Care Home: Rook View

Similar services:

• Thorndene
• Insight - Eastchurch
• Southfields
• Magenta
• Seabourne House
• 33 St John`s Church Road
• Dovedale Court
• Lyncol House

What the care home does well What has improved since the last inspection? Service users individual plans and assessments of risks have been regularly reviewed to reflect their changing needs. Service users decisions about their lifestyle choices have been recorded. A full employment history has been obtained from applicants to work at the home. The home`s policies and procedures have been updated. What the care home could do better: The communal areas of the home still need to be decorated. A requirement was made at the last inspection that areas of the home must be reviewed and repairs, replacements and redecoration must be carried out as needed. A timescale of 11th may 2007 was given but this has not been complied with. Staff must receive training required by law (mandatory), including first aid training.A record of staff induction must be maintained and kept in the home. The requirements of the fire risk assessment should be followed up to ensure that any necessary actions have been carried out. It is recommended that the security of the home is reviewed to ensure the safety of service users and staff. CARE HOME ADULTS 18-65 Rook View Rook View 46 Rook Lane Chaldon Surrey CR3 5AB Lead Inspector Sandra Holland Unannounced Inspection 24th October 2007 10:00 Rook View DS0000013769.V347084.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 Rook View DS0000013769.V347084.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. Rook View DS0000013769.V347084.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rook View Address Rook View 46 Rook Lane Chaldon Surrey CR3 5AB 01883 383817 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) Surrey and Borders Partnership NHS Trust Mrs Kim Susan Mott Care Home 8 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (3) of places Rook View DS0000013769.V347084.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th February 2007 Brief Description of the Service: Rook View is operated by Surrey and Borders Partnership NHS Trust and is one of a number of residential homes owned and managed by the organisation. The home is detached, shares a site with two other residential care services managed by the Trust, and can accommodate up to eight service users with learning disabilities. The home has eight single bedrooms over two floors with one communal dining room leading into the living room. Stairs reach the first floor. Local shops and other facilities and amenities are available close by in Caterham. More extensive facilities are available within a short drive in Redhill. The fees for this service are £ 1191.86 per week. Rook View DS0000013769.V347084.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection site visit was carried out by the Commission for Social Care Inspection (CSCI) under the Inspecting for Better Lives process. A full analysis of all information held about the home was carried out prior to the visit. Mrs Sandra Holland, Regulation Inspector carried out the inspection over seven and a half hours. Staff capably assisted with the inspection and provided the required information, in the absence of the manager. A tour of the home was carried out and most areas were seen, with the exception of bedrooms belonging to service users who were out or did not wish their rooms to be viewed. A number of records and documents were sampled, including medication administration records, service users’ individual plans, health and safety records and staff recruitment and training files. An Annual Quality Assurance Assessment (AQAA) was supplied to the home and this was completed and returned. Information supplied in the AQAA will be referred to in this report. A number of CSCI feedback forms were supplied to service users, their supporters and healthcare professionals involved in their support. Three of these were completed and returned by service users and one by a service users’ relative. The responses are referred to at Standard 39, which relates to quality assurance. The home has an equality and diversity inclusion policy and procedure, which state that it “aims to ensure the elimination of potential or actual discrimination and inequalities in service delivery practices and employment”. A “dignity challenge” was carried out earlier in 2007, to ensure service users’ dignity was being respected and promoted, and actions were taken to address any shortfalls in this. All eight service users were met with and some were spoken with. A small number of service users were unable to tell of their views due to communication difficulties, so for these service users their responses were assessed by observing their body language, facial expressions and interaction with staff. Four members of staff were spoken with. The inspector would like to thank service users and staff for their hospitality, time and assistance. Rook View DS0000013769.V347084.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The communal areas of the home still need to be decorated. A requirement was made at the last inspection that areas of the home must be reviewed and repairs, replacements and redecoration must be carried out as needed. A timescale of 11th may 2007 was given but this has not been complied with. Staff must receive training required by law (mandatory), including first aid training. Rook View DS0000013769.V347084.R01.S.doc Version 5.2 Page 7 A record of staff induction must be maintained and kept in the home. The requirements of the fire risk assessment should be followed up to ensure that any necessary actions have been carried out. It is recommended that the security of the home is reviewed to ensure the safety of service users and staff. 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. Rook View DS0000013769.V347084.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rook View DS0000013769.V347084.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs of prospective service users would be fully assessed before they moved into the home, to ensure that these could be met. The assessment would include trial visits to the home. EVIDENCE: Staff advised that all of the current service users have lived at the home for a number of years, so no new service users have moved into the home. Staff were however, able to describe the detailed assessment process which would be carried out, to assess the needs of any prospective service user. Information about the needs of a prospective user would initially be gathered from wherever they were currently living. If the prospective service was supported by a local authority, an assessment under the care management process would be carried out and the home would obtain a copy of the assessment. A prospective service user would be invited to the home for a number of visits, usually of increasing length, so that the service user could see if the home suited them. This would also enable them to meet other service users and staff, and enable staff to more fully assess the needs of the prospective service Rook View DS0000013769.V347084.R01.S.doc Version 5.2 Page 10 user. Any trial visits would usually include staying for a meal and if the home appeared to suit the service user, an overnight stay would usually be arranged. Rook View DS0000013769.V347084.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed and informative individual plans have been drawn up to give staff effective guidance to the support and care needs of service users. Service users are encouraged and supported to make their own decisions and risks to service users have been assessed. EVIDENCE: Information supplied in the AQAA advised that service users’ individual plans are based on the assessments carried out under the care management process. These were seen to be detailed and contained a comprehensive amount of information, to guide staff to the support and care needs of service users. Each service users’ individual plan is divided into sections covering personal information, health action plans and person centred plans. The person centred plans are written from the point of view of the service users and advise staff of the “things that matter most”, “things that I enjoy”, “how I communicate with Rook View DS0000013769.V347084.R01.S.doc Version 5.2 Page 12 you”, “things to keep me healthy” and “relationship circles”. The person centred plan informs staff of the support each service user needs in order to achieve the “things that I enjoy”, for example. The person centred plans included lots of photographs reflecting the areas of the plan, such as service users on holiday, to illustrate one of the “things that I enjoy”. Daily notes are maintained to record the day to day activities of service users, including attending day services and clubs, visits from relatives and “having a lie-in”. These were seen to link with other areas of the individual plan or other records, such as medication records. Staff were observed to encourage service users to make their own choices and decisions. At lunch, service users were asked what they would like to eat and drink and one service user prepared their own lunch. Later, a service user was offered different activities for the afternoon and cooking was selected, so a batch of cakes were made by the service user, supported by staff. Assessments have been carried out of a number of risks to service users, including those associated with mobility, bathing / hot water, coping with hot food or drinks, using the home’s minibus and going swimming. Other risks associated with helping to run the home, such as using sharp or hot items have also been assessed. Further assessments have been carried out for individual risks, such as using a wheelchair with a lap belt, the moving and handling needs of specific service users and certain behaviours of specific service users. Rook View DS0000013769.V347084.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported to take part in a range of learning and leisure activities, to be part of their local community and to assist in the preparation of well balanced meals. Contact with service users’ families and friends is actively promoted and service users are involved in the day to day running of the home. EVIDENCE: It was clear from speaking to service users and from records seen, that service users are supported to take part in a wide range of activities that are appropriate to their age and cultural background. These include activities to develop or maintain skills, such as woodwork and cookery and leisure activities, such as bowling, swimming, trampolining and drama. Service users also attend a local day centre for older people and said they enjoy going out for meals. If service users wish to attend church or other places of worship, they are supported to do so, staff advised. Rook View DS0000013769.V347084.R01.S.doc Version 5.2 Page 14 The various activities of each service user are recorded in their individual plan and a picture chart of each person’s activities was also seen on the notice board in the dining room. Service users and staff referred to this when discussing the activities planned for the afternoon of the inspection. As one service user indicated that they did not wish to attend the planned activity, they were welcomed to stay at home and a staff member offered a choice of other activities to take part in. Information in the AQAA stated under “how we have improved in the last year”, that there was now more service user involvement in the household tasks, so it was positive to hear service users talking about going shopping and to see a service user returning from a shopping trip, during the course of the inspection. It was also observed that service users were involved in laying the table for the lunchtime meal, clearing away afterwards and taking items for washing to the laundry. The relationship circle in each service users’ individual plan described the people involved in their support. This was seen to include their closest family members at the heart of the circle, other family and friends in the next ring, staff and others in outer rings and so on. This provides staff with clear guidance as to the people the service user feels are important to them. It was positive to note that those considered important to service users, are invited to events in their lives such as birthdays, parties and review meetings. Service users had their lunchtime meal during the inspection visit and it was positive to observe them very much at home and at ease with staff. There was animated conversation between service users, with staff and service spoke of enjoying their meals. Staff were observed to encourage service users to be independent and to make their own choices. As mentioned previously, those service users who were able, or wished to assist, were seen to take part in preparing for the meal. Meals in the home are planned according to a four-weekly menu plan, which had been recently reviewed and was dated to run for four months, until the beginning of 2008. The menu plan appeared well balanced and offered a wide variety of meals. It was positive to note that information in the AQAA indicated that service users views had been considered during the menu review, and the menu plan had been signed by the dietician and the home manager to indicate their involvement in the review. Specific guidelines had been drawn up and were available to advise staff and service users of any individual dietary needs, such as the need for reducing weight or for managing a diabetic diet. Rook View DS0000013769.V347084.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 18 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported in the ways that they prefer and their healthcare needs are very well met. The administration of medication is appropriately managed. EVIDENCE: Staff advised that each service user has an allocated key-worker to ensure that they receive consistent support in the ways they prefer, as these are well known to their key-worker. It was positive to note that an associate keyworker is also allocated to each service user, to ensure continuity of support when the key-worker is not available. A key-worker checklist has been developed to guide staff to the types of support they should be providing to the service users they are linked with. Two service users were happy to say which member of staff was their key-worker. A service user’s relative made positive comments in their CSCI feedback form under the heading “What do you feel that the care home does well ?”. These included the close communication between the service user’s key-worker and Rook View DS0000013769.V347084.R01.S.doc Version 5.2 Page 16 the relative, and that the service user had benefited from consistent support from the same key-worker for a long period. It was clear from speaking to staff and the records seen, that the healthcare needs of service users are very well met and a number of healthcare professionals are involved in their support. These include general practitioners (GP’s), chiropodist, optician, speech and language therapist, dentist, occupational therapist and hospital specialists. Staff advised that service users’ GP’s are contacted if changes are noted in a service users’ health, and the GP then makes referrals to other healthcare professionals as considered appropriate. An occupational therapist’s assessment of the home’s bathing facilities had recently been requested and carried out, because service users are getting older and some are becoming less mobile, staff advised. Information supplied in the AQAA confirmed that a health action plan is developed for each service user and that annual health checks are carried out. This information also stated that there are local policies in place for health promotion, and to enable staff to be aware of the signs and symptoms which may indicate ill health in older people. Medication is supplied to the home in “blister packs” along with printed medication administration record (MAR) charts by a local pharmacy, staff stated. Each blister contains an individual dose of a medication and is designed to enable close monitoring of medication administration and stock. Medication is stored appropriately in the home and appeared to be administered effectively. It was positive to observe that information was available to support and guide staff in many aspects of medication administration. This included the Royal Pharmaceutical Guidelines for the administration of medicines in care homes, guidelines relating to the administration of “as required” medication for individual service users, and the consent from service users’ GP’s to the administration of medication to their patients. Other good practice measures which were noted included regular checks on the amounts of medication held, audits of the home’s medication procedures carried out by the pharmacist, the pharmacy confirming receipt of returned items and a list of the signatures of staff who are trained to administer medication. Rook View DS0000013769.V347084.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure has been drawn up to suit service users’ needs and made available to each person living at the home, but few complaints have been received. The home promotes the awareness of abuse issues and staff are aware of their responsibilities in the protection of service users. EVIDENCE: Information supplied in the AQAA indicated that two complaints have been received in the last year, but neither of these were upheld. The AQAA stated that all service users have a complaints policy and procedure in their handbook, which has been adapted to meet service users’ needs and any concerns raised had been looked into and acted on. No information has been passed to CSCI regarding any complaint made to the home. A record of complaints and compliments is maintained and the complaints policy and procedure is included in this. It was noted that “positive feedback forms” are provided and a number of these had been completed this year. Staff advised that all service users are able to tell of, or indicate their unhappiness, by indicating the cause of their dissatisfaction. Staff stated that they are aware of the communication methods used by some service users and would recognise any unhappiness by changes in moods or behaviours. The home has a safeguarding adults policy and procedure (formerly the protection of vulnerable adults) and this was seen to link with the local Rook View DS0000013769.V347084.R01.S.doc Version 5.2 Page 18 authority safeguarding adults procedures. In the event of an allegation or incident of abuse, staff stated that the local authority procedure would be referred to. An up to date copy of the local authority procedure is kept in the home for staff to refer to if needed. The local authority procedure has been implemented in the past and recommendations have been acted on, staff advised. Staff spoken to said they would report any concerns about service users to the manager or the person in charge, and would have no hesitation in doing so. Staff were also aware that they could report concerns outside the home if needed, to other managers in the Surrey Borders Partnership Trust for example. It was clear from staff training records that staff have received training in safeguarding adults. It was positive to see that an awareness of the issue of abuse is openly promoted in the home. A pictorial leaflet was seen on the dining room notice board to advise service users about possible abuse. It was titled “Abuse is wrong – do not keep quiet”. A Surrey County Council poster titled “Everyday people say nothing” was also displayed to advise about reporting abuse. Small amounts of monies are held for safekeeping on behalf of service users, to enable them to meet their day to day expenses. These are stored securely and individually and are regularly checked by staff to ensure that the amounts are accurate. Two staff sign a record of each transaction of service users’ monies and receipts for any money spent are kept. Rook View DS0000013769.V347084.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some improvements have been made to the standard of the decoration in the home, but further work is required in communal areas to ensure that service users live in a homely, comfortable and safe environment. All areas of the home that were seen were very clean, freshly aired and appeared hygienic. EVIDENCE: The home is decorated and furnished in a homely style and each service user has their own bedroom. The communal areas consist of a large lounge, which is linked through an archway to the dining room. A requirement was made following the last inspection carried out on 13th February 2007, that the communal and individual areas of the home must be reviewed and that any repairs, replacements and redecoration needed must be carried out to ensure that service users live in a homely, comfortable and safe environment. A timescale of 11th May 2007 was given, but this has only partially been met. Rook View DS0000013769.V347084.R01.S.doc Version 5.2 Page 20 All the communal areas were seen and a number of bedrooms were seen, with the permission of the service users to whom the bedrooms belonged. Service users are offered keys to their rooms and a service user was seen coming and going to their room and locking it each time to maintain their privacy. It was observed that some bedrooms have been redecorated and refurbished in individual styles, and service users were proud to show them. It was also noted however, that the communal areas, including the hallways, dining room and lounge still needed to be improved. These areas of the home looked worn, with marks on the wallpaper, tears in wallpaper borders and small holes in the walls where fittings have been removed. Staff advised that the communal areas had not been improved because there was not enough money in the home’s budget. It was clear that service users are actively supported to enjoy their home. The lounge and dining room had been seasonally decorated for Halloween which was approaching, and service users spoke of having a Halloween party. It was positive to see a number of birthday cards in the lounge, which had been received by a service user who had recently celebrated their birthday. Staff stated that they are aware that the home is not suited to service users with mobility problems, particularly as there is no lift to access the upper floor and the stairs are quite steep. Some adaptations have been made however, to promote service users’ independence and ensure their safety, including handles fitted by the patio doors, grab rails around some toilets and a wheelchair accessible shower. As mentioned previously, an occupational therapist’s assessment of the bathrooms has recently been carried out because none of the bathrooms currently have an easily accessible bath. Staff have observed that as service users are getting older and less mobile, getting into a bath is becoming more difficult. All areas of the home which were seen appeared very clean, hygienic and freshly aired. Liquid soap and paper towels are provided and used in the home. It was observed that fabric towels are also provided as some service users prefer these, staff advised. Although fabric towels are not as hygienic as paper towels, staff advised that these are changed on a regular basis and more frequently if it becomes necessary. Staff advised that personal protective equipment including gloves and aprons, are provided and used as required, to prevent infection and the spread of infection. A laundry room is provided and equipped with machines with appropriate settings. The laundry room is situated away from food preparation and storage areas. Rook View DS0000013769.V347084.R01.S.doc Version 5.2 Page 21 The timescale for the previously made requirement regarding Standard 24 has been extended, that the communal areas of the home must be reviewed and any repairs, replacements and redecorations must be carried out as needed. A recommendation has also been made regarding Standard 24, that the home develops a planned maintenance and renewal programme for the fabric and decoration of the premises and keeps records of these. Rook View DS0000013769.V347084.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 and 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A small team of appropriately recruited staff are employed to meet the needs of service users. Staff have received training to enable them to provide effective support to service users, but most staff need to receive updated first aid training, to ensure they can adequately deal with any accidents which service users may be involved in. EVIDENCE: Information supplied in the AQAA stated that a small team of support staff are employed to meet the needs of service users. Staff advised that they support service users to carry out all roles in the home, including shopping, cooking, housekeeping, personal care and laundry. Staff also support service users with their various activities, both in and out of the home, and transport service users to these. As the staff team is totally female although the service user group is made up of males and females, it would not be possible for male service users to request support from male staff. Staff advised that the current male service Rook View DS0000013769.V347084.R01.S.doc Version 5.2 Page 23 users are either independent with their personal care or agreeable to be supported by female staff. The information supplied confirmed that four staff have achieved a National Vocational Qualification (NVQ) to level 2 or above, and two other staff are working towards this. The home meets the recommended 50 of staff trained to this level. In the absence of the manager, the service manager for the home provided access to staff personnel records, as these are stored securely and confidentially and staff in the home do not have access to these. The recruitment files of the most recently recruited staff were seen and the required checks had been carried out. These included obtaining two satisfactory written references and a Criminal Records Bureau (CRB) disclosure. It was also noted that confirmation had been obtained to ensure that the required recruitment checks had been carried out for staff supplied by an agency. Staff advised that a small number of regular agency staff are requested to work in the home, to ensure consistent support and to minimise any unsettlement different staff might cause to service users. It was positive to note that agency staff working regularly in the home have received a recorded induction into the work they are to carry out, the home’s procedures, receive supervision in the home and have received some training carried out in the home, including fire safety. Staff training records were seen and it was clear that staff have undertaken training required by law, including fire safety, food hygiene and moving and handling, and other training to develop their knowledge and skills such as bereavement, confidentiality and shift leader. It was noted however that many staff have not received updated first aid training or have not received first aid training at all, so it is not clear who would manage any accident / incident in the home. It is required that sufficient staff are trained in first aid and recommended that there is a trained first aider on every shift. Records of the induction of agency staff were seen during the inspection visit, but the induction records for recently recruited staff were not available in the absence of the manager. The manager confirmed before this report was written that induction records are held for the recently recruited staff. Two requirements have been made regarding Standard 35, that staff induction records must be maintained and kept in the home, and staff must receive mandatory training, including first aid. Rook View DS0000013769.V347084.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 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a home that is effectively managed and run in their best interests. The health, safety and welfare of service users is promoted, although improving the security of the premises and carrying out the recommendations of the fire risk assessment will help to ensure that the health and safety of service users and staff are protected. EVIDENCE: It is clear that the manager has the knowledge and skills to run the home. Information supplied in the AQAA stated that the manager has a nursing qualification for people with learning disabilities, has almost thirty years experience of supporting people with learning disabilities, has achieved the NVQ Registered Manager’s Award (RMA) and is a qualified NVQ assessor. Rook View DS0000013769.V347084.R01.S.doc Version 5.2 Page 25 The manager has ensured that the home is run in the best interests of the service users and achieves a majority of good outcomes for services users, as assessed at this inspection. Information as to how the home meets service users’ needs is gathered in a variety of ways. A number of CSCI feedback forms were supplied to service users, their families and healthcare professionals involved in their support. Three of these were completed and returned by service users, who had been assisted by staff, and one was completed and returned by a service users’ relative. These indicated that service users were given information about the home and came to visit before they moved in, that service users are able to make their own decisions or choices about how they spend their time and know who to speak to if they are unhappy. These also indicated that service users feel the home is kept fresh and clean, that staff treat them well and usually listen and act on what service users say. Positive comments were made by the relative of a service user who responded on the CSCI feedback form saying, “I am very satisfied with the care my relative receives”, that there is “lengthy and close care from the same key worker” for the service user and there is “close contact between the key worker and relative”. Although staff did not have any information about when a quality assurance survey was last carried out, it was agreed that this information would be supplied to CSCI. The service manager for the home advised that the organisation has updated its quality survey to improve the way that the questions are asked. It is planned to supply this to service users shortly, and it is planned to ask day services staff to assist service users to complete the survey. This will ensure that service users are provided with support that is independent of the home. As mentioned earlier, the home asks those involved with the support of service users, to complete positive feedback forms when compliments are received. This enables monitoring of the feedback and can be shared with staff who may not be on duty when the compliment is received. Visits to the home are carried out under the requirements of Regulation 26 of The Care Homes Regulations. This regulation requires organisations, which are not in day to day control of services to appoint a person to make monthly, unannounced visits to the service. The person should speak to service users and staff, look at the premises and write a short report of their findings. A copy of the report must be left in the home. Reports of recent Regulation 26 visits were seen and recorded positive outcomes. Service users and staff were observed to interact well, the views of the people living at the home were obtained and other aspects of running the home were reviewed. Rook View DS0000013769.V347084.R01.S.doc Version 5.2 Page 26 Information was supplied in the AQAA confirming that equipment and systems in the home are serviced and maintained to ensure the safety of service users and staff. Staff advised that the home received an environmental health inspection in June 2007, but no requirements or recommendations were made. The homes up to date and valid insurance policy and a Health and Safety at Work poster were displayed as required. The home’s fire safety records were seen and these recorded that the systems were tested and serviced regularly, to ensure that they work properly and safeguard all those living and working in the home. A fire risk assessment was carried out earlier this year and recommendations were made, but there was no record of whether these had been met. Staff were aware that one recommendation had been carried out, but did not know the outcome of others. The manager contacted CSCI before this report was written to confirm that two recommendations had been passed to the buildings department for action, but these had not yet been carried out. The manager stated that these would be followed up to ensure they are addressed. Two possible hazards to the health and safety of service users were noted around the home. On the inspector’s arrival both the outer and inner doors to the home were found to be unlocked. The inner door was immediately locked, but on two occasions later in the day the inner door was again found to be unlocked. It is recommended that the security of the home is reviewed to ensure the safety of service users and staff. It was observed that a locked cupboard under the stairs, which was used to store products which may be hazardous to health, had the key to the cupboard still in the lock. Staff who had been using the cupboard immediately removed this. It is recommended that the key is removed immediately after use, to safeguard service users from hazardous materials. Rook View DS0000013769.V347084.R01.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 X 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 1 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X 3 X 3 X X 2 X Rook View DS0000013769.V347084.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? Yes 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 YA24 Regulation Requirement Timescale for action 18/01/08 23(2)(b)(d) The registered persons must review the individual and communal areas of the home and ensure that any repairs, replacements and redecoration take place as needed. This will ensure that service users live in a homely, comfortable and safe environment. Timescale of 11/05/07 not met. 17 (2) Schedule 4 A record of staff induction must be maintained, kept in the home and be available for inspection. 2 YA35 23/11/07 3 YA35 13 (4) Staff must receive mandatory 18/01/08 training. Specifically, arrangements must be made for training staff in first aid. Rook View DS0000013769.V347084.R01.S.doc Version 5.2 Page 29 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 YA24 Good Practice Recommendations It is recommended that a planned maintenance and renewal programme with timescales, is developed. It is good practice to keep records of when these timescales are met. It is recommended that the actions specified in the home’s fire risk assessment are carried out, to ensure the safety of all who live and work there. It is recommended that the security of the premises is reviewed to ensure the safety of all who live and work there. 2 YA42 3 YA42 Rook View DS0000013769.V347084.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Oxford Office 4630 Kingsgate Oxford Business Park South Cowley Oxford OX4 2SU 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 Rook View DS0000013769.V347084.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!