Care Home: Raynel Drive

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What the care home does well The home has a friendly, relaxed and welcoming atmosphere. The manager offers a flexible respite service and tries to accommodate individual needs. Staff have a good knowledge of the needs of the people who use the service and respond well to them. Staff interact well with them and treat them as individuals. In a returned survey from a health professional they said, "They meet the individual care needs of service users." A parent who returned a survey said, "Care staff always welcome .... and treat all residents as individuals", another said, "They consider individual needs of each client." Support plans are person centred and reviewed before each visit to make sure information is up to date. One staff said, "The most important tool for us is the support plan", another said how important it is to become familiar with the support plan before each person`s stay so that they are familiar with the person`s needs. Staff have a good understanding of the diverse and cultural needs of people who use the service. Staff make sure that people who use the service have regular and varied activity that suits them as individuals. Comments received in returned surveys included, "I like going to Raynel Drive", "I like it here, it`s good fun", "Social outings are appropriate and stimulating" "He goes happy and comes home happy". Staff are well supported by the manager of the home. All staff spoken to said the manager was approachable and was a good leader. What has improved since the last inspection? The home has made good progress on meeting the requirements and recommendations made at the last inspection. Support plans have been developed to give more person centred information. They are now signed by people who use the service or their parents to show they are in agreement with them. Risk assessments are now reviewed before every stay at the home to make sure they are up to date.More thought has been given to assessing people`s individual needs with regard to risk taking in order to protect their rights. The home`s medication policy has been updated. There is a new boundary fence in the garden which makes the garden more secure and attractive. Foodstuffs are now stored correctly according to the manufacturers instructions. Infection control is well managed. Recruitment records are now available in the home for inspection. Staff have received training in cultural awareness and diversity. The manager now sits on the allocations panel which makes sure he is involved fully in pre-admission assessments for people who may use the service. Staff have received advice on nutrition and healthy eating and are now putting this into practice. What the care home could do better: The Statement of Purpose and Service User Guide have now been completed, but should now be made available to people who use the service so that information is available to help people decide if the home can meet their needs. The manager should make sure that all support plans link with risk assessments and other guidelines for people who use the service. This will make sure that care needs are not overlooked. The manager must make sure that copies of the complaints procedure are available to all people who use the service and their relatives and anyone acting on behalf of them. This will make sure that people can air their views properly. The manager should give some consideration to reviewing the staffing ratios when people who use the service need two to one support. This will make surethere are sufficient staff to meet the needs of the people who use the service at all times. The manager should review the training needs of staff with regard to management of behaviour that challenges others and safe use of restraint or diffusion techniques to make sure staff`s skills are up to date. CARE HOME ADULTS 18-65 Raynel Drive 9 Raynel Drive Ireland Wood Leeds LS16 6BS Lead Inspector Dawn Navesey Key Unannounced Inspection 11th July 2007 11:30 Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Raynel Drive Address 9 Raynel Drive Ireland Wood Leeds LS16 6BS 0113 2678042 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) Leeds City Council Department of Social Services Mr Joseph Bernard Doyle Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th August 2006 Brief Description of the Service: Raynel Drive is a detached house, with five single bedrooms, providing short term and respite care for young adults with a learning disability. In order to cater for individual need, the service can be booked either weekly or on a flexible basis for a weekend or part weeks. The home is situated in north Leeds near to local shops, public houses, several churches and a sports centre. The bus routes, with nearby bus stops, run to Leeds City Centre, Horsforth and Otley. The accommodation consists of a bathroom and shower room, kitchen, lounge and a dining room. There is a separate laundry room. People who use the service are encouraged to make full use of the facilities in the house and garden, which include a television, DVD player and music system. On the 11th July 2007 the manager confirmed that the fees ranged from £7.37 to £9.13 per night. The home keeps copies of previous inspection reports on the notice board in the entrance hall which means that they are now more easily accessible to people. Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In April 2006 the Commission for Social Care Inspection (CSCI) made some changes to the way in which care services are inspected. Care services are now judged against outcome groups. The inspection report is divided into separate sections for each outcome group for example Choice of Home. An overall judgement is made for each outcome group based on the findings of the inspection. The judgements reflect how well the service delivers outcomes to the people using the service. The judgements categories are “excellent”, “good”, “adequate” and “poor”. The judgements are recorded within the main body of this report. More detailed information about these changes is available on our website – www.csci.org.uk One inspector between 11-30am and 6pm carried out this unannounced inspection. The purpose of this inspection was to make sure the home was providing a good standard of care for the people who use the service. And to monitor progress on the requirements and recommendations made at the last inspection of 8 August 2006. The methods used at this inspection included looking at care records, observing working practices and talking with people who use the service and staff. Information gained from a pre-inspection questionnaire and the home’s service history records were also used. Before the visit, survey cards were sent out to people who use the service, relatives and visiting professionals to the home. A number of these have been returned and this information has also been used in the preparation of this report. Telephone conversations with relatives also took place. Feedback was given to the manager at the end of the visit. Thank you to everyone for the pre-inspection information, returned comment card and for the hospitality and assistance on the day of the visit. Requirements and recommendations made during this visit can be found at the end of the report. What the service does well: Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 6 The home has a friendly, relaxed and welcoming atmosphere. The manager offers a flexible respite service and tries to accommodate individual needs. Staff have a good knowledge of the needs of the people who use the service and respond well to them. Staff interact well with them and treat them as individuals. In a returned survey from a health professional they said, “They meet the individual care needs of service users.” A parent who returned a survey said, “Care staff always welcome …. and treat all residents as individuals”, another said, “They consider individual needs of each client.” Support plans are person centred and reviewed before each visit to make sure information is up to date. One staff said, “The most important tool for us is the support plan”, another said how important it is to become familiar with the support plan before each person’s stay so that they are familiar with the person’s needs. Staff have a good understanding of the diverse and cultural needs of people who use the service. Staff make sure that people who use the service have regular and varied activity that suits them as individuals. Comments received in returned surveys included, “I like going to Raynel Drive”, “I like it here, it’s good fun”, “Social outings are appropriate and stimulating” “He goes happy and comes home happy”. Staff are well supported by the manager of the home. All staff spoken to said the manager was approachable and was a good leader. What has improved since the last inspection? The home has made good progress on meeting the requirements and recommendations made at the last inspection. Support plans have been developed to give more person centred information. They are now signed by people who use the service or their parents to show they are in agreement with them. Risk assessments are now reviewed before every stay at the home to make sure they are up to date. Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 7 More thought has been given to assessing people’s individual needs with regard to risk taking in order to protect their rights. The home’s medication policy has been updated. There is a new boundary fence in the garden which makes the garden more secure and attractive. Foodstuffs are now stored correctly according to the manufacturers instructions. Infection control is well managed. Recruitment records are now available in the home for inspection. Staff have received training in cultural awareness and diversity. The manager now sits on the allocations panel which makes sure he is involved fully in pre-admission assessments for people who may use the service. Staff have received advice on nutrition and healthy eating and are now putting this into practice. What they could do better: The Statement of Purpose and Service User Guide have now been completed, but should now be made available to people who use the service so that information is available to help people decide if the home can meet their needs. The manager should make sure that all support plans link with risk assessments and other guidelines for people who use the service. This will make sure that care needs are not overlooked. The manager must make sure that copies of the complaints procedure are available to all people who use the service and their relatives and anyone acting on behalf of them. This will make sure that people can air their views properly. The manager should give some consideration to reviewing the staffing ratios when people who use the service need two to one support. This will make sure Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 8 there are sufficient staff to meet the needs of the people who use the service at all times. The manager should review the training needs of staff with regard to management of behaviour that challenges others and safe use of restraint or diffusion techniques to make sure staff’s skills are up to date. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 9 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 Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,5 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service and their relatives can be sure that the home will meet their needs following assessment before moving into the home. However, written information about the home is not comprehensive enough for them to decide whether the home will meet their needs. EVIDENCE: Work has been done to develop the home’s Statement of Purpose and Service User Guide. However, this has not been completed yet as the organisation wants to make sure that any documents go through their quality control. This is holding up the process and means that the documents have not been given to people who use the service or their families. The manager has worked hard to produce an informative guide that is relevant to this particular service and is keen to distribute this information. The information in both documents is clear and easy words have been used. A smaller guide to the service has been produced and distributed to people who use the service. This does not have Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 11 the level of detail that the proposed Service User Guide has. It has however, been produced in an easy read format with the use of symbols and pictures. A parent of a person who uses the service said they felt they got enough information about the service before they started to use it and had made a choice to use this service rather than another that was on offer. A person who uses the service said, “I like going to Raynel Drive”. Another said, “I like it here, it’s good fun.” Pre-admission assessments are carried out for all people who may use the service before they stay at the home. This involves visits to the home, overnight stays and the manager or staff going to visit people in their own home. This also now means that the manager sits on an allocations panel and can advise at that point if the home can meet a person’s needs. Parents, carers and people who are to use the service are involved in this process. In a returned survey a parent said, “They were very accommodating and offered a variety of times and dates to visit”, another said, “ …..visited the home and built up to overnight stays”. It is clear that information is gathered from a number of sources such as care managers, community nurses and day centre staff as part of the assessment process. An assessment of the needs of people who use the service takes place before every visit to the home. Key workers contact carers to ask if any changes are needed to the support plan. This is good practice. In a returned survey a parent said, “They contact me prior to each stay to ask if there has been any changes”. The organisation has now produced a contract for people who use the service. This will show in detail the terms and conditions of the service. However, the contracts have not yet been drawn up and distributed as the organisation has been waiting for their legal team to agree them. The manager said they were due to go out to people who use the service this month. Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 12 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Individual needs are met by the implementation of clear and detailed support plans and risk assessments, which have involved people who use the service and their families. People who use the service have a say in the day-to-day running of the home and are encouraged and supported to make choices. EVIDENCE: People who use the service have support plans which have been developed from their pre-admission assessment information. The information is person centred and written in the first person making it very individual to the person. Most of the plans are detailed and give specific information on care and support needs. Likes and dislikes have been identified. Some of the support plans would benefit from some more detail to make sure that care or support needs do not get overlooked. For example, what type of support someone Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 13 needs when helping in the kitchen or with shaving. The manager also needs to make sure that support plans are linked to risk assessments and any other care plans such as behaviour strategies or guidelines on useful routines so that these are not missed or that staff give an inconsistent response to people who use the service. Staff have a good knowledge of the support needs of the people who use the service. They were able to accurately describe the individual needs of people staying at the home on the day of the visit. One staff said, “The most important tool for us is the support plan”, another said how important it is to become familiar with the support plan before each person’s stay so that they are familiar with the person’s needs. In a returned survey from a health professional they said, “They meet the individual care needs of service users.” A parent who returned a survey said, “Care staff always welcome …. and treat all residents as individuals”, another said, “They consider individual needs of each client.” In a telephone call to a parent, they said they had been involved in the support plan and that staff had found out her daughter’s likes and dislikes and how best to communicate with her as English is not her first language. She also confirmed that she had seen the support plan. Most of the plans seen have been signed by the person who uses the service or their carer. Risks to people who use the service have been identified through an assessment process. Action plans have been drawn up to show how risk is minimised. The risk assessments are now reviewed before each visit to make sure there are no changes. The manager and staff have a good attitude to risk taking and it is seen as a normal part of life that gives people more independence. In a returned survey from a parent they said, “They encourage independence”. In a thank you card received in the home a parent said, “ …. has been making his own bed since he came home”. People who use the service were given choices throughout the day on what to do, what to eat and where to go. Staff said that people can choose what time to get up or go to bed and whether to get involved in activities or not. Staff responded well to requests from people and made sure their choices were respected. A meeting is held with all people who use the service on the day they come to the home for respite care to identify any choices around food and activities for the following week. Some people who use the service have expressed a preference to only come when the other people using the service are all female. The manager said he tries to honour this choice but it can be difficult due to trying to meet everyone’s requests. Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16,17 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service are supported to make choices about their lifestyle and supported to develop their life skills. Appropriate, interesting activities are arranged and a good, healthy and varied diet is offered. EVIDENCE: People who use the service are involved in a variety of activity during their stay at the home. This ranges from shopping, going to the pub, meals out, trips to local parks, bowling and cinema. The home has its own minibus. In a telephone call to a parent they said that their daughter likes the regular outings from the home. In a returned survey a parent said, “Social outings are appropriate and stimulating”. Another parent they had some concerns Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 15 that at times, staffing levels and the needs of the people who use the service affect their ability to get people out on activities. It was noted that one person who uses the service needs the support of two staff at times and that this could affect activity. The manager agreed to review this person’s care plan to make sure their needs are being fully met. Some people who use the service keep to their usual routines and continue going to their day centres or college course. All people who use the service said they enjoyed their stays, especially the activity such as shopping or going to the pub. They are encouraged to get involved in activity around the house such as cooking and cleaning. Their agreement to do this is now documented in their support plan. It was clear that some people really enjoyed this involvement and others saw themselves as being on holiday and did not want to get involved. Staff respected their choices. In a returned survey a parent said of her son, “He goes happy and comes home happy”. Staff said they are able to meet the diversity of cultural needs of the people who use the service. They said they have Bollywood films for one person and another is supported to pray using his prayer mat and religious icons. One staff member is currently seeking advice from a local Mosque on the direction of Mecca to be able to support people who wish to pray. This is good practice. There was good interaction between the people who use the service and the staff. It is clear they have good relationships and communication. The menu for the home is planned around the likes and dislikes of the people who use the service. Meal suggestions are made on the first day of the visit and staff try to make sure that everyone gets their choice. People who use the service accompany staff to the supermarket so that any particular foods they want they can see and get for the week. All people who use the service said the food was good. Staff try to get a balance of healthy foods and some “treat” foods as most of the people who use the service consider themselves to be on holiday. Staff said they have tried to make sure that fatty foods are low fat and have used a smoothie maker to offer people more fruits and vegetables. Staff have been given nutritional advice from a community dietician and the local council’s catering manager. They are able to cater for people’s cultural dietary needs. Vegetarian diets are provided and hal hal meat is obtained and stored separately in order to meet the needs of people who use the service who are Muslim. In a returned survey, a parent said, “My son is well cared for and most important to him, well fed”. Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Personal and health care support is provided in a way that meets the needs of the people who use the service. There are good systems in place for safe management of medication. EVIDENCE: Staff support people who use the service with their personal care needs in private and with dignity. The level of detail in most support plans on how personal care and health related tasks are to be carried out makes sure that their needs are properly met. Staff have good knowledge of their likes, dislikes and preferences. People who use the service are supported in ways that respect their culture such as only having staff of the same gender assisting with personal care. A health professional who returned a survey said, “When we have had reviews staff have shown a high regard to privacy Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 17 and dignity”. Another said, “They will seek advice from other professionals and act upon it”. A parent who returned a survey said, “They take good care of my son, always feel happy about letting him go there”. Staff said they contact the families of the people who use the service to keep them informed of any health problems during their stay. A parent spoken to on the phone said she felt well informed about any events during the stay. Another parent who returned a survey said she got information but would like more details on epileptic fits if they had occurred. Staff have received some training in health matters of the people who use the service. They have recently had training in supporting people with autism. One staff member said that this had made her more aware of what is important for people with autism. Some staff have received training in epilepsy and diabetes. The manager is currently trying to arrange for all staff to receive this training. One of the support plans looked at was of a person who has epilepsy. There was no care plan in place to show how this person is supported when they have a fit. However, staff were able to describe what they do and the manager agreed to put a care plan in place. The home is registered with a local GP (General Practitioner) who provides a temporary service for people who use the service when they are staying at the home. The support plans also contain details of people’s own GPs and any other health professionals they are involved with. Medication is well managed in the home. Current medication is checked with parents or carers before each stay. Staff book the medication into the home and draw up a medication administration record (MAR) sheet. This is done in two’s to avoid errors. This is good practice. Any person who uses the service who wants to take responsibility for their own medication can do so after a risk assessment has been carried out. The manager has written a new policy on homely remedies. This is specific and ensures safe practice. A parent who returned a survey expressed some slight concern about medication errors, but said they received full explanation of what had happened and were satisfied with the investigation into it. Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service and their carers have their views listened to, taken seriously and acted upon. There are good systems in place to protect clients from abuse. EVIDENCE: The home has a complaints procedure that has been produced in an easy read format with pictures and symbols. The manager said that this is given out to people who use the service and their parents or carers when they start to use the service. It is not clear if this has been given to people who have been using the service for some time. There is a copy of this in the home but it is not on display for people to easily access. One of the people who use the service said, “I tell the carers if anything worries me”. In a returned survey a parent said, “Have raised issues in the past and they have been dealt with appropriately”. And in a telephone call to a parent they said they had received information on how to complain and felt confident to do so if the need arose. All people who returned a survey said they knew how to complain. Any complaints the home has received are documented in the complaints book and the investigation and outcome are also recorded. Any recent complaints have been responded to promptly and dealt with properly. The home also Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 19 keeps a book for thank you letters and compliments received about the service. Comments included, “I have had a fantastic time while staying in your care” and “She had a good time and is looking forward to the next stay” At the end of each stay people who use the service complete a questionnaire which gives them the opportunity to give their views on the service and anything they may have been unhappy with. Most staff have received training on safeguarding adults. Staff said they are aware of the different types of abuse and any signs that might alert them to it. They are also aware of their responsibilities in reporting any allegations or suspicions of abuse. The organisation has a comprehensive adult protection procedure in place. The home has a no physical restraint policy when dealing with any incidents of behaviour that challenges others. Some staff said they had done safe handling training in the past and been shown safe use of restraint and diffusion techniques. This training was some time ago and the manager agreed to review this to see if updates are needed. Good records are kept of the money of the people who use the service and their monies are kept safe. Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home offers a homely, clean and safe environment for people who use the service. EVIDENCE: The home is warm, clean and fresh smelling. Furnishings are modern and in good order. There is now a second sitting room which has been developed to give people who use the service some private, quiet space. Staff said they intend to further develop this room by adding a games console. Some of the décor around the home is looking tired and worn. Damaged wallpaper and some paintwork needs re-doing. The manager is aware of this and has requested some re-decoration from this years budget. Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 21 The kitchen is well equipped and clean and tidy. There are now good systems in place to make sure food stuffs are stored according to manufacturers instructions. All staff have recently updated their food hygiene training. The manager has considered the use of an emergency call system in bedrooms but feels this isn’t necessary as all people who use the service are mobile and know how to summon staff’s assistance. All bedrooms now have bedside lamps. There is a large garden that has now got fencing around the boundary which makes it safe and secure. The garden looks attractive and garden furniture is in place for people to sit out or have barbecues. People who use the service made good use of the garden on the day of the visit. Clinical waste is properly managed and staff wear protective clothing when attending to the personal care needs of people who use the service. Staff have not received formal training in infection control but were able to say what control measures are in place and showed a good awareness of infection control. Training on infection control has been booked with a local college and is due to take place in October 2007. Liquid soap and paper towels are available at most sinks. Staff also carry hand – sanitising gel as it is not possible to have liquid soap in some bedrooms due to the particular needs of people who use the service. Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 33, 34,35,36 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff are competent and well supervised to meet the needs of people who use the service. They are also protected by the home’s recruitment procedures. EVIDENCE: There are staff on duty throughout the day and night. There are usually two staff on the morning and afternoon shifts. There is an extra person on duty once or twice a week for activities. At night there is one waking member of staff and one sleeping in, who can be called upon in emergency. The manager works as part of this rota with some time for his managerial duties. Staff said they feel there are enough staff and the rota is worked creatively to make the best use of time. As mentioned previously in the report, a parent said she felt there wasn’t enough staff at times, for activities depending on the mix of the needs of the people who use the service and who was staying at the home. The manager said he tries to make sure the needs of people are matched to Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 23 the staffing levels available when organising the allocations of respite care. In a returned survey a parent said, “He feels happy and at ease with staff” and “Very pleased with the home, the staff and the service it offers. Recruitment is properly managed; interviews are held, references and CRB (Criminal Record Bureau) checks are obtained before staff start work and checks are made to make sure staff are eligible for work. Most recruitment records are now kept at the home and available for inspection. In a returned survey a parent said she would like to be informed of staff changes to keep her up to date. The manager said he would look at ways of doing this. Staff’s training is mostly up to date. The manager has recently done an audit of this to check what training is needed. He is keen to train as a trainer in some topics so that he can deliver this training himself as course availability within the organisation can be limited. He is trained to deliver fire training at the moment. Other members of staff have been given training responsibilities too. One of the staff has developed an in-house training course on culture awareness. This is good practice and recognises the diversity of the people who use the service. Another said she was about to do some person centred planning training and would be sharing this with the staff team. New staff follow an induction programme which includes working towards the LDAF (Learning Disability Award Framework). Almost all of the staff team have now completed or are working towards an NVQ (National Vocational Qualification) in care at level 2 or above. All staff said they felt they have a good team and the manager is very supportive. Staff said they felt communication and teamwork within the home is good. Staff said they receive supervision from the manager every two months. Records also showed this. Regular staff meetings also take place. Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed, the interests of the people who use the service are seen as important to the manager and staff and are safeguarded and respected at all times. EVIDENCE: The home has an experienced manager who is working towards the NVQ level 4 in care and has a management qualification. He has good organisational skills and can be flexible to meet the diverse needs of the people who use the service. Staff said he was very approachable and spoke highly of the support Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 25 they receive from him. In a returned survey, a parent said, “Always found manager and key workers easy to talk to”. The unit manager carries out monthly regulation 26 visits at the home. A report of these visits is made showing details of any action to be taken to improve the service. In addition to this the home asks people who use the service to complete a satisfaction survey after every stay. Any areas that people are not happy with are investigated by the manager and addressed. From completed questionnaires it is clear that people are encouraged to express their views. The organisation has now developed a detailed satisfaction questionnaire which is due to go out to all people who use the service and their parents or carers to find out their views on the service . Staff carry out weekly or monthly health and safety checks around the home such as fire alarms, emergency lighting and water temperatures. Maintenance records are well kept. Environmental risk assessments are completed and were up to date. Accident or incident reports are completed and monitored by the manager. The home has a comprehensive range of policies and procedures in place, which promote and protect the health and safety of people who use the service. Gas safety and electrical wiring certificates are up to date. Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 27 Yes. 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 YA22 Regulation 22 Requirement The manager must make sure that copies of the complaints procedure are available to all people who use the service and their relatives and anyone acting on behalf of them. This will make sure that people can air their views properly. This is outstanding from 31/10/06. Timescale for action 30/09/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA1 Good Practice Recommendations The manager should make sure that the new Statement of Purpose and Service User Guide are made available to people who use the service and their parents or carers to make sure that they have information available to help them decide if the home can meet their needs. The manager should make sure that all support plans link with risk assessments and other guidelines for people who DS0000033820.V335497.R01.S.doc Version 5.2 Page 28 2. YA6 Raynel Drive 3. YA33 4. YA35 use the service. This will make sure that care needs are not overlooked. The manager should give some consideration to reviewing the staffing ratios when people who use the service need two to one support. This will make sure there are sufficient staff to meet the needs of the people who use the service at all times. The manager should review the training needs of staff with regard to management of behaviour that challenges others and safe use of restraint or diffusion techniques to make sure staff’s skills are up to date. Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Raynel Drive DS0000033820.V335497.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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