Care Home: Robinia Care (Sheringham Avenue)

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What the care home does well The people living in this home have a good quality of life. There is a stable staff team who care about the people living in the home and have good relationships with them. The residents are respected and are able to achieve a great deal of autonomy in their lives. The staff team have the relevant skills to support the residents to achieve greater levels of independence, which has enabled some people to move onto their own flat. The residents said how much they appreciate and value the support they receive from the staff. The staff also support the residents to work closely with all the care professionals. The home itself is comfortable, clean and homely and is accessible to local shops and public transport links. The home is run very well and the records are up to date and accurate. What has improved since the last inspection? This key inspection found that all of the requirements from the previous key inspection had been met. This included ensuring all the staff had up to date adult protection training and person centred planning training. The home has also prepared an annual business plan giving objectives for the service andseeks the views of residents, relatives and other stakeholders through an annual quality assurance exercise. In addition the home feels that their main improvements in the last year as recorded in their AQAA was to improve the numbers of staff completing their NVQ training and for the manager to also complete her management qualification. They also feel that they are working even more effectively in supporting the residents to move towards more independent living. What the care home could do better: No areas for improvement were identified at this inspection although it is hoped the home will continue to maintain its excellent standards. CARE HOME ADULTS 18-65 Robinia Care (Sheringham Avenue) 1 Sheringham Avenue Oakwood London N14 4UB Lead Inspector Jane Ray Unannounced Inspection 16th September 2008 9:45 Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.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 Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.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. Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Robinia Care (Sheringham Avenue) Address 1 Sheringham Avenue Oakwood London N14 4UB 020 8360 5075 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) sherringham@robinia.co.uk The Robinia Care Group Ltd Champika Kamalinie Gallage Care Home 5 Category(ies) of Learning disability (5), Mental disorder, registration, with number excluding learning disability or dementia (5) of places Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To provide care for five adults (18-65 years of age) of either gender, with a learning disability (LD) who may also have a mental disorder (MD). 25th September 2006 Date of last inspection Brief Description of the Service: This home is operated by Robinia Care Group Ltd, which has a number of care homes throughout the UK. The home opened in September 2004 and is situated in a quiet residential area with access to local shops and buses. This home is a specialist service for five people who have an autistic spectrum disorder. The service user guide for the home describes it as a home environment to support people with Autistic Spectrum Disorder and Aspergers Syndrome, moderate learning disability and behaviours that challenge. There are five men living at the home. Most residents do not have a learning disability but do have an autistic spectrum disorder. The home encourages people to gain independence skills with a view to living more independently in the long-term. The fees charged by the home range from £1,592-£1,733/week. A copy of this report can be obtained direct from the provider or via the CSCI website (web address can be found at page two of this report). Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. The inspection took place on the 16 September 2008 and was unannounced. The inspection lasted for five hours and was the key annual inspection. The inspection looked at how the home was performing in terms of the key National Minimum Standards for Younger Adults and the associated regulations. The inspector was able to speak to and observe the support given to the five current residents. The inspector was also able to spend time talking to the manager and senior carer as well as one of the care staff who were working. The inspector did a tour of the premises and also looked at a range of records including resident records, staff files and health and safety documentation. The home had provided the inspector with a completed self-assessment questionnaire (AQAA) prior to the inspection. Surveys were received from three residents, three relatives and six members of staff. What the service does well: What has improved since the last inspection? This key inspection found that all of the requirements from the previous key inspection had been met. This included ensuring all the staff had up to date adult protection training and person centred planning training. The home has also prepared an annual business plan giving objectives for the service and Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.S.doc Version 5.2 Page 6 seeks the views of residents, relatives and other stakeholders through an annual quality assurance exercise. In addition the home feels that their main improvements in the last year as recorded in their AQAA was to improve the numbers of staff completing their NVQ training and for the manager to also complete her management qualification. They also feel that they are working even more effectively in supporting the residents to move towards more independent living. What they could do better: 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. Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.S.doc Version 5.2 Page 7 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 Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.S.doc Version 5.2 Page 8 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): Standards 1,2,3,4 and 5 were inspected. People using this service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home can be assured that their individual needs will be assessed and that the staff have the skills and ability to meet these needs. People moving to the home have access to the necessary information and can visit the service to see if they want to live there. EVIDENCE: “They help the individuals in their care to develop as individuals and provide the support required for this”. (Survey response completed by a relative) “We have a comprehensive statement of purpose and a service user guide which empowers service users. These are written in easy understandable way with out jargon. All the service users have copies of the service user guide. The statement of purpose is displayed on the wall where everyone can get access to it”. (Extract from AQAA prepared by the home) Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.S.doc Version 5.2 Page 9 “In admissions we spend a quite a lot of time doing the assessments, this includes talking to service users, their relatives, social workers and other professionals. Also we offer them few visits to the service and to spend some time before making a decision”. (Extract from AQAA prepared by the home) We inspected the statement of purpose and this document provides accurate information about the home. This document is clear and would be useful for care professionals and relatives who could need information about the service. A service user guide has also been prepared in a user-friendly format. This guide also includes details of how each person’s equality and diversity will be respected. We looked at the case notes for four of the people who live in the home. They all had assessments that formed part of their person centred plan and included detailed information about each person and how they liked to lead their lives. The AQAA prepared by the home explained that these assessments were prepared in consultation with the resident, carers and other people involved in their life. These assessments provided a good sense of each person and sensitively addressed areas of their lives that were important to them such as their culture, religion and relationships. In addition the assessments also included reports from other care professionals. We discussed the current needs of the people who live in the home with the manager, senior carer and care staff. They have very specific individual needs linked to their autism and mental health. The staff spoken to had a very good understanding of the individual needs of the residents. In addition it was observed that the staff were supporting the residents with great skill and sensitivity, encouraging people to discuss anything they were concerned with. It was noted from the staff training records that were inspected that the training has included courses on autism, mental health, communication, person centred planning and equal opportunities. The staff said they felt very well prepared to meet the specific needs of the residents. There has been one new resident moving to the home since the last inspection and the home is now fully occupied with a waiting list of referrals. From discussions with the staff it is evident that this person was offered a very short but careful introduction to the home, which included two visits. As part of the service user guide each resident has a contract between themselves and the home, clearly stating what the service will provide. The format is easy to understand, contains all the necessary information and has been signed by the resident. Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7,8 and 9 were inspected. People using this service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people living in the home can be confident that they will be supported to prepare their own person centred plan and risk assessments. This along with the overall ethos of the home enables people using the service to have control in their lives and make their own informed decisions. EVIDENCE: “At Sheringham Avenue all the service users wishes and choices are respected by the staff team. All the service users have their support plans completed by themselves in a person centred method. They have mentioned what type of support they wish to have and what they dont want to happen. These support plans are reviewed on a six monthly basis”. (Extract from AQAA prepared by the home) Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.S.doc Version 5.2 Page 11 “The staff team and the social workers take the review meetings very seriously and support the residents to fulfil their wishes. In some cases they are given a chance to take risks after assessing these carefully if this is what they want to do”. (Extract from AQAA prepared by the home) “I look at my support plan and sign any changes. I also read the daily logs to see what the staff have written” (Quote from a resident) We inspected care plans for four of the people currently living in the home. We also spoke to the manager, senior carer and care staff about the care plans. All of the people whose records were inspected had comprehensive holistic person centred care plans in place. These documents had in most cases been written by the resident with staff support and provided information on what is important to that person and their personal goals. The person centred plan covers all aspects of their lives. The plans also state what they don’t want staff to do, such as checking to see if they are alright during the night. The goals are very focussed on that person achieving greater independence. These documents had all been reviewed in the last six months. One resident said how much he had enjoyed preparing his person centred plan. The staff when asked about the person centred plans, were able to describe the goals for each person. All the residents had been supported to have a six monthly review meeting and an annual care plan review meeting with their care manager and the records of these reviews were available. One placing authority had been invited to the residents review but said it would only attend reviews every two years unless there was a specific concern. Residents and their relatives play an active part in these meetings. The records showed that actions agreed at previous reviews had been followed through. Separate support plans are also written for the staff identifying where their input is needed and how this should be provided. These are also regularly reviewed. Each resident had a named key worker. The staff was asked about their role as a key-worker and this showed that the support they provided was very comprehensive including helping with personal shopping, attending review meetings if possible, ensuring all the residents personal care needs were met, and organising leisure activities. The residents were able to tell us the name of their key-worker and clearly valued this relationship and the support they received. We read the risk assessments for four of the people who live in the home. It was possible to see that an effort had been made to identify areas of personal risk and look at how this can be managed without placing unnecessary restrictions on people. The risk assessments had been prepared using one format and they were clear and easy to follow. It was also possible to observe Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.S.doc Version 5.2 Page 12 the actions from the risk assessments being implemented in the home, such as helping people to choose healthy meal options, or prompting people to attend to their personal care. Each person living in the home had individual behavioural guidelines as part of their support plans and risk assessment and these were clearly written and gave guidance to the staff. All the staff were observed to be very calm and patient and when speaking to residents they were all aware of how to appropriately diffuse a situation when a person is becoming distressed. We observed the people living in the home and their interaction with the staff. It was positive to note that they were constantly making choices including where they wanted to go, what they were going to cook and what money they wanted to spend. The staff were observed to be very aware of the need to communicate sensitively with the residents especially when they needed to discuss areas that might be more personal or where the resident might be anxious. The residents are also hold regular residents meetings called house meetings and these take place monthly. The record of these meetings was inspected and a number of issues relating to aspects of living in the home had been discussed including the domestic duties, health and safety issues and how the group was getting on with each other. The residents are able to make their own records of this meeting. Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 11,12,13,14,15,16 and 17 were inspected. People using this service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home are supported to develop their independent living skills and are also enabled to follow their own routine. The home has made progress in supporting the residents to enjoy a wide range of communitybased activities, based on their individual interests. This enables them to enjoy an active and meaningful lifestyle. EVIDENCE: “All the service users at Sheringham have been given the opportunity to get involved in making their own activity plans rather than all of them doing the same activity. They all plan their menus on a weekly basis and do shopping according to their wishes. They do activities like drama, video making /social Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.S.doc Version 5.2 Page 14 skills sessions if they wish to join these. All of them do different college courses eg two service users are doing performing arts and media studies, another service user is doing a gardening course and another service user is doing an IT course. A service user who moved in went for a job interview and is waiting to start soon”. (Extract from AQAA provided by the home) “I have an activity plan with all the activities I enjoy” (Extract from residents survey) “Our service users are very happy and some of them are working towards moving to a supported living service” (Extract from a staff survey) We were able to talk to the residents and read in their person centred support plans, which describe how they were being supported by staff to develop their independent living skills. The residents explained how they all plan their menu for the week and then shop for the food at local supermarkets. One person said that he only has two convenience meals a week and the rest of the time cooks fresh food. Residents also tidy their own rooms and do their laundry. Apart from one person they are able to go out independently and have been supported to learn how to use local public transport including the bus and trains. Each person has an individual activity programme and at the time of the inspection these were being updated to reflect the college courses, which were just starting. Several residents spoke about the college courses they are attending and these included adult literacy, gardening and IT. One resident talked about how he completed a preparation for employment catering course and is being supported to find employment. The manager explained how care professionals come into the home to provide sessions that include drama, video making, aromatherapy and relaxation. Some residents were able to describe how they enjoy these sessions and show us some of the things they had made. Other activities also take place that reflect each persons individual interests such as going to the cinema, bowling and meals out. One resident said he liked going to the pub. Another talked about how he enjoys playing golf. In terms of holidays the manager explained that four of the residents have booked a holiday in Turkey in October. One other resident has already had a holiday this year in Blackpool The AQAA identified that two of the residents are Christian and one Buddhist. The senior carer explained that one resident who is Roman Catholic goes to church regularly. The manager explained that most of the people living in the home have close contact with their relatives, who either come to visit them or they are Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.S.doc Version 5.2 Page 15 supported to go home. The staff have a good knowledge of each persons family relationships and their importance to each resident. The residents have friendships with each other and other people they know outside the home. One resident has a girlfriend who lives in the north of England who he sees during holidays. Some residents need support in managing their relationships. It was observed that the people living in the home were able to follow a routine of their choice and that people get up at different times according to their individual wishes and needs. At the time of the inspection some of the colleges had not yet started again and so people were able to get up later. It was very positive to note that the residents were supported in a very person centred and individual manner. Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.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): Standards 18,19 and 20 were inspected. People using this service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people living in the home are offered support that is flexible and meets their changing needs. Each person is supported to access professional healthcare input based on their individual needs. Medication is stored and administered safely, whilst promoting the independence of the residents who take medication. EVIDENCE: “All the service users at Sheringham are registered with the local surgery and with all the primary heath care professionals. One service user visits a dietician as he is on a gluten free diet. They are all up to date with their health care check ups. All the staff have done a course on handling medication with Boots and team leaders have done an advance course in medication. These courses were refreshed on an annual basis to keep the knowledge up to date. Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.S.doc Version 5.2 Page 17 Four service users have done their health action plans with the support of the staff”. (Extract from the AQAA prepared by the home) “All the work with Sheringham Avenue has been fantastic and professional. I trust and rely on them 100 ” (Extract from a survey completed by a care professional as part of the homes own quality assurance exercise) We observed during the inspection that the staff were supporting the people living in the home to receive personal care in a manner that preserved their privacy and dignity. This mainly consisted of prompting people to attend to their own care. It was observed that the residents were appropriately dressed and that their clothing was very suitable for the weather and the activities they were attending. The staff explained about how some residents buy their own clothes and others go shopping with relatives. The residents were also well groomed in terms of their personal care including haircuts and were able to talk about how they went to the local barber. We looked at the healthcare records for four of the people living in the home. They each had a very comprehensive health action plan as part of their person centred plan that identified all their healthcare needs. They had all been supported to access a range of healthcare professionals including the GP, dentist, optician, chiropodist, psychiatrist and other appointments according to their individual needs. It was also positive to see that new healthcare input was being accessed as the needs of the resident changed. One resident who is recovering from a badly broken leg has been having input link to this specific need. The staff spoken to all demonstrated that they were very aware of the importance of monitoring each person’s mental health as well as their physical health. The medication in the home was inspected. The home uses the Boots blister pack system. The home keeps records to show how much medication is delivered to the home and any returned medication, which enables there be an audit trail for the medication. The medication administration records were inspected and were completed correctly. The residents also sign when they come to take their medication. A daily record is kept of the temperature in the medication storage cupboard and this has remained within an acceptable level. Some of the residents have PRN medication. The PRN administration guidelines are clear and are available for staff to access in the medication folder. The staff training records were inspected and everyone had received medication training. Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.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): Standards 22 and 23 were inspected. People using this service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people living in the home have access to an appropriate complaints procedure and feel able to express their views. Procedures and training on safeguarding vulnerable adults are in place to protect the residents. Systems to ensure resident’s personal monies are being protected help to promote their independence and develop budgeting skills. EVIDENCE: “We have very clear policies and procedures in safe guarding adults, complaints and concerns. Service users were given a copy of the service users guide, which clearly explains, how to make a complaint and to whom. Service users sometimes do make written complaints and these were taken seriously and dealt with in a 28 day time period”. (Extract from the AQAA prepared by the home) “If anything is the matter I will speak to the manager” (Quote from a resident) Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.S.doc Version 5.2 Page 19 Robinia has an appropriate service user complaints procedure, which we inspected in the service user guide and this is clear and easy to follow. We looked at the record of complaints and as reflected in the AQAA there have been three complaints in the last year. These have been addressed appropriately within the correct timescale. All the residents in their survey said they would know who to speak to if they were not happy. It was observed that the staff were listening very carefully to the residents. There has been one adult protection issues in the last year and the home participated appropriately as part of this process and subsequently reviewed the residents risk assessments. The staff training records were inspected and they had all received training on safeguarding vulnerable adults and additional more comprehensive training was also taking place in October and November. The staff spoken to during the inspection all showed a good understanding of how to recognise abuse and what action they would need to take. All of the staff whose training records were inspected had attended appropriate training to enable them to support people who have complex challenging behaviours. Staff were observed supporting residents in a calm, patient and appropriate manner. We checked the personal finances for three residents including their building society books and cash record. One resident had a relative acting as their appointee but the other two have their money paid into a bank or building society account. They are able to withdraw their own money and then place money in their individual pouch in the safe to help with budgeting. The residents were then observed asking staff for their money and they sign to say this has been handed to them. Each person has a plan in place as part of their person centred plan agreeing on how they will manage their finances. Most residents smoke and need assistance to ensure they have enough money for all their social activities and holidays. Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.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): Standards 24 and 30 were inspected. People using this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people who use this service can usually feel confident that they are living in a well maintained home. The home is kept clean and is a pleasant and homely environment for the people who live here. EVIDENCE: “Home is designed for 5 people to live in with 3 ensuites, two kitchens, dining area, lounge, laundry room and an office. There are two additonal toilets . Home was decorated in May 2007 and all the rooms were decorated according to the choice of the service users. All of them have the necessary furniture in their rooms and all five of them have their own televisions in their rooms. Service users can also choose to bring their furniture if they wish. Two kitchens are shared by five of them so they can cook their meal of choice. They have separate fridge and freezer spaces and separate kitchen cupboards to Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.S.doc Version 5.2 Page 21 store their food. If they wish they can keep these locked”. (Extract from AQAA prepared by the home) The home is well decorated, well maintained and continues to provide an overall pleasant environment to meet the current service users needs. The home has one downstairs bedroom and the rest are upstairs. Everything in the home was working well and the senior explained that any repairs are reported to the maintenance team. The residents were observed spending time in their rooms but also relaxing in their communal lounge. The lounge has a television with access to satellite channels. The home has a pleasant back garden, which is also the designated smoking area. The house has satisfactory laundry facilities and storage for chemical cleaning materials. The home was seen to be clean and tidy during the inspection. One resident showed the inspector his room. This bedroom was comfortable and personalised and reflected his individual areas of interest. Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.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): Standards 32,33,34,35 and 36 were inspected. People using this service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. The residents are supported by a caring and committed team of staff. The staff are receiving relevant training and are supported by regular supervision sessions. This enables them to work to a high standard and deliver good care. EVIDENCE: “At the moment Sheringham has a full staff team. All the staff were CRB and POVA checked and obtained two refefrences. All the staff have gone through a full induction process and have completed all the mandatory training. This includes CWPLD (LDAF) Robinias pathway training”. (Extract from the AQAA prepared by the home) “We have a very good team of workers and very good management” (Extract from staff survey) Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.S.doc Version 5.2 Page 23 We looked at the rota and this showed that there is a manager, three seniors and team of care staff working at the home. The staff turnover has been low over the past year with only two members of staff leaving. Two new staff have started working at the home. The staffing levels consist of two or three staff on the day shifts and one waking night staff. The staffing levels reduce when the residents are visiting relatives. The rota was inspected and this confirmed the staffing levels. The manager and care staff explained that staff team meetings take place on a monthly basis. The record of these meetings was inspected and it could be seen that they discuss a range of operational issues. The staff spoken to said that the team was working well together and that there was open communication between team members. They also felt confident to raise any concerns with the manager. The records for the two new staff confirmed that they had completed induction training in the home. This was confirmed by talking to the staff working in the home. The induction consists of a brief introduction to the home in the first week and a longer induction over the first few months. The AQAA prepared by the home stated that out of the twelve current staff they have all completed an NVQ in care or are working towards this qualification. We looked at the recruitment records for the two members of staff who have started working at the home since the previous inspection. It was found that all these staff had two references, ID with visa where needed, POVA and CRB disclosure check. The staff members had completed and signed a contract of employment. Each member of staff has a record of the training they have received and the manager has an overview of the training received by the whole staff team to enable future training to be planned. The training is organised with the staff at head office and a programme of training for 2008 was available and was very comprehensive. The staff said that the training was very good. We looked at the record of supervision sessions. All the staff had received regular individual supervision about every month. The staff confirmed they were receiving regular supervision. The manager supervises the senior carers and the seniors supervise the rest of the team. Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.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): Standards 37,39 and 42 were inspected. People using this service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. People using this service can be assured that an experienced manager who provides effective leadership is available. Comprehensive health and safety measures are in place to safeguard the people living in the home. The quality improvement system in the home seeks the views of the residents, relatives and other stakeholders so they can contribute their ideas. EVIDENCE: “The registered manager has been working in the service since the time the home was opened and has gained experience and knowledge. The manager has completed the RMA, NVQ 4 and IOSH. The home has a clear vision based Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.S.doc Version 5.2 Page 25 on the organisations values. The service has a business plan, which clearly states the aims of the home. The home has written policies and procedures in place and these are discussed with the staff in supervisions. Monthly inspections (Reg 26 visits) are done by the Area Manager to maintain quality and standards in the home. Annual quality assurance checks are by the Regional Operational Managers. The staff Team at Sherringham has a very good awareness of health and safety, security etc All the working practices in the home are safe and risk assessed and actions are taken to minimise the risks. The home has good monitoring and record keeping systems. People who use the service have access to their records whenever they wish. The staff team work hard as a team by following CSCI standards to maintain quality and high standards at all times. There is an insurance cover for the home to meet any loss or legal liabilities. The home proactively monitors its health and safety performance, consults other experts and specialist agencies about health and safety issues as required”. (Extract from the AQAA prepared by the home) The manager who has worked at the home since it opened has many years of experience. The manager confirmed that she has completed the NVQ level 4 and RMA. The residents and staff were all observed to be relaxed with her and able to discuss anything that needed to be addressed. There is a happy atmosphere in the home as a result of the good relationships staff have developed with the residents. The homes internal annual quality assurance exercise has taken place and through the use of questionnaires has sought the views of residents, relatives and other care professionals. These questionnaires were inspected and the feedback was very positive. This exercise took place nearly a year ago and is about to be updated. The record of regulation 26 visits were inspected and show that the home is regularly monitored by senior managers in the organisation. The home notifies the Commission of any serious incidents such as when a resident needs to go to hospital. A recent inspection by the London fire service identified that the home meets fire safety standards. The home has an emergency plan and fire safety risk assessment. The fire alarm and fire extinguishers had been serviced. The fire alarm records show the alarm is checked weekly and the fire drills take place quarterly. The staff training records showed they had all received fire safety training. The AQAA showed that all the health and safety maintenance checks had taken place. The home has a very comprehensive health and safety audit system, which includes monthly checks and a detailed annual audit. Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.S.doc Version 5.2 Page 26 The staff training records show that the staff have completed the health and safety training including food hygiene, infection control, manual handling and first aid. It was observed that all the records in the home were well organised and accurately completed. They are easily accessible for whoever needs to use them. Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 4 3 4 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 4 STAFFING Standard No Score 31 x 32 3 33 4 34 3 35 4 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 4 4 x LIFESTYLES Standard No Score 11 4 12 3 13 3 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 x 4 x 3 x x 4 x Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.S.doc Version 5.2 Page 29 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Robinia Care (Sheringham Avenue) DS0000061218.V372113.R02.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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