Care Home: Pinfold Lane

Similar services:

• Larch Avenue
• Alderson Road 12
• Cranworth Close Registered Care Home
• Pennine Camphill
• Muston Road (70)
• Grayling
• The Cornerstone
• John Street Nursing Home

What the care home does well The admission process follows good practice and makes sure that this is the right care setting for the individual. The staff look at whether their care needs can be met, and also that they get on with the others living there. This means that people get the support they need in the setting they are happy with. People’s support plans are person centred and very detailed, so they give staff the right information to support each person according to their individual needs.Pinfold LaneDS0000001491.V377672.R01.S.docVersion 5.3People receive personal support that is flexible, consistent and responsive to their changing needs; this includes providing one-to-one support where needed. One staff member said: “We support people to live a full and happy life”. Each person has the opportunity to have the type of holiday they enjoy, supported by as many staff as necessary to meet their care needs. Staff try to find stimulating and fulfilling activities for people to experience. Staff work well with other health and social care professionals, to make sure that people’s health needs are met. Staff said: “There is fantastic communication within the house and with outside agencies that work with service users”. Complaints are managed well and people and their families are confident that any concerns will be taken seriously. Staff receive good quality training, and receive regular supervision to support them in their roles. Comments from someone recruited a few months previously: “The training has been fantastic”. Staff spoken to said they felt the home is well managed and enjoy working here. Comments included: “I come to my job happy every day”, “We aspire to provide the highest quality care and the service is well led by the manager and the senior”. The service is well-managed, for the benefit of the people living there. A comment by a person living at the home was: “it’s fantastic!” What has improved since the last inspection? The staff have found good ways to use the building so that people who do not get on well together have their own space. At the random inspection in February 2008, staff said they had noticed an improvement in the environment. They said it is much cleaner and that management have worked hard to try and make it more homely. Some redecoration has been done, and one person has had new bedroom furniture. Someone has also been assessed for a new bath that would meet his needs better, and this is on order. At this key inspection the home was fully staffed, for the first time, according to the manager. Apart from one person, there is a whole new staff team since this manager was placed there in an acting capacity two years ago.Pinfold LaneDS0000001491.V377672.R01.S.docVersion 5.3We spoke to four support staff during the visit, who gave very good feedback about their work. One said: “There is more consistency for the people we support. It’s much better now we’re fully staffed”. One person who had worked there for some time through an agency and was now a permanent support worker said there was a “huge difference” in how the staff team worked together now. Comments on staff surveys included: “The consistency of the staff team has improved this year, I hope this continues. The arrangements for monitoring the quality of the service and for consulting with people, their relatives and other professionals who they come into contact with, means that the team gets constant feedback about how they are doing. This is helping the service to develop and improve so that people get the best support. What the care home could do better: Some of the information in the service user guide is rather wordy and could be simplified to make it more accessible. It also needs to be updated with current information. One person’s survey indicated that he would like to be able to go out more often. A copy of the local authority’s Adult Safeguarding procedure must be obtained, and available for staff to refer to. This would make sure that all of the correct procedures are followed if an incident of abuse was suspected. It would also be good practice to make the existing abuse policy available in a more accessible format, so that people and their families know what to expect from the service. Key inspection report CARE HOME ADULTS 18-65 Pinfold Lane 1 Pinfold Lane Garforth Leeds West Yorkshire LS25 1HE Lead Inspector Stevie Allerton Key Unannounced Inspection 24th August 2009 10:15 Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 Page 3 SERVICE INFORMATION Name of service Pinfold Lane Address 1 Pinfold Lane Garforth Leeds West Yorkshire LS25 1HE 0113 2863691 0113 2863691 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) www.c-i-c.co.uk. Community Integrated Care Manager post vacant Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th August 2007 Brief Description of the Service: Pinfold Lane is a detached house situated close to the town of Garforth. It has an enclosed garden to the rear of the building. There is parking for two cars at the front of the building. Local shops and the town centre are within easy access. Pinfold Lane is part of the Community Integrated Care organisation, and is registered to provide personal care for up to 4 people with learning disabilities. The accommodation consists of four single bedrooms, a lounge and conservatory, shower room and bathroom, laundry, and a domestic style kitchen/diner. All laundry is done on the premises. The home has a vehicle, which is regularly used by people who live at the home. At the time of this inspection the fees were £968 per week. For up to date information about care fees, contact the manager at the home. Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection was carried out without prior notification and was conducted by one inspector over the course of a day. Before the visit, accumulated information about the home was reviewed. This included looking at any notified incidents or accidents and other information passed to CSCI since the last inspection. This report includes information gathered at the random inspection that was carried out on 20/02/08. This information was used to plan this inspection visit. The home completed their Annual Quality Assurance Assessment (AQAA) fully, but this was not available until after the inspection visit had been carried out. Surveys were sent out to people living at the home and to the staff. All three people living there responded, along with five staff. Feedback was very positive. Two people were case tracked, and other files were looked at. Case tracking is the method used to assess whether people who use services receive good quality care that meets their individual needs. Where appropriate, issues relating to the cultural and diverse needs of residents and staff were considered. Using this method, all twenty-one key standards from the Care Homes for Younger Adults National Minimum Standards, plus other standards relevant to the visit, were able to be assessed. We spent time with people living at the service and spoke to relevant members of the staff team who provide support to them. What the service does well: The admission process follows good practice and makes sure that this is the right care setting for the individual. The staff look at whether their care needs can be met, and also that they get on with the others living there. This means that people get the support they need in the setting they are happy with. People’s support plans are person centred and very detailed, so they give staff the right information to support each person according to their individual needs. Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 Page 6 People receive personal support that is flexible, consistent and responsive to their changing needs; this includes providing one-to-one support where needed. One staff member said: “We support people to live a full and happy life”. Each person has the opportunity to have the type of holiday they enjoy, supported by as many staff as necessary to meet their care needs. Staff try to find stimulating and fulfilling activities for people to experience. Staff work well with other health and social care professionals, to make sure that people’s health needs are met. Staff said: “There is fantastic communication within the house and with outside agencies that work with service users”. Complaints are managed well and people and their families are confident that any concerns will be taken seriously. Staff receive good quality training, and receive regular supervision to support them in their roles. Comments from someone recruited a few months previously: “The training has been fantastic”. Staff spoken to said they felt the home is well managed and enjoy working here. Comments included: “I come to my job happy every day”, “We aspire to provide the highest quality care and the service is well led by the manager and the senior”. The service is well-managed, for the benefit of the people living there. A comment by a person living at the home was: “it’s fantastic!” What has improved since the last inspection? The staff have found good ways to use the building so that people who do not get on well together have their own space. At the random inspection in February 2008, staff said they had noticed an improvement in the environment. They said it is much cleaner and that management have worked hard to try and make it more homely. Some redecoration has been done, and one person has had new bedroom furniture. Someone has also been assessed for a new bath that would meet his needs better, and this is on order. At this key inspection the home was fully staffed, for the first time, according to the manager. Apart from one person, there is a whole new staff team since this manager was placed there in an acting capacity two years ago. Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 Page 7 We spoke to four support staff during the visit, who gave very good feedback about their work. One said: “There is more consistency for the people we support. It’s much better now we’re fully staffed”. One person who had worked there for some time through an agency and was now a permanent support worker said there was a “huge difference” in how the staff team worked together now. Comments on staff surveys included: “The consistency of the staff team has improved this year, I hope this continues. The arrangements for monitoring the quality of the service and for consulting with people, their relatives and other professionals who they come into contact with, means that the team gets constant feedback about how they are doing. This is helping the service to develop and improve so that people get the best support. What they could do better: 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 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 Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 3 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although there are some areas of the Service User Guide that need updating, this is generally a useful and informative document that is presented in a suitable format and tells people what they need to know. The admission process follows good practice and makes sure that this is the right care setting for the individual; not only can their care needs be met, but that they get on with the others living there. This means that people get the support they need in the setting they are happy with. EVIDENCE: There are currently only three people living at the service, following a recent death. There is an enquiry in progress regarding a possible new person, so the process for this was looked at. Documents showed that the prospective client had visited the home with his parent, which had seemed to go quite well. The next step would be for the manager to carry out an initial assessment (CIC’s own Needs and Risk Assessment Form, which triggers support plans) and gauge the compatibility of Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 Page 10 the four people together. If the place is offered, then there will be a gradual easing in to the service, with overnight and weekend stays. The records showed that a Mental Capacity Act assessment had been carried out for this person. The information provided to the parent of this person included a DVD to view. We looked at the Service User Guide, which was quite user-friendly in most areas. However, some of the mission statements were not easy to understand and could be simplified. The document reflects diversity, mentioning religious faith, communication and relationships, and how the service makes sure that people are not denied access to these things because of their disability. The Guide also contained CSCI inspection reports; however, these were very out of date, being from 2004 and 2006. Other information was also out of date, in particular the management and staffing details of the service, and the contact details for CQC within the section on complaints. Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Because the support plans are person centred and very detailed, they give staff the right information to support each person according to their individual needs. It is clearly noted where people can make choices and how they communicate these, which makes sure that staff know how much support people need to make decisions in their daily lives. EVIDENCE: Two people were case tracked, their care records looked at in depth and crossreferenced with other documents. Conversation was had with one person and support was observed with others, to give a flavour of how the written support plans are put into action. Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 Page 12 One person was going on holiday on the day of the visit and told us how excited he was about this. This man is a wheelchair user, so a mobility assessment had been carried out for his holiday accommodation. The support plans provided sufficient detail for any staff member to know his routine and how he wishes to be supported. There was evidence in care records that one person had recently had a multidisciplinary review of his placement. The records showed how decisions had been made in his best interests, as he has no verbal communication and is unable to voice an opinion. Staff spoke about how they know through certain behaviours how this man is feeling about something. This was also detailed in his support plans. The new support plans appear to be developing well. They are person-centred and are providing the staff, and other professionals involved with individuals, with the information they need to support each individual fully. Risk assessments provide the basis for the support plans. There are still tensions between two people living at the home. They are able to be kept separate for most of the time, because the building lends itself favourably to providing space for this. The current arrangements were explored: one person uses the conservatory, where he has the things he likes to do. He clearly dislikes anyone to invade his space. The other person has a dining room (his former bedroom) where he enjoys his own pursuits. The remaining person currently has exclusive use of the communal lounge and the dining kitchen, but was also seen to spend time sitting in the main hall. Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 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): This is what people staying in this care home experience: 12, 13, 15, 16 & 17 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to use the facilities and shops in the local community, maintain contact with their family, and go further afield on holiday, all of which contribute to them leading fulfilling and interesting lives. People’s wishes are respected, shown by the flexibility of the house routines. EVIDENCE: All of the people living at the service have 1:1 support for their daytime activities. We spoke to one man who was waiting to set off on holiday, going to Blackpool for five days, with three support staff accompanying him. He said he was very excited about this. He attends day services three times a week and also has 1:1 support whilst at home. He likes to travel by train. He also said that he likes to be involved with shopping and meals. He has started Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 Page 14 doing some home baking with a staff member - both of them are learning together. At home, he plays with Lego and sorts playing cards, and has a room where he does these activities. He also has his meals in here, supported by staff, on his own with no distractions. He has a listening device in his room at night, the reasons for which are documented in his risk assessments and support plans. Another person attends day services 5 days per week. At home, he spends time in the conservatory in his hammock. We were taken in to meet him and promptly escorted by him back out of the door. Staff said that he responds better to day trips than longer holidays and was recently taken on a barge trip for the day, which the staff (and his mother) were thrilled to see his positive response to. Another person attends day services twice a week. His mother visits him every week, collected by the support staff by car. He likes rides out in the house vehicle and gets a lot of use out of this. Staff said that he has recently started going to the hairdresser locally. He will sit for long enough to get his hair cut, then go for a pint of Guinness afterwards. He has his own caravan on a holiday park and enjoys going there. His survey indicated that he would like to be able to go out more often. All of the people living at the house contribute their mobility benefit towards the upkeep of the vehicle, and are then charged for fuel according to the mileage used. Some people get much more use out of the vehicle than others, therefore they contribute more accordingly. Menus were seen. These showed a good range of meals, with sufficient flexibility on a day to day basis to meet people’s individual wishes. The staff team are putting more emphasis on home-cooked meals rather than convenience foods. Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal support that is flexible, consistent and responsive to their changing needs. People’s health care needs are met. EVIDENCE: Some people will not allow invasive treatment by medical staff. An example is that the support staff are currently working with nurses from the Learning Disability team to de-sensitise one person so that blood samples can be taken. He needs blood tests to help diagnose a current health problem, but this cannot be achieved yet. If his behaviour starts to challenge the support staff on occasions, they work with other health and social care professionals and make use of behaviour charts to try and identify potential triggers for this. However, staff are always Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 Page 16 aware that there could be a medical cause, for changes in behaviour, hence the need for blood testing. The staff said that it had taken a long time, but they had successfully desensitised one person about having his toe-nails cut. Initially, the chiropodist could only do one nail but now all of them can be cut, a significant achievement for this man. Another person has mobility problems and now uses a wheelchair and a standing aid. He has a listening monitor in his room at night, to alert night staff to his well-being. He moved bedrooms last year into what was the dining room at the front of the house, due to mobility issues and tensions with another person living there that were a threat to his physical well-being. He has 1:1 support whilst at home and also for his personal care needs whilst at day services. Support plans that were seen reflected the detailed input required from the support workers in order to ensure his health and wellbeing. All of the Support Plans seen included a Mini Nutritional Assessment (MNA), one of CIC’s internal assessment tools, which identify who is at risk through not eating properly and how staff must support them. Keyworker meetings take place once a month and changes in peoples’ health are picked up and referred appropriately. Staff said they can tell if someone without verbal communication is feeling unwell, by their knowledge of that person’s normal behaviour. Each person has a Health Action Plan included in their care notes. This includes a useful section for staff about the side effects of medication being taken by them. The manager reports that the service gets really good support from the health care professionals within the multi-disciplinary team. One of the support staff took me through the medication, its’ storage, recording and administration. Recording was good and there were no issues noted with the system in place. Staff have been through an assessment of their competency to administer medication, the certificates of which were seen. Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People who use the 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 have a good level of training and are confident they know what constitutes abuse, but the procedure to follow if abuse is detected needs to be updated. This is to make sure that people are properly protected. Complaints are managed well and people and their families are confident that they can raise concerns and they will be taken seriously. EVIDENCE: We looked at the procedure for safeguarding money. Support staff were observed going through the normal daily process of handing over the finances to the key-holder on the following shift. This is a robust system that will pick up any errors early. The complaints procedure was accessible and easy to follow. There was evidence in the records that the staff have worked to resolve complaints and concerns that have arisen from the families of people living there. The organisation has also shown that it takes complaints seriously and investigates them according to its own policies. Staff have had training in whistle-blowing and reporting concerns and were knowledgeable about how to make sure that the people they work with are Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 Page 18 safeguarded from abuse. However, what was not clear was what the procedure would be for the manager to follow if a staff member did report some abuse, for example. It was difficult to find a local policy on abuse. When this policy was located, it was found to mention the Leeds multi-agency protection procedures, but the home did not have a copy of these. It is essential that a copy of the local safeguarding procedure is obtained and that senior staff are familiar with it. It would also be good practice for the service’s policy on safeguarding to be made available to people’s families, friends and advocates, so that they know what they can expect from the service if an incident does occur. Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 28 & 30 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean, well-maintained and safe environment that meets their diverse needs. EVIDENCE: A tour of the house was carried out. We looked specifically at the arrangements in practice now that a bedroom has been swapped with the previous dining room. The person’s new room is very spacious and has plenty of room for his wheelchair, and other mobility equipment. The notes from his recent review highlighted that he needed new bedroom furniture, which he has now got, and that he needed a different bath to accommodate his disability. The manager said that this was in progress. Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 Page 20 His former room now contains a dining table, but this room is only used by him – he eats separately in here, assisted by the staff, and uses his Lego, etc., on the table. The rest of the people eat at the dining table in the kitchen. Staff reported that this arrangement is working well and that they were much more successful at reducing the tensions in the house, by separating the two people involved in negative interactions with each other. There appears to be enough room to allow different people to do different things without impinging on each other. Beyond the TV lounge there is a conservatory area where one person likes to spend time in his hammock, mostly on his own, although staff can easily observe him from the lounge. Everywhere that was seen was clean and well maintained (some decorating has been done) and general safety standards were good. One of the support staff told me that he does the regular maintenance checks on the house, as well as carrying out the weekly fire safety checks. Records were seen that confirmed this. In the fire safety records there was a good account of an issue that had arisen regarding personal safety for someone during an evacuation drill. Their risk assessment and corresponding support plan had been updated accordingly. Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by a staff team that have the necessary skills and training to deliver good quality care. The staff team is now settling down after a disruptive period of change and are working more consistently together, which benefits the people they support. EVIDENCE: At the random inspection in February 2008, we found that a lot of agency staff were working at the home, although many of the same agency workers have been covering the shifts. We looked at the staff rotas but it was difficult to work out which staff had covered some shifts. At that visit, staff said the team worked very well together, although they had been under pressure because of the staffing problems. They said ‘shifts are well organised’ and they understand ‘what needs doing’. Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 Page 22 At this key inspection the home was fully staffed, for the first time, according to the manager. Apart from one person, there is a whole new staff team since this manager was placed there in an acting capacity two years ago. We spoke to four support staff during the visit, who gave very good feedback about their work. One said “It’s a good group of people to work with. There is more consistency for the people we support. It’s much better now we’re fully staffed”. One person who had worked there for some time through an agency and was now a permanent support worker said there was a “huge difference” in how the staff team worked together now. Another person had been there for only a few months, said “The training has been fantastic”. We looked at the personnel records for two recently recruited staff. These contained all of the required information for their recruitment. They also contained evidence that structured induction training had been carried out, followed up by training specific to that care setting, such as person-centred planning and crisis prevention. Records showed that people had supervision every 6 -8 weeks. This was also confirmed on the staff surveys that were returned following the site visit. The senior support worker will be starting NVQ (National Vocational Qualifications) at level 3 this autumn and another three will be starting level 2. The staff rotas showed that there are currently two staff on duty as a minimum during the day, unless one person who has 1:1 support is at home, in which case there is an extra support worker. There is one waking night staff and one sleeping-in on call. Although with only three people currently resident, these staffing levels do allow for individuals to go out at evenings and weekends, it must be kept under review and increased if necessary once the vacant place is filled. One of the people living there can be actively involved in staff selection. Interviews are held at the home and candidates invited to meet the people living there beforehand. Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 40, 41 & 42 People who use the 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 is well-managed, for the benefit of the people living there. The arrangements for monitoring the quality of the service and for consulting with people, their relatives and other professionals who they come into contact with, means that the team gets constant feedback about how they are doing. This is helping the service to develop and improve so that people get the best support. EVIDENCE: Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 Page 24 At the random inspection in February 2008, staff said they thought things were well organised, and the two staff on duty were happy with the management arrangements. They said the acting manager was introducing positive changes. A manager from another home had been working at the home on a full time basis and had been supporting the acting manager. The acting manager said she had received good support. At this key inspection, the acting manager said that she continued to receive good support from her immediate Line Manager, who is the person who carries out the monthly internal monitoring visits. The services in Leeds have a managers’ meeting once a month and use each other for mutual support. For example, the manager at one of the other services has supported her in carrying out the assessment process with the new person referred. She felt that when she arrived two years ago, there was a lot of work needed in order to bring the home up to standard. She is aware that there is still work to do, but she is satisfied that things are going in the right direction. She is applying to CQC for registration as manager of the home. Staff spoken to said they felt the home is well managed and enjoy working here. Comments included: “We support people to live a full and happy life”, “I come to my job happy every day”, “We aspire to provide the highest quality care and the service is well led by the manager and the senior”, “The consistency of the staff team has improved this year, I hope this continues”, “There is fantastic communication within the house and with outside agencies that work with service users” Records were looked at, including: support plans and daily records, accident records, medication records, complaints records, financial records, menus, cleaning schedules, maintenance records, fire safety records, staff files, training records, staffing rotas, minutes of staff meetings and the results of internal stakeholder surveys. Records were easy to follow and the home’s policies are in the main accessible and easy to read. A comment by a person living at the home was, “it’s fantastic!” Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 Page 25 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 3 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 2 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 2 3 3 X Version 5.3 Page 26 Pinfold Lane DS0000001491.V377672.R01.S.doc 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 YA1 Regulation 5 Requirement The Service User Guide must contain up to date information, regarding the management and staffing arrangements, the current contact details for CQC in the Complaints section, and the most recent inspection report. This is so that people have all of the information they need about the service, so that they can make an informed choice about where to live. All staff must have easy access to the local authority’s adult protection procedures. This is so that any suspicions or instances of abuse are reported correctly and vulnerable people are safeguarded. All written policies and procedures must be up to date. This is so that people’s rights and best interests are safeguarded. Timescale for action 24/02/10 2 YA23 12 24/11/09 3 YA40 12 24/11/09 Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 Page 27 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 YA1 YA23 Good Practice Recommendations It would be good practice to simplify some of the language used within the Service User Guide, and use plain English, so that it is more accessible to people. It would be good practice to share the policy about adult protection with people and their families and advocates, in a suitable format, so that they know what to expect if an incident occurred. Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 Page 28 Care Quality Commission Care Quality Commission Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Pinfold Lane DS0000001491.V377672.R01.S.doc Version 5.3 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!