Care Home: Ormerod Home Trust

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What the care home does well PCP (person centred planning) is well established at the home. A real effort is made to ensure that the individual remains the central focus and information is presented in meaningful ways, such as using photographs and pictures. Staff work hard to help people to form and maintain relationships and are proactive in ensuring that good communication is maintained with relatives. The sister of one individual has recently had a baby and he had been supported to send a card and present, which he would be unable to do alone. Gestures such as this help the person to remain an active member of his family and reinforce his relationship as an uncle. Ormerod provides an excellent staff-training programme. All the staff, apart from the newest recruit, are qualified at NVQ (National Vocational Qualification) level 2 or above. Training is organised by a dedicated training team based at the main office. The training team now operate a mentoring scheme, whereby each staff member is allocated a mentor from the training team, who meets with that person to carry out a training assessment, which is regularly reviewed. This is an improvement to an already excellent system for arranging and providing high quality training for staff. The supervision and appraisal system is excellent and regular staff meetings also take place, meaning that staff are well supported and guided in their work. The range of quality assurance systems is excellent and the registered manager is proactive in ensuring that high standards are maintained. What has improved since the last inspection? Any areas for improvement raised at the last key inspection have been fully responded to and these improvements have been maintained. The information in the individual service plans is being reviewed and updated more frequently and at least every six months. This minimum review period is now entrenched within the working practice at the home. The last inspection report advised that guidance was sought from the fire safety department regarding the use of stair gates and this was promptly arranged. Medication arrangements are being regularly audited, which helps to maintain a consistency in adhering to the written medication policy at the home. Since the last inspection the rear garden has been decked, some internal redecoration has taken place, a new carpet and fireplace have been fitted in the lounge and the ground floor windows have been double-glazed. The team leader at the home is now registered with the CSCI, an endorsement of her qualifications, experience and knowledge. All staff apart from the newest recruit have achieved NVQ (National Vocational qualification) level 2 or above. As well as the improvements outlined above, the staff team have worked hard to maintain consistently high standards at St Patrick`s Rd. What the care home could do better: Risk management plans are in place and are being regularly reviewed. However the risk management plan in relation to the use of bed rails would be strengthened if it included the regular checking of this equipment. The property is generally well maintained, however some areas such as the hall and dining room are in need of decoration. It is understood that this hasbeen planned. Some new radiator panels are needed and the bath panel in the upstairs bathroom should be replaced. Consideration should also be given to updating the kitchen. CARE HOME ADULTS 18-65 Ormerod Home Trust 56 St Patricks Road South St Annes Lancashire FY8 1XN Lead Inspector Lesley Plant Unannounced Inspection 22 August 2008 1:00 nd Ormerod Home Trust DS0000010045.V367632.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 Ormerod Home Trust DS0000010045.V367632.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. Ormerod Home Trust DS0000010045.V367632.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ormerod Home Trust Address 56 St Patricks Road South St Annes Lancashire FY8 1XN 01253 723513 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) SSharples@ormerodtrust.org.uk Ormerod Home Trust Limited Ms Jayne Morris Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Ormerod Home Trust DS0000010045.V367632.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th October 2006 Brief Description of the Service: 56 St Patrick’s Road South is registered to provide support for four people with learning disabilities. The home is situated in a residential area of St Annes, within easy reach of local amenities. The property is a dormer bungalow, with full wheelchair access on the ground floor. The registered provider is the Ormerod Trust, which operates a number of residential and community based services in the Fylde and Wyre area. The service is guided by the policies and procedures of Ormerod. Fees vary according to the assessed needs of the individual. Ormerod Home Trust DS0000010045.V367632.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 3 star. This means the people who use this service experience excellent quality outcomes. This inspection was unannounced and looked at all the key national minimum standards, plus supervision arrangements for staff. At the time of the inspection there were four people living at the home. The inspector spoke to the two support workers on duty, records and documentation were viewed and a tour of the building was carried out. The four people living at the home have specific communication needs and therefore discussion with individuals was limited. Time was spent observing staff and those living at the home as they engaged in activities. CSCI surveys providing feedback were received from seven members of staff and one relative. Information was also gained from the Annual Quality Assurance Assessment completed by the registered manager. A visit to the organisation’s main office also took place, where the inspector met with the senior support worker from the home and examined staff recruitment, supervision and training records. Since the last key inspection in October 2006 an Annual Service Review has taken place in December 2007. Information within the review concluded that the service continued to provide good outcomes to those living at the home. The report relating to this is held at the CSCI office and would be made available to enquirers on request. What the service does well: PCP (person centred planning) is well established at the home. A real effort is made to ensure that the individual remains the central focus and information is presented in meaningful ways, such as using photographs and pictures. Staff work hard to help people to form and maintain relationships and are proactive in ensuring that good communication is maintained with relatives. The sister of one individual has recently had a baby and he had been supported to send a card and present, which he would be unable to do alone. Gestures such as this help the person to remain an active member of his family and reinforce his relationship as an uncle. Ormerod provides an excellent staff-training programme. All the staff, apart from the newest recruit, are qualified at NVQ (National Vocational Qualification) level 2 or above. Training is organised by a dedicated training team based at the main office. The training team now operate a mentoring scheme, whereby each staff member is allocated a mentor from the training team, who meets with that person to carry out a training assessment, which is Ormerod Home Trust DS0000010045.V367632.R01.S.doc Version 5.2 Page 6 regularly reviewed. This is an improvement to an already excellent system for arranging and providing high quality training for staff. The supervision and appraisal system is excellent and regular staff meetings also take place, meaning that staff are well supported and guided in their work. The range of quality assurance systems is excellent and the registered manager is proactive in ensuring that high standards are maintained. What has improved since the last inspection? What they could do better: Risk management plans are in place and are being regularly reviewed. However the risk management plan in relation to the use of bed rails would be strengthened if it included the regular checking of this equipment. The property is generally well maintained, however some areas such as the hall and dining room are in need of decoration. It is understood that this has Ormerod Home Trust DS0000010045.V367632.R01.S.doc Version 5.2 Page 7 been planned. Some new radiator panels are needed and the bath panel in the upstairs bathroom should be replaced. Consideration should also be given to updating the kitchen. 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. Ormerod Home Trust DS0000010045.V367632.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 Ormerod Home Trust DS0000010045.V367632.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): 2 Quality in this outcome area is good. Well-established assessment and introductory processes, ensure that needs are assessed and only suitable placements are made. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The provider organisation has well-established processes in place, which ensure that a thorough assessment of needs takes place before anyone is admitted to the home. The people currently living at the home have all lived there for some years. The last person admitted to the home had previously lived within another service operated by Ormerod and was therefore well known to the provider organisation. The written policy regarding admission to the service includes the giving of information, the terms and conditions of residency and a set assessment format. Information about the home is produced in a pictorial format and complimented by written material. All introductions are planned and taken at a pace suitable to the individual. Relatives and other involved parties are consulted and involved in the assessment and admission process. Ormerod Home Trust DS0000010045.V367632.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 excellent. Person centred planning is well established, supporting individuals to achieve their chosen goals. Good assistance is provided to help those living at the home to make decisions about their lives. Where risks are identified, risk management plans help to reduce any potential harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person living at the home has a personal file containing care planning information and the ongoing records kept by staff. The personal files for two people were viewed. Each person has an individual plan giving detailed information regarding the support required, such as for personal care, social support and healthcare. This guides staff in their day-to-day work and is particularly useful for new staff. This information is being regularly reviewed and updated to reflect any changes. For one person reviews had taken place in September 2007 and March 2008, with the next review scheduled for September this year. The other record showed that this information had been reviewed and fully rewritten in June 2008. The key worker explained that a full Ormerod Home Trust DS0000010045.V367632.R01.S.doc Version 5.2 Page 11 reassessment had taken place. Individual support plans are reviewed at least every six months and more often if needs have changed. PCP (person centred planning) is well established at the home. PCP’s take place each year and focus on the dreams and aspirations of each person. Time is also spent reflecting on the past year, with a strong focus on the strengths of the individual concerned. A real effort is made to ensure that the individual remains the central focus and information is presented in meaningful ways, such as using photographs and pictures. It was noted that for one person his last PCP meeting had been presented in the form of a slide show, using computer equipment. Relatives and other relevant parties are involved in the process. Goals are set for the next 12 months and include holiday planning and personal development goals. The key worker then monitors progress towards achieving the agreed goals and completes a PCP update record approximately every two months. This system helps to keep staff focussed and ‘on track’. The form used to record any incidents looks at what happened before and after the incident. This helps staff to identify any triggers and to look closely at how individuals have responded to any intervention by staff. This means that best practice protocols can be developed regarding any difficult or potentially damaging behaviour. Staff support individuals to make decisions regarding their day-to-day lives. Each person also has a communication profile, which includes an interpretation of behaviours and descriptions of how the person may respond to different situations. These communication profiles are of particular importance at St Patrick’s Rd as the people currently living at the home all have specific communication needs, as verbal communication is limited. All but the newest staff recruit have undertaken specific communication training. Communication is also explored during induction and NVQ programmes. This training along with the individual communication profiles helps staff to understand and respond to the choices made by those living at the home. Pictures, symbols and photographs are also used to encourage decision-making, such as those displayed in the hallway showing different regular activities. For one person ‘objects of reference’ are used to aid understanding and prompt decisionmaking. The home now has a computer and internet access. This is used to find information regarding shows, days out and holiday options and is another useful tool in involving people in making decisions regarding leisure activities. Staff work hard, with the use of these aids, to involve individuals in decision making within the home. Risk assessments are in place and address such activities as being a passenger in a vehicle, swimming and seizures. Risk assessments are being regularly reviewed along with the individual care plans. A new electronic bed, with integral bed rails has been purchased for one person. A risk assessment is in place and this stresses the importance of using protective padding on the bed rails. The staff member on duty explained that the manufacturer would carry Ormerod Home Trust DS0000010045.V367632.R01.S.doc Version 5.2 Page 12 out a six monthly maintenance check on this equipment. However it is still recommended that the checking of the bed rail, regarding any damage, spaces between the bars etc. is carried out by staff and included within the risk management plan. A stair gate is in place, for the protection of one person at the home. The individual’s parent has signed a consent agreement regarding the use of this equipment and as advised at the last inspection advice has been sought from the fire safety department regarding its use. Ormerod Home Trust DS0000010045.V367632.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. Activities are arranged according to people’s preferences and staff provide very good support to ensure that family links and relationships are maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The people living at St Patrick’s Rd are supported to take part in a range of meaningful activities. Staff from the home or staff from the Ormerod day services team provide the necessary assistance. Some individual funding is provided, which enables a degree of one to one support. The Person Centred Planning process helps to identify and maintain existing interests and also encourages the exploration of new activities. Local sensory drama classes have proved popular and remain a regular activity. On the day of this inspection three people living at the home had just returned from one of these sessions. Each person has an individual weekly plan of activities, which reflects their own likes and preferences. Displayed in the dining room is a pictorial outline of the Ormerod Home Trust DS0000010045.V367632.R01.S.doc Version 5.2 Page 14 regular activities enjoyed by each person. Photographs are used in this display, to help to make the activity chart meaningful for the individual concerned. Good community links are maintained. Those living at the home regularly access local facilities such as when carrying out food shopping. A car is available for trips further afield and staff are currently exploring leasing a larger vehicle which could accommodate all four residents, plus staff and with room for wheelchairs. Although individual activities are provided and actively promoted there may be occasions when all those living at the home may wish to enjoy a group event. In addition, a mini bus is provided by the Ormerod, which can be booked and used for trips out. Each file contains a record of social activities undertaken. Two records were viewed and evidenced activities such as rambling, swimming, eating out, shopping, and visiting the zoo. Home-based activities such as listening to music and baking also take place. One person has a swing seat in the rear garden, which he was enjoying using on the afternoon of this inspection visit. Each person has a holiday planned, taking place within the next month. Two people are going to Scarborough, with the other two residents going to different destinations abroad. Staff have got to know individuals extremely well and have supported people to book holidays to meet their different needs, interests and preferences. One person particularly enjoys theme parks and water parks and these activities have been built into his holiday plans. Friends and family members are welcome to visit at any time and the staff are proactive in ensuring that good communication is established and maintained. Relatives are involved in the person centred planning process and are invited to these meetings. Ormerod, the provider organisation holds occasional ‘family days’ at their head office, social events which relatives and friends can attend and find out more about the service. Staff work very hard to help people to form and maintain relationships. Each file contains a family contact sheet, where telephone calls, visits etc are recorded. Files also contain lists of family birthdays and key workers help individuals to send cards and presents to relatives and friends on special occasions. The sister of one individual has recently had a baby and it had been recorded that he had been supported to send a card and present, which he would be unable to do alone. Gestures such as this help the person to remain an active member of his family and reinforce his relationship as an uncle. The relative who completed a CSCI survey confirmed that staff help her relative to keep in touch and that she is always kept up to date with important issues. Staff undertake training regarding working with families and one staff member who completed a CSCI survey stated; “I do feel that we have a really good and strong team and have really good relationships with the service users family.” Ormerod Home Trust DS0000010045.V367632.R01.S.doc Version 5.2 Page 15 Daily routines at the home are flexible and are adapted to fit in with the days’ activities. Involvement with domestic tasks varies from person to person according to their abilities and motivation. People living at the home are involved in some household routines such as food shopping and cooking. The people living at the home are involved in the weekly food shopping and accompany staff on shopping trips. Menus are written each week, to act as a guide when planning the shopping list. The menu for the current week was viewed and showed a good variety of meals. Staff are aware of peoples’ preferences and this information is also contained in individual files. The records for one person show an allergy to seafood and the staff spoken to were well aware of this. An alternative meal is provided for this person when the other residents are having fish. Although some people at the home enjoy getting involved in activities such as baking, staff take on the main cooking duties at the home. The senior support worker on the team has provided some training and guidance regarding nutrition. A risk assessment is in place for one person who may rush his food and therefore may be at risk of choking. Some of the people living at the home require assistance at meal times and specific cutlery and plates have been purchased to promote independence in this area. Individuals also enjoy eating out in pubs, cafes or restaurants. Ormerod Home Trust DS0000010045.V367632.R01.S.doc Version 5.2 Page 16 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. Personal care and health care needs are met, with good records being maintained, meaning that any changes can be responded to. Staff training ensures that staff have the correct knowledge and abilities in relation to administering medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Files contain information and guidance for staff regarding personal preferences in relation to how personal care should be provided. This information is particularly useful for new staff. Each person has a nominated key worker who is responsible for drawing up this guidance and keeping it up to date. Some specialist equipment is in place, which is regularly serviced. The people currently living at the home require full support with their personal care needs. Staff undergo training regarding this intensive personal care. Times for going to bed and getting up are flexible and vary according to the activities planned for each day. Health care arrangements are very good, with each person having a written health action plan. Particular information is also recorded regarding how an Ormerod Home Trust DS0000010045.V367632.R01.S.doc Version 5.2 Page 17 individual would best be supported when attending any health care appointment or if having to be admitted to hospital. The files viewed showed good records of health care appointments and their outcome. A seizure management plan is in place for one individual with epilepsy, with records of seizures being kept and a specific protocol for staff regarding medication, which may need to be given. Moving and handling risk assessments have been carried out and records relating to continence, food intake and weight are kept where appropriate which means that changes can be responded to. Records show contact with other professionals such as the continence nurse. One person at the home is prone to sitting cross-legged and staff were seen prompting him to sit in such a way that would not cause stress to his legs/circulation. The relative who completed a CSCI survey commented; “The staff at St Patrick’s have taken care to fully understand ***** and provide him with all the active stimulation he needs and keep a close eye on his health needs.” Medication is safely stored in individual locked cupboards in the staff sleep in room. The medication administration records viewed had been completed appropriately. The dispensing pharmacist provides the majority of medication in blister packs. The parent and the GP of one person have both provided written consent for medication to be administered in food, as the medication is vital and the person concerned does not realise the consequences of refusing to take this medication. A specific protocol is in place for one person who requires medication to be administered following a seizure. All staff have undertaken medication training and further training regarding this specific administration technique. Ormerod Home Trust DS0000010045.V367632.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 and 23 Quality in this outcome area is good. Arrangements for handling complaints are in place. Policies, procedures, good practice and staff training promote the protection of those living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been no complaints since the last inspection. A complaints procedure is in place. This is produced in plain text and with pictures, to aid the understanding of those living at the home. Each person living at the home has a copy of this document “Making a complaint or speaking out.” Good contact is kept with relatives, who would advocate on the individuals behalf if necessary. The relative who completed a CSCI survey confirmed that they were aware of how to raise any concern or make a complaint. The provider organisation has procedures in place, which promote the protection of those using the service. Staff recruitment includes appropriate checks. Arrangements for the safe keeping of money are good, with regular monitoring taking place. The finance records and money held for one person at the home were examined. The money held corresponded with the balance shown in the account book. Each person has an individual account book, with clear records of any income and expenditure. Both the registered manager and the senior support worker regularly check the accounts and any money held at the home. New staff undergo structured induction training, which addresses issues of abuse and protection. This is also covered within NVQ programmes. Ormerod Home Trust DS0000010045.V367632.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 and 30 Quality in this outcome area is good. The property is attractive and provides a homely environment. The home is clean, attractive and generally well maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is situated close to a good selection of local shops and within walking distance of St Annes centre, giving easy access to a range of local amenities. The property is a dorma bungalow, with full wheelchair access on the ground floor. On the ground floor there are two bedrooms, a lounge, a dining room, a kitchen, the staff sleep in room and a large bathroom suitable for people with physical difficulties. One of the bedrooms on the ground floor has direct access to this bathroom. The first floor contains two further bedrooms and another bathroom. Bedroom furnishings and decoration reflect the interests and needs of each person. There is a small, enclosed decked garden at the rear of the home, with large more open gardens at the front and side of the building. Ormerod Home Trust DS0000010045.V367632.R01.S.doc Version 5.2 Page 20 Since the last inspection the rear garden has been decked, some internal redecoration has taken place, a new carpet and fireplace have been fitted in the lounge and the ground floor windows have been double-glazed. Generally the home is well maintained and decorated to a good standard. However the hall and dining room are both looking a little tired. The staff on duty confirmed that both these areas are soon to be decorated and a new dining table purchased. The radiator panels in these two areas are damaged and it is recommended that these are attended to within the re decoration programme. In addition the bath panel in the first floor bathroom also needs replacing. The kitchen is rather dated and plans should be made for the refurbishment of this room. Domestic staff are not employed at the home, as support staff carry out cleaning tasks as part of their day-to-day work. The home was clean and staff are clearly working hard to maintain good standards within the home. There is a separate laundry area in an outbuilding accessed from the rear yard. Staff undergo infection control training within the induction programme and this is also covered within NVQ training. There are infection control procedures in place and protective clothing is provided. Ormerod Home Trust DS0000010045.V367632.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, 34, 35 and 36 Quality in this outcome area is excellent. Robust recruitment procedures and excellent staff training and staff supervision systems, mean that a competent, qualified and effective staff team are in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff on duty were observed interacting with those living at the home. Staff displayed good communication skills and the atmosphere was friendly and relaxed. As well as undertaking the general staff training programme, the staff at St Patrick’s Rd have received training to meet the specific needs of those living there. This includes communication training and training regarding a particular method of administering medication. A recently appointed staff member confirmed that he too had received training in this medication procedure. Records show that the staff team has remained stable with few changes since the last key inspection. The team currently consists of eight care staff including the senior support worker who is based at the home. All but the newest recruit have achieved NVQ (National Vocational Ormerod Home Trust DS0000010045.V367632.R01.S.doc Version 5.2 Page 22 Qualification) level 2 or above. Ormerod provides excellent opportunities for qualification training for staff and the percentage of qualified staff at the home exceeds the minimum recommendation. The relative who completed a CSCI survey commented; “***** has excellent carers who always put his welfare first.” The organisation has a well-established recruitment process in place. The records for a recently appointed member of staff were viewed. Recruitment documentation included a pre employment health questionnaire, a record of the interview, including the questions asked, the written exercise completed by the candidate, application form, two references and a CRB (Criminal Records Bureau) disclosure, which includes a check against the POVA (Protection of Vulnerable Adults) list. Recruitment files also contain a useful checklist of the process and documentation required, which is signed and dated at each stage of recruitment. A number of people supported elsewhere within Ormerod services have received training and are involved in staff selection. Staff training is organised by a dedicated training team based at the organisations headquarters. The training matrix for the staff team shows that staff receive an excellent level of training. The programme includes a threeweek induction programme, which the newest recruit to the team is soon to attend. All new staff, even those with previous experience, undertake this induction programme. At present he is working through the house based induction programme, which is being led by an experienced team member as part of her NVQ training. The staff training programme includes training regarding first aid, medication, health and safety, food hygiene, moving and handling, abuse, working with families, person centred planning and fire safety. There is a rolling programme of core training, with dates being set for the year. The training matrix shows what training has been completed and when refresher courses are due. The training team operate a mentoring scheme, whereby each staff member is allocated a mentor from the training team, who meets with that person to carry out a training assessment, which is regularly reviewed. All training dates are then set for the forthcoming year. This has been introduced in order promote staff responsibility and ownership of their professional development. This is an improvement to an already excellent system for arranging and providing high quality training for staff. The arrangements for the support and supervision of staff are excellent. The records on the three staff files viewed showed that supervisions take place on a monthly basis and that each person also has an annual appraisal. The senior support worker carries out the supervision meetings with the support workers Ormerod Home Trust DS0000010045.V367632.R01.S.doc Version 5.2 Page 23 on the team. The team leader (registered manager) has monthly supervisions with the senior support worker and also carries out the annual staff appraisals. Each person has a supervision file containing a copy of their role specification and a signed supervision agreement. The supervision recording format includes a review of work performance and a record of agreed future targets. Excellent records are maintained, showing good details of the areas discussed and any outcomes. The Team Leader and senior support worker are clearly working hard to maintain this excellent level of staff support and supervision. The format used for annual appraisals includes a self-appraisal by the staff member concerned. Records of probationary reports were also viewed. Regular monthly staff meetings take place and the minutes of recent meetings were seen. Items on the agenda include issues regarding the welfare of those living at the home as well as discussions regarding domestic/organisational matters. The records for a recently appointed staff member, in post for two months, showed that two formal supervision meetings had already take place. During the inspection this staff member spoke of his introduction to the service and the support he was receiving, saying that all aspects had been very good and extremely thorough. The supervision and appraisal system is excellent, meaning that staff are well supported and guided in their work. Feedback from the staff who completed CSCI surveys was extremely positive regarding the training and supervision provided. However there was a general theme within the responses that some staff feel that senior managers do not always listen or take on board staff views. This may be a minor grumble and part of working for a large organisation. It is advised that if there is an issue, it is explored and solutions found. Ormerod Home Trust DS0000010045.V367632.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, 39 and 42 Quality in this outcome area is excellent. Strong management and the excellent monitoring and quality assurance systems ensure that a high quality service is maintained. Staff training, policies and good practice promote the health and safety of those living and working at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is well run, with good systems in place and information maintained in an organised manner The team leader has recently registered with the CSCI as the registered manager of the home and is also the registered manager of another small care home provided by Ormerod. The registered manager has worked for Ormerod for many years and has gained the Registered Managers Award, NVQ level 4 in Care and NVQ assessor and verifier qualifications. Regular update training is also undertaken, as seen on the training matrix for Ormerod Home Trust DS0000010045.V367632.R01.S.doc Version 5.2 Page 25 the organisation. The registered manager is very experienced and works hard to uphold the working practices and standards expected by Ormerod. The senior support worker at the home also carries out certain managerial tasks. The range of quality monitoring systems is excellent. There are internal and external quality monitoring systems in place. Ormerod has achieved the Investors in People Award and is also affiliated to the Quality Review network, which carries out quality monitoring work with and for people with learning disabilities. There is a suggestion box in the entrance to the Ormerod main office, inviting ideas and feedback about the service provided. The registered manager carries out a bi monthly audit and a senior manager within the organisation undertakes monthly visits, with reports being sent to the CSCI. The registered manager’s audit looks at finances, medication, risk assessments and other areas of service provision. This audit also includes the monitoring and relevance of policies and concludes with a section regarding any action needed. Feedback questionnaires are regularly sent to all people using Ormerod services, including those living at St Patrick’s Rd. When Ormerod was planning to introduce a new logo for the organisation, staff and people living at the home were invited to vote on the logo of their choice, demonstrating that the views of people who use the service are valued. Staff and people who use Ormerod services are represented at learning disability and community partnership forums, where there is opportunity to contribute to wider planning and decision-making. Person centred planning is well established at St Patrick’s Rd and is a vital element of quality assurance, giving all those involved, including relatives, an opportunity to give feedback about the service and to support the individual to plan for the future. The regular staff meetings and supervision sessions also provide good opportunities for staff to air their views and for any work performance issues to be addressed. The excellent staff-training programme addresses health and safety topics and staff regularly attend refresher training. The organisation has a health and safety manager, who carries out regular visits to the home, producing a written report highlighting any areas for improvement. This audit focuses on hygiene, cleanliness, food storage and food preparation. Staff are responsible for carrying out certain checks such as recording fridge, freezer and water temperatures. Some records of these checks were viewed. The fire book was viewed and evidenced that fire drills are held monthly and fire equipment is maintained. Staff sign the fire book to confirm that they are aware of action to take in the event of a fire. The newest recruit had signed this record. Ormerod Home Trust DS0000010045.V367632.R01.S.doc Version 5.2 Page 26 Information in the Annual Quality Assurance Assessment completed by the registered manager confirms that regular health and safety checks, such as the checking of equipment, take place. There are appropriate health and safety policies in place and risk assessments address any potential hazard at the home. Ormerod Home Trust DS0000010045.V367632.R01.S.doc Version 5.2 Page 27 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 X 2 3 3 X 4 X 5 X 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 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 4 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 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 X 4 X X 3 X Ormerod Home Trust DS0000010045.V367632.R01.S.doc Version 5.2 Page 28 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. 2. Refer to Standard YA9 YA24 Good Practice Recommendations The risk management plan for any bed rail should include the regular checking of the equipment. The hall and dining room should be decorated and the radiator panels renewed. A new bath panel is needed in the first floor bathroom. Consideration should be given to updating the kitchen. Ormerod Home Trust DS0000010045.V367632.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 Ormerod Home Trust DS0000010045.V367632.R01.S.doc Version 5.2 Page 30 - 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. 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