those who were able to communicate their wishes said that they liked there rooms and the home was kept clean and tidy. Each person has his or her own bedroom, which were personalised and well maintained. Both houses were clean and there were no unpleasant odours, which indicate that effective cleaning and infection control procedures are in place. Staff need to ensure that foodstuff is labelled once opened so people know when the food needs to be consumed by. At night time, there is one sleeping staff member in each house. Each house has separate ‘sleep–in’ rooms. Nairn Close - Orkney Close DS0000004360.V369603.R01.S.doc Version 5.2 Page 22 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, 34, 35 - Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. A well-trained and competent team of established staff who have a good understanding of each person’s individual needs support them. The home operates a robust system of recruiting staff for the protection of the people who live there. EVIDENCE: It was evident from watching staff at work that they have formed meaningful relationships with the people who live at Orkney and Nairn Close. Both houses were appropriately staffed on the day of the inspection. The acting manager told us that the staffing levels at each house could vary depending on when people are at college or on holiday. Two staff files were looked at to ascertain whether recruitment policies were robust. The recruitment records sampled showed that appropriate checks had been made to make sure that staff were suitably experienced and qualified to work with vulnerable adults. Criminal Records Bureau checks had been made and written references received before the employee began work so that Nairn Close - Orkney Close DS0000004360.V369603.R01.S.doc Version 5.2 Page 23 people were protected from the risk of having unsuitable staff work in the home with them. Records show that staff are receiving formal supervision. The total number of staff within the home is fourteen; this includes a full time acting manager. The majority of staff work part time. Information supplied by the manager state that 7 members of care staff are qualified to National Vocational Qualification in Care Level 2 (NVQ level 2). This is at the national Minimum Standard for 50 of staff to be qualified. This should mean that residents benefit from having their needs met by staff that are appropriately experienced and qualified. Three members of staff are currently enrolled to do NVQ level two. The training records of staff working at the home were seen and demonstrate that staff receive mandatory training. It was evident that staff have opportunities to attend various training programs. Staff present during this visit were able to answer our questions about meeting the needs of people who live in the home and have clearly got to know them well. The home does not have any domestic or catering staff. Care staff take on these duties during their shifts. Most of the care staff are trained in food hygiene. Nairn Close - Orkney Close DS0000004360.V369603.R01.S.doc Version 5.2 Page 24 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, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is being managed in a way that listens to and acts upon the views of the people who live there. The management of areas of health and safety practice is sufficient to ensure people are protected from potential risk of harm. EVIDENCE: At the time of the last inspection there was a manager in post however she is currently off work ill and the deputy manager was running the service. During conversation with the deputy manager, she demonstrated a clear understanding of the way the service should continue to ensure ongoing development so that people who use this service can continue to live ordinary and meaningful lives. It was observed that staff feel they can talk comfortably Nairn Close - Orkney Close DS0000004360.V369603.R01.S.doc Version 5.2 Page 25 with her and discussions heard between staff and the deputy manager were open and respectful. The Annual Quality Assurance Assessment (AQQA) completed by the service manager was completed to a good standard. Information provided was supported by a range of evidence, and the Annual Quality Assurance Assessment (AQAA) fully informed us about changes the home has made and where improvements still need to be made. A representative of the registered provider visits houses on a regular basis to report on the standard of care provided of which reports are made available within the home. From looking at the most recent report and discussion with the staff team it was evident that the views of people who live in the home had been actively sought with regard to the way in which the service is being run. We were told that there are regular house meetings so that people have an opportunity to discuss issues that are important to them, such as planning activities and menus. A number of checks are made by staff to make sure that peoples’ health and safety is maintained. Records showed that the fire alarm system had been regularly tested and serviced to make sure that it was working properly. One person living at the home also carries out fire checks with staff members as this is a particular interest of theirs. The acting manager is ensuring that regular supervision is happening in the absence of the manager. Records of supervision notes were evident. Information from supervision records demonstrates peoples personal development as well as information on changing needs of people who use the service and how care needs to changed to meet changing needs. One survey returned to us by a staff member stated ‘I would like to compliment our acting team leader and our acting assistant…have been fantastic, keeping up to date with proceedings and keeping staff morale up and being there for us when we have needed them’. Nairn Close - Orkney Close DS0000004360.V369603.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 X 3 X 4 X 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 X 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 3 X Nairn Close - Orkney Close DS0000004360.V369603.R01.S.doc Version 5.2 Page 27 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard AP7 Good Practice Recommendations Staff should ensure Care Plans are place for the use of listening devices in people’s rooms at nighttime. This is to ensure people’s privacy and dignities are maintained. If possible staff should seek the consent of people who are assessed as needing listening devices The people who live at this service would benefit from a user-friendly complaints leaflet that is accessible to them. The service should continue to develop all staffs understanding and awareness of safeguarding and whistle blowing polices and procedures. 2. 3. YA22 YA35 Nairn Close - Orkney Close DS0000004360.V369603.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Nairn Close - Orkney Close DS0000004360.V369603.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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