Care Home: Raby Hall

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What the care home does well The service continues to employ longstanding members of staff who offer great stability to the home. Members of the staff team appeared to know people well and have formed good relationships. Comments made were quite positive including, "all staff have been here a long while and have built up good rapports and knowledge about each of the clients, especially regarding their behaviour, communication, needs and choices....." Some people are provided with work experience and attend local college courses in accordance with their wishes and abilities. Regular checks are made on the safety of the building and equipment to make sure the service is a safe place to live. What has improved since the last inspection? The service has produced good information and brochures about each of the houses which uses pictures and large print. They give these documents to people who are thinking about moving there. They have procedures in place for assessing peoples needs including trial visits and overnight visits to help people make a choice about the service. The society`s aims and plans for the future are published in a document called, " Our future strategy for 08/09-2012/13". This has helped to keep everyone involved and updated with the aims of the organisation. The personal support plans gave enough information to show how each persons personal care and support would be met. Some care plans have enough information to show how they would be supported with a range of diverse needs including their behaviour and communication. Staff described a recent trial they had been asked to be involved with regarding implementing new health care assessments. They were called "anticipatory care calenders for clients and learning disability baseline assessments." They are national assessments that will eventually be used within the country but were initially trialed at Raby Hall to help pick on on specific health needs. This is an example of how much input and development the organisation go to, to continually improve the support and care provided at Raby Hall. Medications are appropriately managed, providing a safe system of supporting people with the administration and storage of their medications. The service had procedures for responding to concerns and complaints and for making sure that people have a pictorial complaints procedure which is clear to read and understand.Staff explained that they had organized various holidays for some people and supported each of them with their trips out. Recent trips had included Pwelli, Poland and the Munich beer festival and a trip out on a narrow boat. We have received 4 staff surveys all positive and staff had ticked the boxes indicating no problems, comments made included, "The courses provided during the induction are thorough and informative and enable the staff to do the job to the highest standards." "All training is relevant and often essential to my role, staff are given quite regular updated training and have the opportunity to do NVQ( care qualification) in care." Staff explained that they had recently been funded and supported to do a specialised training certificate with the national Autistic society. This gave them even further specialised insight in how to support someone with autism. This was a good example of the commitment of the organisation to invest in specific training courses so that staff are up to date and able to provide specialised support to people living at Raby Hall. A staff satisfaction survey dated Oct 08 was overall very positive with 3/4 of the staff team, "...feeling the society is a good place to work..." We also received 4 comment cards from people living at Raby Hall, which were overall quite positive and included comments such as, "I get on well with the staff." We looked at the summary of a recent relatives survey in march 08. It contained alot of positive comments. Some comments said, "general care is excellent." What the care home could do better: Full feed back was given to the manager and staff both during and on conclusion of our visit. The Manager should have clear procedures and records to show how each persons finances are managed. This will help to provide clear and transparent financial procedures accessible to everyone. People should be included in the management procedures offered in managing their finances. Capacity assessments will help show they are managed in each persons best interest. To provide a clear plan of what maintenance the organisation will fund and carry out to enhance the living conditions. This should include dates of when specific repairs and refurbishment will take place. This will help to keep everyone at Raby Hall informed and included in the developments of their home. Staff training records must be up to date to make sure that staff are updated in their practice and able to safely and appropriately support people living at Raby Hall. Various unpleasant smells needed further review and investigation so that action can be taken to get rid of these smells to enhance the living conditions at the service. A review of cleaning schedules and responsibilities should take place so that a good standard of cleanliness is provided at the service at all times. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Raby Hall Raby Hall Road Bromborough Wirral CH63 0NN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Diane Sharrock     Date: 1 8 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: Raby Hall Raby Hall Road Bromborough Wirral CH63 0NN 01513347510 01513341762 carl.kipling@was.demon.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Carl Joseph Kipling Type of registration: Number of places registered: Wirral Autistic Society care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Raby Hall is registered to provide personal care and accommodation to 27 adults who have autism. The home consists of four units. Old Hall, Respite Unit, The Courtyard and The Lodge. People are accommodated in single bedrooms and have access to communal bathrooms and toilet facilities. Lounges and dining rooms are available for communal use. There is access to a domestic style kitchen within each of the houses. The home is set within extensive grounds. People are accommodated in the unit of Raby Hall most suited to their needs and a programme of education, employment or training is provided as appropriate. The home is close to local shops and to public transport services. Parking is available. The weekly cost for the service ranged from 1148.00 pounds to 2315.00. pounds. A statement of purpose, which describes the services offered at Raby Hall is available for relatives and social and health care professionals to refer to. A service user guide that is suited to the needs of the people 27 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 32 Brief description of the care home living there is openly available. The registered manager Mr Carl Kipling has worked with within the service for over 15 years. Care Homes for Adults (18-65 years) Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The overall quality rating for this service is 2 star. This means that people who use the service experience good quality outcomes. This unannounced visit took place on the 18 Th December 2008 over a period of 7 hours. This was carried out with the help of the registered manager and the staff on duty. We gathered information for this visit in a number of ways. We (the commission) looked at records and included both staff and people living at the services comments and opinions. Observations made during our visit have also been used as evidence for this report. Care Homes for Adults (18-65 years) Page 6 of 32 Case tracking was used as part of the visit to the service. This involves looking at the support and care a person gets from the staff including their care plans, medication, money and their living conditions. We also spent time meeting both staff and people living there. Inspections involve measuring a number of standards considered as important by the commission. A selection of comment cards were also sent before the inspection and we left some more to offer people further opportunity to give their opinions. The manager completed a questionnaire we sent before our visit. The information from this was used by us to plan this visit and in writing this report. The document was completed and was returned to the commission before this visit took place. What the care home does well: What has improved since the last inspection? The service has produced good information and brochures about each of the houses which uses pictures and large print. They give these documents to people who are thinking about moving there. They have procedures in place for assessing peoples needs including trial visits and overnight visits to help people make a choice about the service. The societys aims and plans for the future are published in a document called, Our future strategy for 08/09-2012/13. This has helped to keep everyone involved and updated with the aims of the organisation. The personal support plans gave enough information to show how each persons personal care and support would be met. Some care plans have enough information to show how they would be supported with a range of diverse needs including their behaviour and communication. Staff described a recent trial they had been asked to be involved with regarding implementing new health care assessments. They were called anticipatory care calenders for clients and learning disability baseline assessments. They are national assessments that will eventually be used within the country but were initially trialed at Raby Hall to help pick on on specific health needs. This is an example of how much input and development the organisation go to, to continually improve the support and care provided at Raby Hall. Medications are appropriately managed, providing a safe system of supporting people with the administration and storage of their medications. The service had procedures for responding to concerns and complaints and for making sure that people have a pictorial complaints procedure which is clear to read and understand. Care Homes for Adults (18-65 years) Page 8 of 32 Staff explained that they had organized various holidays for some people and supported each of them with their trips out. Recent trips had included Pwelli, Poland and the Munich beer festival and a trip out on a narrow boat. We have received 4 staff surveys all positive and staff had ticked the boxes indicating no problems, comments made included, The courses provided during the induction are thorough and informative and enable the staff to do the job to the highest standards. All training is relevant and often essential to my role, staff are given quite regular updated training and have the opportunity to do NVQ( care qualification) in care. Staff explained that they had recently been funded and supported to do a specialised training certificate with the national Autistic society. This gave them even further specialised insight in how to support someone with autism. This was a good example of the commitment of the organisation to invest in specific training courses so that staff are up to date and able to provide specialised support to people living at Raby Hall. A staff satisfaction survey dated Oct 08 was overall very positive with 3/4 of the staff team, ...feeling the society is a good place to work... We also received 4 comment cards from people living at Raby Hall, which were overall quite positive and included comments such as, I get on well with the staff. We looked at the summary of a recent relatives survey in march 08. It contained alot of positive comments. Some comments said, general care is excellent. What they could do better: Full feed back was given to the manager and staff both during and on conclusion of our visit. The Manager should have clear procedures and records to show how each persons finances are managed. This will help to provide clear and transparent financial procedures accessible to everyone. People should be included in the management procedures offered in managing their finances. Capacity assessments will help show they are managed in each persons best interest. To provide a clear plan of what maintenance the organisation will fund and carry out to enhance the living conditions. This should include dates of when specific repairs and refurbishment will take place. This will help to keep everyone at Raby Hall informed and included in the developments of their home. Staff training records must be up to date to make sure that staff are updated in their practice and able to safely and appropriately support people living at Raby Hall. Various unpleasant smells needed further review and investigation so that action can be taken to get rid of these smells to enhance the living conditions at the service. A review of cleaning schedules and responsibilities should take place so that a good standard of cleanliness is provided at the service at all times. Care Homes for Adults (18-65 years) Page 9 of 32 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 10 of 32 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 11 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good information is given to anyone thinking about living at Raby Hall. This makes sure that the service is the right place for the person to stay and that their needs can be met. Evidence: There is a good system to introduce people to the home with information provided about the service so they can choose to live at Raby Hall and know that their needs can be met. The manager has developed a service user guide and a statement of purpose which are available to anyone including any prospective person wanting to come to Raby Hall. The guide includes good levels of information on the purpose of the home and the facilities on offer and includes visual pictures which may help some people understand the information given. Care Homes for Adults (18-65 years) Page 12 of 32 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are detailed enough to show people how their needs and personal goals will be met and supported while living at Raby Hall. Evidence: Individual care plans were available for each person who lives at the service, we looked at three of them. The care plans have been reviewed and developed following the previous inspection visit and show that regular reviews are carried out by staff. The support plans gave enough information to show how each persons care and support would be met . Some care plans have enough information to show how they would be supported with a range of diverse needs including their behaviour or communication. They also gave detailed information about what each person likes and doesnt like including when they liked to go to bed and get up. One plan showed details for an aromatherapy treatment, were by a therapist calls to give a specialised treatment to help with relaxation. Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: Staff said they had a long standing team with staff being in place for many years. They felt this gave alot of stability to the service and staff knew peoples needs very well. The staff have developed records called, communication passports. They explained that a large majority of the people they support have non verbal forms of communication. These records are developed over time by staff who get to know each persons needs, choices and behaviours. The passports are a good example of the time taken by staff to produce records that help everyone to be kept updated in each persons likes, dislikes and choices, helping people be supported in all aspects of every day life. Staff were knowledgeable about the needs of people and knew how to meet their needs. For example staff were able to explain how various people preferred to be supported and how they wanted support so they can remain independent with some things such as, personal care and cleaning their home and doing laundry. Staff were observed to be respectful and seemed to have a good rapport with each of the people living at Raby Hall. We received 4 staff comment cards which were mainly very positive about the service and included comments such as, Clients needs and wishes are always put first. Information regarding clients is accurate and up to date. New clients seem to settle into the service well. Clients are given opportunities to develop their skills and experiences. We received 4 comment cards filled in by people living at the service which were mainly positive and some of the comments contained within the surveys included, I am happy. I get on well with the staff. I go to work during the day. We looked at a sample of financial records kept at the service of personal allowances which were well kept and accurate and in good order. However we visited head office as various records and management of peoples monies are carried out there. People did not have financial care plans or records in place showing clear and easy to understand procedures as to how their money was being managed or stored. There was no evidence of whether capacity assessments had taken place. It wasnt clear as to whether peoples mobility benefits were used for the use of communal minibuss or whether permission or assessment had been sought regarding the use and management of the minibus. Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: We could not find policies or procedures describing the current management of each persons finances. Care Homes for Adults (18-65 years) Page 15 of 32 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The individual needs and choices of activities for people living at Raby Hall are identified so that staff can support them to meet those needs and choices. Evidence: Relatives and staff have regular meetings to discuss the running of the service. We looked at these records which showed good discussions on everything keeping everyone informed and included in the developments of their home. In chatting to staff and looking at records they showed that staff support people to maintain family links and friendships. Records showed that families and friends are always welcome. During our visit we met some of the people who live at the home however most people were still out at work or at the day centre. Some people are provided with work experience and attend local college courses in accordance with their wishes and Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: abilities. Staff explained that they had organized various holidays for some people and supported each of them with their trips out. Recent trips had included Pwelli, Poland and the Munich beer festival and a trip out on a narrow boat. Staff explained that people pay for their own holidays and there was no fund provided by the company. Discussion took place around the national minimum standards were its advised as good practice that the organisation should provide at least one holiday each year for each person living at Raby Hall. The service has its own minibus which was in use during our visit. The records around the management and funding of the communal minibus wasnt clear. This needs to be reviewed to show that everyone is included and in agreement to the current arrangements regarding who manages, maintains and funds this service. Care plans and information kept by the chef help to provide good dietary requirements for everyone, including details of special diets, personal choices and requests. Care Homes for Adults (18-65 years) Page 17 of 32 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Raby Hall have their needs met and their care is provided in a manner that protects their privacy and dignity. Evidence: The individual needs and choices of the people staying at Raby Hall are identified so that staff can support them to meet those needs. Individual care plans were available for each person, we looked at three of them. The plans had been recently updated and revised and gave information to show how their personal care and support would be met. The plans provided staff with guidance and were appropriate instructions as to the support each person required. They also included enough detail to show how they support people with their health care needs including regular dental, podiatrist and optical check ups. We met some people living at the service and generally chatted to the staff during our visit. Most comments made were quite positive including, all staff have been here a Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: long while and have built up good rapports and knowledge about each of the clients especially regarding their behaviour, communication, needs and choices. In discussions with staff they were able to explain the way in which people staying at Raby Hall make decisions and how they are able to plan on keeping healthy, for example, staff support people in going to health care appointments at the doctors and to the hospital to help keep healthy and up to date with their health needs. Staff also described a recent trial they had been asked to be involved with regarding implementing new health care assessments called anticipatory care calenders for clients and learning disability baseline assessments. They explained it was a national assessment that will eventually be used within the country but was initially trialed at Raby Hall to help pick on on specific health needs. This is another example of how much input and development the organisation go to, to continually improve the support and care provided at Raby Hall. We looked at the management of medications and found that they were appropriately managed, providing a safe system of supporting people with the administration and storage of their medications. Care Homes for Adults (18-65 years) Page 19 of 32 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are handled well and taken seriously ensuring people feel listened to. Evidence: Information about how to raise a concern or complaint is made available to the people living at Raby Hall. This is good practice as it helps to increase the opportunities for people using the service to have a better understanding of the ways in which they can raise concerns. We looked at some of the complaint forms that had picture formats that some people had recently chosen to use. These forms helped staff to offer feedback and support to help resolve each persons complaint and showed how they listened and acted upon each persons opinions. The staff have notified the commission of several incidents mainly regarding challenging behaviour. These notifications explained how they followed the local safeguarding procedures showing that they are acting appropriately in trying to support and safeguard each person. Some of the staff we chatted to described various training that they had attended including, complaints,safeguarding and abuse awareness. However in looking at training records it was noted that some records had not been updated and were in Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: need of review. We looked at the management of financial records for personal allowances for 3 people and these were found to be accurately managed and detailed. However we visited head office as various records and management of each persons monies are carried out there. People at the service did not have financial care plans or records in place showing easy to understand procedures as to how their money was being managed or stored. Care Homes for Adults (18-65 years) Page 21 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in an comfortable and safe home. Evidence: We looked at a sample of maintenance certificates which showed up to date checks as listed in the homes pre inspection questionnaire. This helped show what actions were taken to keep the home safe and well maintained. We noticed that most of the certificate and maintenance checks are kept in the main head office and the manager didnt always have access to them. We discussed the managers legal responsibility in being aware and making sure that all of the registered houses within Raby Hall had up to date checks in place to show clear evidence that they are allways safely maintained. We looked at a sample of areas and bedrooms within the service. There are various sizes to the bedrooms, some larger than others. Some bedrooms are very personalised and reflect each persons character and personality with lots of personalised items. Some bedrooms are bare and reflected the persons needs. Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: Most areas were clean and tidy and offered an adequate standard to live in. Some areas in some of the bathrooms needed cleaning and dusting. Staff felt that some of the people living at Raby Hall are supported in keeping some areas clean. Most of the comment cards received by people before our visit said they were happy with the cleanliness and management of the environment however, two people felt the home was, usually clean and fresh. We discussed some unpleasant smells near the main office and in one bathroom. These needed further review and investigation so that action could be taken to get rid of any unpleasant smells to enhance the living conditions at the home. The manager and staff explained that they had tried to refurbish and develop the building over a number of years to try and make it more homely and domestic in style. However they acknowledged this had been difficult in some areas due to the size and style of the building. The manager has produced a very detailed maintenance and refurbishment list covering all of the houses identifying what developments, decoration, and repair could be done to offer further improvements to the living facilities. Some areas included, eg to have new sofas in the panel room. The plan has an approximated date for purchase of, early next year, but no confirmed dates. The plan also requests a dishwasher in the small kitchen again no confirmed dated just says new year. Care Homes for Adults (18-65 years) Page 23 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home are supported by a team of staff who know them well. Evidence: Records showed that before anyone is appointed to work at Raby Hall they have a series of checks that are carried out. These include obtaining written references and checking with the criminal records bureau (CRB). These checks help to make sure the people living there are safe and that staff are suitable to support them. Observation of staff and discussions with them indicate that the staff know the needs of the people well and know their likes and dislikes. It was evident the staff had a good understanding of how to support people at Raby Hall. Especially with specific needs including challenging behaviours and support associated with autism and how to make sure their needs are met and their individuality respected and catered for. Some staff explained that they had recently been funded and supported to do a specialised training certificate with the national Autistic society. They felt it gave even further specialised insight in how to support someone with autism. This was a good example of the commitment of the organisation to invest in specific Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: training courses so that staff are up to date and able to provide specialised support to people living at Raby Hall. We have received 4 staff surveys all positive and they ticked the boxes indicating no problems. Comments made included, The courses provided during the induction are thorough and informative and enable the staff to do the job to the highest standards. All training is relevant and often essential to my role, staff are given quite regular updated training and have the opportunity to do NVQ (care qualification) in care. We also received 4 comment cards from people living at Raby Hall, which were overall quite positive and included comments such as, I get on well with the staff. We spoke with staff and looked at staff training records which showed what training had been provided. Most of the records were kept at head office and the manager had requested an update of staff training so that his inhouse records could be up to date. Some staff records were up to date however some records had not been updated so it was unclear as to whether certain people were uptodate with all of their training needs. Staff explained they mainly have long standing members of staff and rarely have new staff which showed the stability of the current staff team Care Homes for Adults (18-65 years) Page 25 of 32 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well managed, safe home. Evidence: The home is visited on a regular basis by a representative of the organisation. These visits form part of the quality assurance process and form an opinion on the standard of care and support provided. These visits are also a requirement of the care home regulations and a report has to be produced to show evidence of these checks. We looked at a sample of these checks which showed detailed areas looked at by senior staff which helped give additional management and review of standards within the service. Records and certificates showed that regular checks are carried out on the building and equipment. This includes checking electrical appliances and the gas supply. These checks help to make sure that the environment is well managed and is a safe Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: place to live and work in. Most of these certificates are kept at head office as recorded under the section headed, environment. The manager has been honest in describing the work and development carried out over the years to try and change and improve the services and environment at Raby Hall. Some areas of development have been difficult to achieve due to the size and age of the building. However developments are ongoing and staff explained that they will continue to develop and explore areas of achieving ways to always benefit people living there. The manager has worked at the home over 15 years and has alot of experience with the client group and has extensive knowledge and training in autism. There were various comments and compliments from staff regarding the manager and his role within the service. Staff comments were very positive about working within the organisation and staff comment cards were also very positive, one comment stated, I have regular contact and support from my team leader and quite regular contact with the manager of the unit. The manager showed us a publication of a recent staff satisfaction survey dated oct 08. Overall it was very positive with 3/4 of the staff team epressed comments such as, feeling the society is a good place to work. The manager was able to use the survey for a benchmark to the future as over 137 staff had filled in the survey. Staff explained that the chief executive of the company had been to staff meetings following the survey to discuss the published findings and to talk about the societys aims and plans for the future. This published document was called, Our future strategy for 08/09-2012/13. This has helped to keep everyone involved and updated with the aims of the organisation. We looked at the summary of a recent relatives survey dated march 08. It contained alot of positive comments. The manager explained they do this yearly to obtain peoples opinions about the service. Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: Some comments said, general care is excellent. The manager explained that various records such as maintenance certificates, personnel files, training records and financial records are kept at head office. This meant that the manager was not always in receipt of nessessary records covering all four houses at Raby Hall. We discussed the managers responsibilities within the care home regulations wereby all necessary information should be accessible to him. This will allow him to evidence that they are safely managed and show evidence of good practice and management of the training, finances, personnel and maintenance and safety checks. Care Homes for Adults (18-65 years) Page 28 of 32 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 29 of 32 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 20 To have updated financial 16/06/2009 records, care plans in place. To provide people with the name of the appointee and summaries of financial procedures. These records must be clear and accessible to everyone residing at Raby Hall and their representatives. To show clear and transparent records as to how each persons monies, benefits are managed and safeguarded. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 The Manager should have clear procedures and records to show how each persons finances are managed. This will help to evidence they are kept in the best interest of everyone living in all four houses at Raby Hall. People should be included in the management procedures offered in managing their finances and capacity assessments will help show they are managed in each persons best interest. Page 30 of 32 Care Homes for Adults (18-65 years) 2 14 The organisation should look at the feesability of being able to financially provide at least one holiday each year for each person living at Raby Hall. Various unpleasant smells needed further review and investigation so that action can be taken to get rid of these smells to enhance the living conditions at the service. A review of cleaning schedules and responsibilities should be reviewed so that a good standard of cleanliness is provided at the service at all times. To provide a clear plan of what developments the organisation will fund and carry out to enhance the living conditions. This should include clear dates of when specific repairs and refurbishment will take place. This will help to keep everyone at Raby Hall informed and included in the developments of their home. The manager should be kept upto date with all necessary personnel records for every member of staff employed at Raby Hall. These staff files are usually kept at head office and the manager needs to be aware that all staff have necessary checks in place to ensure they are suitable for their staff role at the service. To have updated individual training and development plans for each member of staff so they can be supported with updated training to help them with their job roles. The manager should have access to updated records for all staff working within each house at Raby Hall so he can identify and plan updated training for staff so they are up to date with skills necessary for their job role.. The manager should have all necessary information accessible to him so that he can evidence they are safely managed and show evidence of good practice and management of the training, finances, personnel and maintenance and safety checks. 3 24 4 24 5 34 6 35 7 39 Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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