Care Home: Nutley Hall

Similar services:

• Insight - Eastchurch
• Southfields
• Magenta
• Seabourne House
• 33 St John`s Church Road
• Dovedale Court
• Lyncol House
• Thorndene

What the care home does well Nutley hall is a well maintained residential service which is run in the best interests of the residents placed there. Staff are very committed to the approach and underlying views and values of the service and use their enthusiasm to support the residents placed at Nutley Hall. The Registered Manager ensures prospective residents are comprehensively assessed and all relevant information is obtained, then a structured introduction into the service is arranged and care plans drawn up. As part of the initial assessment and introductory process the staff group will meet to ascertain the person`s suitability for the service. Comments received from relatives included. `Our x has been at Nutley Hall for x years & not once in that time have we had any reason to complain, we are just so grateful for all the care & attention x has had. To us Nutley Hall is an oasis of love, tranquillity & happiness. If only there were more like this`. `They make it a home for the resident giving them security and love at all times, it is clean, very healthy diet and a full programme`. `Giving my x a varied life, plenty of confidence in what x does there, work & play. Giving my x love & wonderful care, looking after x health & well being`. `It provides a very relaxed way of life, which suits my x needs`. `They are as near to perfection as possible! `They help everyone to take part in activities` `The home is outstanding in care and stimulation`. Comments received from staff about what the service does well included `community life, health and welfare, green issues, meetings, outings, cultural life, workshops, music, plays, singing, and talks by the doctor`. `The awareness about the residents well being! And everything that comes to meet this need`.` We are all actively seeking to improve the service`. What has improved since the last inspection? The home has reviewed its supervision contracts since the last inspection. There is a now a supervision contract written for staff, which explains the home`s policy and expectations of the supervision and the outcomes with regards to the National Minimum Standard. Nutley Hall has also reviewed the traditional terminology regarding staff being called house parents and they are now referred to as house coordinators. What the care home could do better: Comments were received from visiting professionals and included some concern that residents were not able to have their first preference in the workshop settings, and that if for example their was no room in the horse riding session that was carried out, a resident would then need to wait until a place became available. The Registered Manager should ensure that complaints are recorded correctly to enable a clear audit trail. The Registered Manager must also ensure that the CSCI and other relevant bodies are notified of any significant incidents in the service. The Registered Manager should ensure that care plans contain only relevant information and that historical information is filed separately, and that the two risk assessments discussed during the inspection are updated. Practises of labelling residents clothes should be reviewed.The Registered Manager must ensure the AQAA is returned to the CSCI within the required time frame. The Registered Manager was awaiting clarification with regard to the timescales for the AQAAs return. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Nutley Hall Nutley Uckfield East Sussex TN22 3NJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alexis Reilly     Date: 1 5 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: Nutley Hall Nutley Uckfield East Sussex TN22 3NJ 01825712696 01825713469 office@nutleyhall.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Nutley Hall Ltd care home 33 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 33 The maximum number of service users to be accommodated is 33. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home Nutley Hall is made up of seven independent living units with each house being shared by residents with live-in support workers. The Main House is a detached Victorian building set in three acres of grounds. The home was founded in 1959 as a residential centre for people with learning disabilities, set up to run and developed according to anthroposophical principles that seek to optimize physical and mental health and well being in each individual. The home is situated on the A22 in the centre of the village of Nutley about five miles north of Uckfield and overlooks the Ashdown forest. In addition to the residents accommodation there a number of different workshops and a bakery with shop, which is open to the public. Nutley Hall is essentially a community of residents and staff living and working together which has grown and developed organically over a number of years. Several staff and service users have lived at Care Homes for Adults (18-65 years) Page 4 of 32 Brief description of the care home Nutley Hall for many years. The organisational structure is non-hierarchical although the Registered Manager is ultimately responsible for running the service. Care Homes for Adults (18-65 years) Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The inspection began at 9.30am and finished at 2pm. A subsequent telephone conversation also took place between the inspector and the Registered Manager of the service. The inspector met residents in the home and in the various workshops, meeting all but one resident who was part of the case tracking. The inspector took the opportunity to speak to all the staff that ran the work shops and the individual house coordinators of two of the residents case tracked. The inspector was able to view the bedrooms of five of the residents placed in the home whom she met during the tour of the premises. The inspector case tracked four residents, examining the care plans and the associated documents such as risk assessments and activities plans for these individuals. Other documents examined were copies of notifications, accidents and appointments, evidence of external reviews, the record of complaints and the Care Homes for Adults (18-65 years) Page 6 of 32 complaints procedure. Staff recruitment files of three of the staff met and spoken with and the sheets which record the administration of medication were also examined, as were the guidelines and contract for supervision sessions the statement of purpose, service user guide and terms and conditions of contract. An environmental tour was carried out which included the main house, and the cottages, the house in the lane adjacent to Nutley Hall was not inspected. The inspector visited workshops including the Bakery, Woodwork, Laundry, candle making and the main Kitchen. The inspector spent time with the Registered Manager and staff and gained views about the service from professionals in the community, their comments are included in the report. Comments are also included from returned surveys to the CSCI and the views of residents and parents are included in this report. Information was also taken from the previous AQAA which was comprehensively filled in. The current base rate for new residents is nine hundred and forty pounds per week. Nutley Hall is now registered with Companies House and the Charity Commission and is known as Nutley Hall. The service was previous inspected on 17th January 2007. What the care home does well: What has improved since the last inspection? What they could do better: Comments were received from visiting professionals and included some concern that residents were not able to have their first preference in the workshop settings, and that if for example their was no room in the horse riding session that was carried out, a resident would then need to wait until a place became available. The Registered Manager should ensure that complaints are recorded correctly to enable a clear audit trail. The Registered Manager must also ensure that the CSCI and other relevant bodies are notified of any significant incidents in the service. The Registered Manager should ensure that care plans contain only relevant information and that historical information is filed separately, and that the two risk assessments discussed during the inspection are updated. Practises of labelling residents clothes should be reviewed. Care Homes for Adults (18-65 years) Page 8 of 32 The Registered Manager must ensure the AQAA is returned to the CSCI within the required time frame. The Registered Manager was awaiting clarification with regard to the timescales for the AQAAs return. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 32 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has had two recent admissions. The Registered Manager has formulated a comprehensive assessment process which ensures a persons suitability for the service. Evidence was supporting to suggest that the Registered Manager obtains assessment documents from the community and uses these as a basis for care planning within the service. Evidence: As part of the inspection the inspector case tracked four residents in the home, two of these were newly admitted residents, and spoke with three of the four residents case tracked. Other residents were seen in the home. As part of the case tracking the inspector examined the person centred care plans and the associated documents such as risk assessments and activities plans for these individuals, also evidenced were the external reviews and supporting care needs assessments from the community learning disability teams to ascertain if the needs identified in the assessment are used as a basis for a comprehensive care plan. Care Homes for Adults (18-65 years) Page 11 of 32 Evidence: Nutley Hall has demonstrated it carries out a comprehensive assessment and induction into life in the service, and that the needs identified in the community assessments are highlighted and brought forward as areas to work on whilst living at Nutley Hall. The Registered Manager ensures prospective residents are comprehensively assessed and all relevant information is obtained, then a structured introduction into the service is arranged and care plans drawn up. As part of the initial assessment and introductory process the staff group will meet to ascertain the persons suitability. Two residents surveys were returned to the CSCI both of these confirmed that the individuals were given information and made their own decision with regard to living at Nutley hall. The CSCI received five completed surveys from parents/guardians of residents at Nutley hall, four of these confirmed that they had always received sufficient information about the home and that it meets the needs of the relative placed and promotes contact. One survey marked these answers as usually. Care Homes for Adults (18-65 years) Page 12 of 32 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have care plans in place which are person centred and are clear documents to work from. However in relation to one of the care plans seen it needs to be better organised and historical information filed. Risk assessments are in the main comprehensive however a recommendation has been made to update two in particular. Residents are able to make their own choices within the boundaries of the community setting. Contact with advocacy services is promoted. Evidence: As part of the inspection the inspector case tracked four residents in the home and spoke with three of them, meeting other residents during the tour of the home. As part of the case tracking the inspector examined the person centred care plans and the associated documents such as risk assessments and activities plans for these individuals, also evidenced were the external reviews from the community learning disability team, this helped the inspector to ascertain if the needs identified in the Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: assessment are used by the Registered Manager as the basis for a comprehensive care plan. Other documents examined were copies of notifications, and accidents and appointments. The inspector spent time with the Registered Manager and gained views about the services from professionals in the community. Comments from service users, relatives and staff are included in the report. Care plans contain the relevant information, however on the day of the inspection one of the care plans was a very big document and included historical information which would be better kept elsewhere. Risk assessments were completed and the inspector saw evidence of detailed guidance for dealing with individuals behaviour. Contact with advocacy services is promoted. However in relation to two residents risk assessment the inspector has made recommendations that with regard to one resident an historical issue is made reference to, and in relation to a identified risk of the second resident that this risk is kept under constant review. The inspector evidenced pictorial timetables in place. Comments received from residents were I have learnt to do my own laundry,I went bowling, and I like going out to buy diet coke,I like the candle making. The CSCI received five completed surveys from parents/guardians of residents at Nutley hall, these confirmed they felt that the staff always kept them up to date with important issues and that their relative always received appropriate care. Four of the five surveys concluded that they felt the staff had the right skills and experience one suggests that this is usually the case. And all five agreed that Nutley hall supported people to live the life they wish. Comments were received from visiting professionals and included some concern that residents were not able to join in their first preference in the workshop settings, and that if for example their was no room in the horse riding session that was carried out, a resident would then need to wait until a place became available. Nutley Hall has is very much a community based home and as such places emphasis on the importance of forums for residents to express their views, wishes & concerns, this is done through the Wednesday Community Meeting, mealtime conversations, house coordinators group & individual consultations, social interactions in workshop and education sessions, and meetings with the Registered Manager. The Registered Manager informed the inspector that residents will be given their choice of workshop settings whenever possible, and encouragement to choose their own workshop projects. Residents do have the choice not to participate in community events or programmes. Care Homes for Adults (18-65 years) Page 14 of 32 Care Homes for Adults (18-65 years) Page 15 of 32 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents at Nutley Hall are involved in a work based community approach to care. Residents do have choice and have access to other activities in the community however the cost of those is met by the resident. Residents are consulted and listened to regarding their life at Nutley Hall. Evidence: As part of the inspection the inspector case tracked four residents in the home, speaking to three of these on the day of the inspection, other residents were seen in the home and spoken with as were the staff who lead in the individual workshops. As part of the case tracking the inspector examined the person centred care plans and the associated documents such as risk assessments and activities plans for these individuals, also evidenced were the external reviews from the community learning disability team, or community placements. Other documents examined were copies of Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: notifications, and accidents and appointments, evidence of external reviews, the record of complaints and the complaints procedure. The inspector spent time with the Registered Manager and house coordinators and gained views about the services from professionals in the community, and also gained comments from service users and relatives these are included in the report. The inspector toured all the workshops and met with the residents and staff within the work setting. The workshops including the Bakery, Woodwork, Candle Making and the main Kitchen. Nutley Hall continues to be part of the local community and the bakery is open to the general public. The Inspector was also informed that bread and other goods made in the workshops are supplied to local shops and from Nutley Hall on annual events. The CSCI received two completed surveys from the residents at Nutley hall these confirmed that they were able to choose what they did in the day, evening and at weekends. Nutley Hall runs a full programme of activities within the workshops of Nutley Hall and other activities in the community. Nutley Hall provides work based activities during the day in their craft workshops, or in the garden kitchen or household, a decision is made with the resident what work is best for their development and they are placed in that specific workshop. Nutley hall will arrange social and physical activities and help resident to go out on outings although these will need to be paid for by the individual. If transport is provided resident will be asked to pay a contribution toward the petrol used. Two cooks and a group of residents cook the main meal of the day in the main house and distribute this between the various houses, but the evening and weekend meals are prepared and cooked in the individual houses. All the houses and flats have well equipped kitchen and dining areas. Menus are based on a grain based whole food diet with an emphasis on fresh vegetables and fruit and seed including pulses and nuts, and diary produce. Menus avoid over reliance on potatoes, fatty foods, sugar and concentrated animal protein. They aim to provide healthy, balanced meals. Mealtimes have particular significant at Nutley hall, being used as companionable occasions when residents and staff in each house group come together as part of the community life. Nutley Hall has its own transport for the use of residents. Other workshops on offer at Nutley Hall are music, clowning workshops and drama. There is also a Woodland Project day activity which enables residents to work in the wider community & on Ashdown Forest, and joint ventures with other day-care provisions are arranged. Residents have also been involved in the repair of the parish bus-shelter. Residents Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: also participate in the residential conference in Scotland for care staff & service users. Nutley Hall also has several pets. Care Homes for Adults (18-65 years) Page 18 of 32 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a comprehensive plan of care and input for health related issues. The Registered Manager has a good relationship with the general practise and residents health care needs are reviewed and referrals made if appropriate. The policies and procedures for medication were found to be in good order and staff had received the relevant training. Evidence: As part of the inspection the inspector case tracked four residents in the home and spoke with three of them, other residents were met during the environmental tour of the service. As part of the case tracking the inspector examined the person centred care plans and the associated documents such as risk assessments and activities plans for these individuals, also evidenced were the external reviews from the community learning disability team. Other documents examined were copies of notifications, and accidents and appointments; evidence of external reviews, and a sample of MAR sheets. Nutley Hall has the required policies and procedures in place for the safe handling of medication, policies for homely remedies and a controlled drugs procedure is in place. Only a minimal number of residents self medicate in the service and more Care Homes for Adults (18-65 years) Page 19 of 32 Evidence: could be done to promote this. In discussion with the Registered Manager it is evident that promoting self medicating in the home has been raised at a review and he will endeavour to work toward promoting this in the home. The home has good links with local health practise, GPs and nurses, with the community dentist, opticians and local learning disability team, evidence was found of input from speech therapy, and also psychological as well as practical and supportive approaches to providing care and support to the residents placed. However the institutional practise of labelling residents clothes should be reviewed. Care Homes for Adults (18-65 years) Page 20 of 32 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service must review the way they record complaints and also ensure incidents of notice are sent to the CSCI and the relevant bodies. Residents are protected by the homes recruitment procedures. Evidence: As part of the inspection the inspector examined copies of notifications, and accidents and the record of complaints and the complaints procedure. The inspector spent time with the Registered Manager, senior house coordinator, and house coordinator and gained views about the services from professionals in the community, from relatives of residents and also comments from service users these are included in the report. The Registered Manager has not notified the CSCI of significant incidents which have occurred in the home. The Registered Manager must ensure they familiarise themselves with the guidance and report incidents of notice to the CSCI. The inspector had a discussion with the Registered Manager with regard to recording of complaints in the service. The practise currently is only to record formal more substantial complaints of which the last one was three half years ago. The inspector advised that all minor complaints should be recorded and recorded in a separate log to ensure a clear audit trail is available to view. The service has a policy on restraint and staff have received training. Care Homes for Adults (18-65 years) Page 21 of 32 Evidence: The recruitment documents of three staff employed in the home since the last inspection were examined and found to be in good order. The home has a very clear policy in place and will not employ any member of staff before a satisfactory CRB or police check is obtained. The CSCI received two completed surveys from the residents at Nutley hall these confirmed that the residents knew who to speak to if they were unhappy and that staff always treated them well. The CSCI received five completed surveys from relatives/guardians of the residents at Nutley Hall, four of these confirmed that they were aware how to make a complaint, and three confirmed that the home always responds appropriately if a complaints is raised, one survey stating that this is usually the case. Care Homes for Adults (18-65 years) Page 22 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Nutley Hall provides a homely, spacious and well maintained accommodation, of a high standard in which to live. On the day of the inspection the homes were clean, warm and well maintained. Evidence: As part of the inspection the Registered Manager accompanied the inspector on a tour of the whole community site of Nutley Hall including the main house, and the cottages; the house in the lane adjacent to Nutley Hall was not inspected. During the tour the inspector met with the staff and the residents in the workshops. Nutley Hall, is located in beautiful grounds and is furnished, decorated and maintained to a high standard. The garden and estate are also well-kept. Each house has its own individual style & character, is warm, friendly, comfortable and homely. Residents own rooms are personalised according to their preferences. . The inspector saw the bedrooms of all the residents spoken with during the tour of the home. These reflected the interest and hobbies of the individuals. There is plenty of shared living space in each house, and in the central meeting room and the study, in the gardens & grounds and in the community hall/social centre (Orchard House). Regular system checks are carried out on all equipment, appliances Care Homes for Adults (18-65 years) Page 23 of 32 Evidence: & fuel & electrical installations and on fire protection equipment & systems. There is a repair, maintenance and replacement priority programme in use with a buildings/maintenance overseer in addition to a full-time & a part-time maintenance person. Outside contractors are called in as and when needed, and for major building or decoration projects. Care Homes for Adults (18-65 years) Page 24 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff interact well with residents and have an understanding of their needs through, training and the community based approach and beliefs of the service. Staff receive training and supervision appropriate to their role in the home. Residents are protected by the homes recruitment procedures. Evidence: As part of the inspection the inspector examined three recruitment files of staff recruited to the service since the last inspection and met those staff members. Records were found to be in good order. Staff are trained in areas relevant to the needs of residents, Staff development is progressed through OCN (Open College Network) & NVQ, BACE (University of Aberdeen Bachelor of Arts in Curative Education), Dornach (Switzerland) & Camphill accredited (anthroposophical) trainings, and other relevant state-recognised qualifications. All permanent house coordinators have achieved NVQ qualifications; one new assistant coordinator is working towards NVQ3 and two permanent assistants are working towards a level 3 Open College Network (OCN) award in Social Care. Staff participation at conferences, workshops & meetings of care home associations and professionals, and at Camphill and Steiner-oriented councils, courses & conferences. Nutley Hall has a non hierarchical organisational structure with Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: individual areas of responsibility represented at the weekly community staff meeting and the weekly core group meetings of senior permanent staff and in the management group. In addition there are separate regular meetings for residential carers and workshop leaders. The CSCI received two completed staff surveys from staff employed at Nutley Hall these showed that usually the staff are given up to date information about the residents they work with, both surveys confirmed that they were CRB and reference checked prior to starting work in the service. That the induction covered the required information was relevant to their role and helped them understand the needs of the residents. The surveys also confirmed that the manager meets with them regularly, that they knew what action to take if a relative or advocate had a concern and that there are always enough staff working in the home. The home has reviewed its supervision contracts since the last inspection and there is a now a supervision contracts written for staff, which explains the homes policy and expectations of the supervision, and the outcomes with regards to the National Minimum Standard YA 36. Nutley Hall has also reviewed the traditional terminology regarding staff being called house parents. Care Homes for Adults (18-65 years) Page 26 of 32 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Registered Manager is very experienced and knowledgeable in running the service. Staff are committed and enjoy working at the home and residents are supported and guided to live in this community setting. However the Registered Manager must ensure he complies with the CSCI guidance and ensure complaints and incidents of notice are dealt with appropriately. Evidence: As part of the inspection the inspector case tracked four residents in the home and met three of the four residents case tracked, other residents were met during the environmental tour of the home. As part of the case tracking the inspector examined the person centred care plans and the associated documents such as risk assessments and activities plans for these individuals, also evidenced were the external reviews from the community learning disability team and other relevant assessments. Other documents examined were copies of notifications, and accidents and appointments, evidence of external reviews, the record of complaints and the complaints procedure. The staff recruitment files of three new staff within the service were examined and the Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: list of staff training was evidenced. The inspector spent time with the Registered Manager, and house coordinators and gained views about the services from professionals in the community, and also comments from service users and relatives these are included in the report. Nutley Hall is a non profit making company registered with the charity commissioners; Trustees represent a cross section of professions from care, medicine, education, banking, and business and residents families. The trustees meet quarterly but delegate the day to day organisation and running of the service to the management team lead by the Registered Manager. The Registered Manager has BSc Economics honours degree, has a registered SFES status as a PGCE qualified teacher and has a qualification as a Steiner/Waldorf teacher. He has over 35 years teaching education and management experience in mainstream and Steiner schools. He has achieved NVQ level 4 in administration and the Registered Managers Award and is a qualified NVQ assessor. Care plans in the main were found to be in good order, however in relation to two care plans; the historical information needed filling and two risk assessments of residents required updating. Activities in the service are based around traditional work skills and residents are involved in choosing which workshop they would like to work in, the service tries to ensure people get their first choice. Some external activities are not financed by the home and there is an expectation that residents will pay for these themselves. The service has reviewed its policy and guidance for staff on supervision and is aiming to continue the development of staff by the development of professional registration of all permanent care staff with CAHSC (Council for Anthroposophical Health & Social Care). There is a proposal to organise a special annual community meeting to involve everybody in a quality appraisal, setting out the services visions and goals and looking at the services relationship to other organisations and the wider community. All staff have up-to-date external First Aid training, Moving and Handling and infection control. Staff that administer medication have received the relevant Safe Handling of Medication training. Staff have also received external training for epilepsy, challenging behaviour and dementia in addition to in-house training. Most permanent care staff have recently attended training in the Mental Capacity Act. The service must ensure it records complaints in a separate complaints book and notifies the CSCI and relevant others of any significant incidents which occur in the service. The Registered Manager must ensure the AQAA is returned by the required date. Care Homes for Adults (18-65 years) Page 28 of 32 Care Homes for Adults (18-65 years) Page 29 of 32 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 30 of 32 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 23 12 The Registered Manager 01/05/2009 must ensure that any significant incidents of notice are reported to the CSCI and other relevant bodies To ensure residents are safeguarded at all times. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 6 9 The Registered Manager should ensure that care plans contain only relevant up to date documents. The Registered Manager should ensure that in relation to the two risk assessments highlighted during the inspection the discussed risks are included in these documents. The Registered Manager should review the practise of labelling residents clothes. The registered manager must ensure that complaints are recorded appropriately 3 4 18 22 Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 32 of 32 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!