Care Home: Parkfields (Jaffray Care Society)

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What the care home does well The service is well resourced and therefore the home, which provides excellent facilities, is well-maintained and subject to ongoing development and improvement. Service users are happy. One service user said `its gorgeous` and `I like the staff` because `they are nice to me`. Staff in turn benefit from a robust an ongoing training programme. Service users live busy and active lives and access community facilities daily often on an individual rather than a group basis. Each service user has had a holiday, which are organised according to need. For example one resident went away with two staff whilst others have been away in compatible pairs. Guidance available to staff is good and as a result service users benefit from a consistent approach. It was positive to observe this amongst care staff and none care staff. It was evident that non-care staff are also aware of service users needs and how to respond to them. One relative who provided feedback is very pleased with how behaviour is managed and has noticed improvements, which they attribute to the approach of staff. Service users are encouraged to make choices and their dignity and privacy is respected and promoted in ways that were tangible during the inspection process. The service is well managed. A parent wrote that `this is a service we have been praying for, for many years` and that they are `now able to relax and know that X is well cared for in an excellent home environment and that he is well supported by all the staff` What has improved since the last inspection? Since the last inspection steps have been taken to provide a contract for service users. This is a positive step although they would benefit from the inclusion of more information about their rights and the responsibilities of all parties. The environment continues to develop and improve to meet residents` needs on an ongoing basis. A considerable amount of redecoration has taken place to ensure that the property continues to provide a comfortable and pleasant environment for all. Action has been taken to assess the risk from hazardous chemicals. The Manager has enrolled on the Registered Managers Award following uncertainty about whether her current qualifications are equivalent. This will serve to resolve the issue, which has been ongoing. What the care home could do better: Areas identified for improvement were discussed and agreed with the Deputy Manager at the end of the inspection. It would be good practice to ensure that information relating to how to make a complaint is more visible to service users and visitors to the premises. Although it is accepted that contracts have been simplified to make them accessible to people with a learning disability, fuller information about rights and responsibilities of all parties, should be included. Some control measures are in place to prevent service users accessing areas where water temperatures are not restricted. Risk assessments however have not been carried out to ensure that all variables have been considered and planned for and this would help to identify and minimize risks of scalds. Service users receive good health screening and most are supported to receive dental care. This appeared to be lacking for one service user who finds it difficult to access this service and although his care plan showed the need for six monthly checks, neither this nor a plan to facilitate this could be evidenced. As this service caters for people who can exhibit challenging behaviour, it is essential that any physical intervention employed can be fully accounted for in records. Shortfalls in record keeping do not currently comply with the Department of Health and the British Institute of Learning Disabilities guidelines for good practice. This hampered assessment of physical intervention practice and leaves the service unable to evidence that such measures are in service users interests, are time limited and are safe. However we are not aware of any concerns about how the home manages this in practice. CARE HOME ADULTS 18-65 Parkfields (Jaffray Care Society) Parkfield Crescent Parkfields Wolverhampton West Midlands WV2 2DF Lead Inspector Deborah Sharman Key Unannounced Inspection 30th October 2007 09:00 Parkfields (Jaffray Care Society) DS0000064571.V353176.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 Parkfields (Jaffray Care Society) DS0000064571.V353176.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. Parkfields (Jaffray Care Society) DS0000064571.V353176.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Parkfields (Jaffray Care Society) Address Parkfield Crescent Parkfields Wolverhampton West Midlands WV2 2DF 01902 405031 01902 405036 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) Jaffray Care Society Miss Lian Marie Hargreaves Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Parkfields (Jaffray Care Society) DS0000064571.V353176.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th July 2006 Brief Description of the Service: This is a home registered for 8 people with learning disabilities. It consists of two neighbouring bungalows which were purpose built in a residential estate in Parkfields which is to the south of Wolverhampton City centre. This gives good transport access to the local facilities for the residents. The location of the home also makes it easily accessible to the relatives and friends of those living there. Jaffray Care is the organisation that provides the care at this home. Each bungalow is designed to accommodate four people and are managed by Lian Hargreaves with each of her two deputy managers having particular responsibility for one of the buildings. The fees range from £1750.00 to £2210.00 per week. This information was correct at the time of inspection. Up to date information should be requested from the service. Parkfields (Jaffray Care Society) DS0000064571.V353176.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One Inspector carried out this unannounced key inspection between 9.30 am and 5.30 pm. As the inspection visit was unannounced this means that no one associated with the home received prior notification and were therefore unable to prepare. As it was a key inspection the plan was to assess all National Minimum Standards defined by the Commission for Social Care Inspection (CSCI) as ‘key’. These are the National Standards, which significantly affect the experiences of care for people living at the home. Progress the home has made towards meeting previous CSCI requirements issued to ensure improvement was also assessed. Information about the performance of the home was sought and collated in a number of ways. Prior to inspection the Commission for Social Care Inspection was provided with written information and data about the home in their annual return. Additionally prior to inspection, the Commission for Social Care Inspection sought the views of people who stay at Parkfields and those of their relatives. Written responses were received from 2 relatives and a health professional. No responses were received from service users. Staff were also canvassed and seven responses were received after the inspection but prior to writing this report. All this information was analysed where possible prior to inspection and helped to formulate a plan for the inspection and has helped in determining a judgement about the quality of care the home provides. During the course of the inspection the Inspector used a variety of methods to make a judgement about how service users are cared for. The Registered Manager was not available on the inspection day to answer questions and generally support the process. The Deputy Manager and a senior carer deputised for her and supported the inspection process. The Inspector was however able to speak to the manager by telephone on a couple of occasions towards the end of the inspection day to clarify some issues. The Inspector interviewed three care staff and the maintenance manager and was able to talk to three service users in some detail throughout the inspection day. The Inspector assessed in detail the care provided to one person and aspects of care for four others using care documentation. The Inspector also observed interaction between staff and service users. The Inspector sampled a variety of other documentation related to the management of the care home such as training, staff supervision, maintenance of the premises, accidents and complaints. Parkfields (Jaffray Care Society) DS0000064571.V353176.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Parkfields (Jaffray Care Society) DS0000064571.V353176.R01.S.doc Version 5.2 Page 7 Areas identified for improvement were discussed and agreed with the Deputy Manager at the end of the inspection. It would be good practice to ensure that information relating to how to make a complaint is more visible to service users and visitors to the premises. Although it is accepted that contracts have been simplified to make them accessible to people with a learning disability, fuller information about rights and responsibilities of all parties, should be included. Some control measures are in place to prevent service users accessing areas where water temperatures are not restricted. Risk assessments however have not been carried out to ensure that all variables have been considered and planned for and this would help to identify and minimize risks of scalds. Service users receive good health screening and most are supported to receive dental care. This appeared to be lacking for one service user who finds it difficult to access this service and although his care plan showed the need for six monthly checks, neither this nor a plan to facilitate this could be evidenced. As this service caters for people who can exhibit challenging behaviour, it is essential that any physical intervention employed can be fully accounted for in records. Shortfalls in record keeping do not currently comply with the Department of Health and the British Institute of Learning Disabilities guidelines for good practice. This hampered assessment of physical intervention practice and leaves the service unable to evidence that such measures are in service users interests, are time limited and are safe. However we are not aware of any concerns about how the home manages this in practice. 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. Parkfields (Jaffray Care Society) DS0000064571.V353176.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 Parkfields (Jaffray Care Society) DS0000064571.V353176.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 5. Quality in this outcome area is adequate. Prospective users’ individual aspirations and needs are assessed. Contracts have been put in place but could better fully outline each party’s responsibilities towards the other. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have not been any new service users admitted to the home. Discussion with staff however showed that they are satisfied that they are given sufficient information about how to meet new service users needs prior to them moving in. Service users are always offered the opportunity to visit before deciding whether to move in. There was evidence that service users are provided with written information about the service but all copies provided at inspection were marked as draft and were not dated. This made it difficult to judge when the literature (which does not tell readers how many people it is registered to care for), was last reviewed. Since the last inspection steps have been taken to provide service users with contracts. These would be more useful if they had been signed and included Parkfields (Jaffray Care Society) DS0000064571.V353176.R01.S.doc Version 5.2 Page 10 the full rights and responsibilities of all parties, fees, arrangements for the review of care and the period of notice needed to be given by both parties. This would better protect service users interests. Parkfields (Jaffray Care Society) DS0000064571.V353176.R01.S.doc Version 5.2 Page 11 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, 9. Quality in this outcome area is good. Service user plans are comprehensive and updated regularly and so give good direction to staff. This helps to ensure that individuals needs are met. Where possible service users are consulted and make decisions about their lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users care plans and risk assessments were assessed. They provide good detail across a range of appropriate needs to guide staff as to how to provide individualised care. Service users preferences, cultures, abilities and dignity are essential elements included in the written guidance provided. The Inspector observed staff adhering to elements of the planned care. It was positive to see a number of staff including none care staff all relating to a service user in a consistent manner that accorded with the plan of care. This helps to minimise frustration for a service user and has helped his behaviour to improve. Parkfields (Jaffray Care Society) DS0000064571.V353176.R01.S.doc Version 5.2 Page 12 Care plans and risk assessments are regularly reviewed and discussion with staff showed they are familiar with the detail of the plans. The only suggested improvement is that care plans which refer to physical intervention should provide greater detail than reference to ‘CPI’ as this does not inform the reader which technique is suitable for the individuals assessed behaviour based upon health, gender and disability. The Inspector observed staff throughout the day offering choices and responding well to service users requests. Parkfields (Jaffray Care Society) DS0000064571.V353176.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, 14, 15, 16, 17. Quality in this outcome area is good. Service users are supported to pursue hobbies and interests and have very regular access to community facilities. They are helped and encouraged to keep in contact with their families and enjoy their meals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussion with service users and staff and sight of care records show that service users lead busy lives and are supported to pursue their interests and hobbies in the community on an individual daily basis. One service user goes to play snooker weekly at the local bowling alley and he told the Inspector that he loves this. Another service user had been shopping with a staff member on the day of inspection to buy a birthday card and had enjoyed eating lunch out. The Inspector noted that positive support was provided to a service user when he asked to watch wrestling in his bedroom. Parkfields (Jaffray Care Society) DS0000064571.V353176.R01.S.doc Version 5.2 Page 14 Service users have regular contact with their family. Many had attended a Halloween party the night before this unannounced inspection. One service user enjoyed telling the Inspector how he had dressed up as a ghost for the party. All service users except one who is on an extended visit to family have had a holiday this year having been accompanied by staff either singly or in pairs. Two service users who were asked told the Inspector that they enjoy their meals. Staff were observed offering a choice of drinks regularly throughout the day. Discussion and records show that service users case tracked are provided with their favourite foods and alternatives are offered where necessary. Staff have a good knowledge of what service users like and dislike to eat. Service users help with grocery shopping twice per week. Parkfields (Jaffray Care Society) DS0000064571.V353176.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. Quality in this outcome area is generally good. Changes in service users health are recognised and responded to and health screening is provided to positively promote good health for service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans contain sufficient personalised information about how to provide personal care in a way that accords with service users preferences and needs. Guidance is explicitly mindful of choice, rights and dignity. All service users present as clean and well groomed with individual style. In the Inspectors presence a service user told a staff member that he wished to change his top. Without delay the staff member accompanied him to his room to support this request in private. At other times he was redirected to his bedroom sensitively when it was apparent that his privacy and dignity would otherwise have been compromised. Care plans contain detailed care information in respect of health conditions specific to individuals. Changes in health are noticed and monitored and it was Parkfields (Jaffray Care Society) DS0000064571.V353176.R01.S.doc Version 5.2 Page 16 positive to see that a service users complaint of pain had been listened to and acted upon. Health screening e.g. psychiatric, optical, dental and chiropody is provided regularly for service users. However case tracking has shown that for one service user where compliance with screening is difficult, routine dental screening has not been provided since 2005 when a dental assessment and other medical tests were carried out under anaesthetic. Although the care plan says dental screening is required six monthly, the outcome of this medical procedure in 2005 is not known and a plan for further or ongoing treatment is not in place. This requires attention. Medication has been used on a frequent basis as required to support the management of behaviours for the service user case tracked. However assessment of robust medication records showed that this was in accordance with medical prescription and care plan guidelines. The Inspector was aware that in November 2006 there had been a medication error where a service user was given the wrong medication. This is a serious error and has the potential to cause serious harm to the service user. Managers treated the incident with the seriousness that it deserves and responded appropriately to make the situation immediately safe and took steps to ensure that the risk of a repeat was minimised. There have been no further errors or problems. Medication systems are thorough and no practice or management concerns were identified. Parkfields (Jaffray Care Society) DS0000064571.V353176.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Quality in this outcome area is good. Staff are aware of incidents they must report and acted appropriately when a concern was identified. Steps are taken to safeguard service users but record keeping following physical intervention must improve to account for decisions made and actions taken. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Although the complaints log was not available when requested the Inspector was told that no complaints have been received. There is a complaints policy available and it is in an accessible format. The Inspector suggested that complaints information should be readily available where service users and visitors can see it. One of two relatives who responded to CSCI said that s/he did not know how to complain should they need to and publicly available information will help to address this. Policies to protect service users are in place and staff who feel service users are safe were aware of what abuse is and their role in responding to it. Records show most staff have received training in abuse awareness and safeguarding. The service users whose care was looked at in detail had not been subject to any physical restraints as his behaviours are managed using a combination of diffusion, distraction and prescribed medication. Therefore practice was assessed in respect of a further service user where physical intervention has Parkfields (Jaffray Care Society) DS0000064571.V353176.R01.S.doc Version 5.2 Page 18 been used to manage behaviour that challenges and presents a risk to self and or to others. There were five incidents in October 2007 where his / her behaviour had been successfully redirected or managed with prescribed medication. Two earlier incidents however in September 2007 require review. A combination of ‘as required’ medication and physical intervention were used on these two occasions when the service user became aggressive following requests for drinks. Discussion with staff and sight of the care plan show that there is a drinks regime in place to limit the frequency of drinks that must be strictly adhered to for medical reasons. This care plan that was drawn up by health professionals indicates times when the service user can have a drink. The Inspector’s concern is that challenging behaviours are arising when this is being rigidly implemented. It is accepted that the guidance says that it must be strictly followed. However the effect on welfare and safety along with his /her rights must also be considered. Records show that staff refusing the service user a drink 20 minutes before the due time prompted challenging behaviour. The care plan is based upon a medical rather than a social model of care and there is little flexibility or compromise within it. This must be reviewed with health professionals. Records do refer to physical interventions but their use is limited in their current format. Attempts to assess the nature of physical intervention were thwarted by the lack of appropriately detailed records. Records available do not indicate which staff were involved, for how long, using which specific technique etc and therefore do not comply with the Department of Health and the British Institute of Learning Disability guidelines for good practice. Limitations in record keeping meant that it was not possible to audit whether staff who had been involved in the physical intervention were appropriately trained. Three quarters of the staff team have been trained. It was also not possible to assess from records whether restraints employed were time limited and in the service users interests. These implications were discussed with the Deputy Manager in the absence of the manager who agreed that physical intervention records must be improved. Unexplained bruising to a service user is within the adult protection multi disciplinary arena. Although minutes from the first meeting with Social Services were not available the manager explained by phone that Social Services were satisfied with action taken by the service to minimise further risk. The manager is unclear what stage the investigation is at currently and was advised to make further enquiries. The management of service users finances were not assessed at this inspection. Parkfields (Jaffray Care Society) DS0000064571.V353176.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, 30. Quality in this outcome area is excellent. Service users are provided with an attractive and homely place to live that is exceptionally well-maintained and responsive to service users needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users live in a homely, clean, fresh, tidy and modern environment. Service users said they like their bedrooms, which are personalised reflecting service user needs and interests. What is striking is how the environment is sympathetically designed to meet service users needs in a socially inclusive and discreet way. Wardrobes for example are built in to avoid the risk of freestanding wardrobes toppling and ongoing adjustments have been made as staff have got to know service users’ individual needs. For example some carpet has been replaced with modern washable flooring, door closures have been changed throughout to prevent risk from one service users tendency to slam doors, pictures are secured and where necessary televisions are wall Parkfields (Jaffray Care Society) DS0000064571.V353176.R01.S.doc Version 5.2 Page 20 mounted. Grab rails line corridors. There is an ongoing programme of maintenance and decoration. An external fence was being painted on the day of inspection and since the last inspection several bedrooms and a lounge have been redecorated and a new carpet provided. The maintenance manager confirmed that resources are readily available to support him to achieve his objectives. A tour of the environment showed there to be no evident hazards. Fire doors were not propped open, there were no trip hazards and hazardous chemicals were safely locked away. Inspection of the kitchen and laundry showed them to be clean and well resourced with hand washing facilities. Staff know how to minimise the risk of infection and said that equipment is always available. Parkfields (Jaffray Care Society) DS0000064571.V353176.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): 31, 32, 33, 34, 35, 36. Quality in this outcome area is good. Staff are well trained, motivated and competent. They are supported well on a day-to-day basis and service users report liking the staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Several staff report being very satisfied with the training opportunities available to them. A new member of staff is delighted with the training she has been given and demonstrated a very developed understanding of her job role and purpose. She was pleased with how her induction had prepared her for her role. Although this did not meet national standards, a new induction programme is now in place ready for use with new staff appointed in the future. Staff are also satisfied with staffing levels feeling that staffing ratios are sufficient to meet service users needs. The rota shows that staff are rostered flexibly to meet peak periods of activity. Parkfields (Jaffray Care Society) DS0000064571.V353176.R01.S.doc Version 5.2 Page 22 Staff described feeling well supported on a day-to-day basis. Inspection of supervision records for three staff however shows that improvements are required to the frequency with which formal supervision is provided. A new staff member had had one supervision in five months since employment. In two years another staff member had had a probationary review and one supervision. A third staff member in two years had had a probationary review, two supervisions and two performance reviews. It is good practice for care staff to receive a minimum of 6 supervisions every year. Inspection of recruitment records for two staff members show them to have been recruited safely minimising risk to service users from new staff. One service user said to the Inspector ‘it’s gorgeous living here. I like the staff. They’re nice to me’. Parkfields (Jaffray Care Society) DS0000064571.V353176.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42. Quality in this outcome area is good. Service users are benefiting from a service that is managed well. A safe environment is provided for service users and environmental risks are minimised. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Manager said she feels supported 110 and ‘couldn’t have a more supportive management team’. She described feeling ‘happy and contented’ at work and in receipt of supervision every two months. She has undertaken training recently to update her knowledge and skills in medication and the Mental Capacity Act. In response to lack of clarity about whether her existing management qualifications are equivalent to the Registered Managers Award, the Manager has enrolled for the latter to bring resolution to the matter. Parkfields (Jaffray Care Society) DS0000064571.V353176.R01.S.doc Version 5.2 Page 24 Staff are very satisfied with resources and support available to them and all safety and service maintenance documentation requested was available and up to date. The only omissions identified were risk assessments for unregulated water temperatures at outlets in the laundry and kitchen. Risk to service users is minimized by coded locks that restrict access to these areas but control measures have not been considered for service users once they are in these rooms. Health and Safety and Fire consultants have been employed and have carried out assessments of the property. Areas for improvement have been brought to the provider’s attention, the Inspector was told including the need for an emergency contingency plan. Regulation 26 visits are carried out, accidents are recorded, staff were able to tell the Inspector where the first aid box is and staff meetings are held weekly and are well documented. Service users take part in regular meetings where they are encouraged to give feedback about the service. These meetings are minuted very well and are available in an accessible pictorial format. A senior manager using the national minimum standards as a framework assesses the quality of service provision on an ongoing basis. Two staff spoken to both feel that the service provided is ‘excellent’. Inspection has shown good outcomes for service users who are happy. There are however some areas arising from this inspection that need attention. As a priority these include: Physical intervention records Assessment of risk where water temperature exceeds the accepted safe range The development of a care plan for dental screening for one service user Improved frequency of formal supervision to staff Complaints information to be readily available to service users and visitors within the premises The inclusion of more detail and signatures in contracts with service users Ensuring the provision of induction to national standards using the new tool for any newly appointed staff. Parkfields (Jaffray Care Society) DS0000064571.V353176.R01.S.doc Version 5.2 Page 25 Parkfields (Jaffray Care Society) DS0000064571.V353176.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Parkfields (Jaffray Care Society) DS0000064571.V353176.R01.S.doc Version 5.2 Page 27 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA19 Regulation 13(1)(b) Requirement Service users must be provided with access to health services when needed. Steps must be taken to ensure that the dental health of the service user whose care was looked at in detail is planned for and acted upon. Timescale for action 31/12/07 2 YA23 13(7) New requirement arising from this inspection October 2007. 31/12/07 Steps must be taken to ensure that no service user is subject to physical restraint unless restraint of the kind employed is the only practicable means of securing the welfare of that or any other service user and there are exceptional circumstances. This will include providing fuller detail in physical intervention / behaviour care plans which are agreed in a multi disciplinary forum and ensuring any restraints employed are recorded in a manner that is consistent with national guidance. New requirement arising from this inspection October 2007. Parkfields (Jaffray Care Society) DS0000064571.V353176.R01.S.doc Version 5.2 Page 28 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA5 Good Practice Recommendations Care contracts should be more fully developed to ensure they include the rights and responsibilities of all parties in accordance with National Minimum Standard 5. New recommendation arising from this inspection October 2007. Written information explaining how to make a complaint should be made publicly available on the premises in formats appropriate to service users and visitors. New recommendation arising from this inspection October 2007 The current drinks programme in place in respect of one service user should be reviewed with health professionals. This is to ensure that his / her social needs, wishes and rights are all considered in addition to health needs and to reduce the risk of harm from aggression to self and others arising from the programme. New recommendation arising from this inspection October 2007. Steps should be taken to improve the frequency with which formal supervision is provided to staff. All staff should receive a minimum of 6 recorded supervisions per year. New recommendation arising from this inspection October 2007 2 YA22 3 YA23 4 YA36 Parkfields (Jaffray Care Society) DS0000064571.V353176.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection 1st Floor Chapter House South Abbey Lawn Abbey Foregate Shrewsbury SY2 5DE 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 Parkfields (Jaffray Care Society) DS0000064571.V353176.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. 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