Care Home: Sandford Road,4

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What the care home does well The service provides support and accommodation to those residents who need their daily living skills maximised in order that they can move to more independent accommodation. In this respect the service has been successful with residents moving out of the home to more independent accommodation. Community Options operates an open culture throughout the organisation, which promotes mental health, enabling residents to live fulfilling lives and be as independent as possible.Training for staff is a high priority ensuring that they have sufficient training in all topics as well as recovery and mental health issues. The service ensures that staff are suitably trained to meet the needs of residents and this was very evident during this site visit. What has improved since the last inspection? The appointment of a training coordinator has ensured that training of staff is given a high priority and that statutory updates are addressed in the appropriate time frames. The training department actively source appropriate training as identified by the service and staff themselves. Care plans have improved and more information was incorporated into these which provides staff with detailed information on which to provide care and support. Care plans also ensure that consistency in care is maintained which is essential when dealing with mental health residents. All residents have copies of the company`s policy and procedure relating to equal opportunities and diversity. The home`s systems of key working tries to reflect people`s individual needs whether that be gender or cultural specific e.g. a female resident will be offered a female key worker etc. All staff have training in the areas of diversity and attend recovery workshops. In addition training on faith and spirituality is provided to all staff. What the care home could do better: In the interests of safe medication, handling all medication must be administered directly from the original labelled container to the resident and not placed into any secondary container for later administration by another carer. The Regulation 26 visits need to be conducted monthly and a report on the findings retained. These should be informative and give a picture of the service; previously, some of these have been very limited and provided little information. CARE HOME ADULTS 18-65 Sandford Road,4 4 Sandford Road Bromley Kent BR2 9AW Lead Inspector Miss Rosemary Blenkinsopp Key Unannounced Inspection 14th October 2008 09:40 Sandford Road,4 DS0000006910.V372960.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 Sandford Road,4 DS0000006910.V372960.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. Sandford Road,4 DS0000006910.V372960.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sandford Road,4 Address 4 Sandford Road Bromley Kent BR2 9AW 020 8313 1017 020 8313 9703 gina.benjamin@community-options.org.uk www.community-options.org.uk Community Options Limited 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) Mrs Regina Ann Benjamin Care Home 5 Category(ies) of Past or present alcohol dependence (5), Past or registration, with number present drug dependence (5), Mental disorder, of places excluding learning disability or dementia (5) Sandford Road,4 DS0000006910.V372960.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th July 2007 Brief Description of the Service: Sandford Road is part of the Community Options group of homes. This is a voluntary organisation providing a broad spectrum of services to mental health clients including residential homes and domiciliary services. The home is a domestic style house located in a residential area of Bromley. The home provides support for five residents in the category of mental disorder including past or present alcohol and drug abuse. This is referred to as dual diagnosis. The residents in this home are undergoing rehabilitation in order that they may live more independently in the community. The usual length of stay in this facility is two years. Residents in this home are subject to Care Programme Approach (CPA) after care systems. This ensures that monitoring and reviews take place by the multidisciplinary team when residents are living in the community. The staff in the home are on site throughout the 24-hour period. The manager and her deputy support the staff team. Senior management is provided through Community Options and on call systems are in place. Multidisciplinary mental health teams are provided through the Primary Care Trust. All other health care is accessed through the community. The weekly fee for this service is £950.00 per week. Sandford Road,4 DS0000006910.V372960.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating of the service is 2 star. This means the people who use this service experience good. The manager facilitated the site visit. Periods of observation were undertaken on the site visit. Prior to the inspection the manager had completed the AQAA and forwarded this to the CSCI. Comment cards were sent to the service and provided during the site visit or though. During the visit the inspector met with several residents. Many comment cards were returned although not until after the site visit. Staff were interviewed as part of the site visit. All of the information obtained from the sources identified above has been incorporated into this report. A selection of documents were inspected including care plans, complaints information as well as health and safety records. Feedback was provided to the manager at the end of the inspection. Other information which has been considered when producing this report and rating, is the information supplied and obtained throughout the year including Regulation 37 reports and complaints. Following the inspection members of the multi disciplinary team were contacted regarding the service. Favourable comments were received in respect of staff, support to residents, communication with multidisciplinary team members and the environment. What the service does well: The service provides support and accommodation to those residents who need their daily living skills maximised in order that they can move to more independent accommodation. In this respect the service has been successful with residents moving out of the home to more independent accommodation. Community Options operates an open culture throughout the organisation, which promotes mental health, enabling residents to live fulfilling lives and be as independent as possible. Sandford Road,4 DS0000006910.V372960.R01.S.doc Version 5.2 Page 6 Training for staff is a high priority ensuring that they have sufficient training in all topics as well as recovery and mental health issues. The service ensures that staff are suitably trained to meet the needs of residents and this was very evident during this site visit. What has improved since the last inspection? 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. Sandford Road,4 DS0000006910.V372960.R01.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 Sandford Road,4 DS0000006910.V372960.R01.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): 2. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The pre-admissions procedures provide residents with a range of information, including visits to the service, to assist their decision making process, and enable them to establish whether the service is right for them. Staff are provided with comprehensive information on which they can base an initial care plan and address resident’s needs. EVIDENCE: At the time of the site visit all residents were male. This is not a specification or part of the admission criteria, it just so happens that all recent referrals have been male. Prospective residents are provided with a “ready to read”, folder which provides them with a lot of information about the service and local amenities. One resident confirmed that prior to admission he had had two trail visits, had been provided with information about the home and had an over night stay. This had given him, he said, a good insight into the home staff and other residents and enabled him to make the decision about permanent placement. Sandford Road,4 DS0000006910.V372960.R01.S.doc Version 5.2 Page 9 All prospective residents submit an application form for possible placement which is completed either by them or their care managers. In reality because of the lack of service provision choice in placements is limited. There were licence agreements signed by the residents and the manager on the individual’s file. Residents in this home are issued with a contract for Dual Diagnosis; in so much as they suffer from mental health problems and substance misuse. In a second file there was evidence of the application form and two assessments conducted by staff from Community Options, which provided good information. The two assessments had taken place four months apart as admission had been delayed. It is good practice to do updated reassessments when delays occur, as situations may change and the home may be unable to meet the resident’s needs. Assessment information is also obtained through the Car Programme Approach (CPA). These procedures provide information on the resident including care plan and review information to the place where they are living. This ensures that consistency and continuity in the service are maintained. Other information obtained through the assessment process, included a psychiatric report and a summary from the last residential placement. Those residents, who had been recently admitted, confirmed that they had visited the home prior to moving in and had been assessed. Once the home has conducted their assessment, and knows that they can meet the resident’s needs, then an offer letter is sent. The Statement of Purpose is available and sets out the level of services provided. An inventory of property is taken when residents are admitted to afford them protection. Sandford Road,4 DS0000006910.V372960.R01.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): 6, 7, and 9. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The information in care plans enables the staff to plan and deliver the care. With comprehensive information available to staff and members of the multidisciplinary team, a consistent approach to care is maintained, which benefits residents. Risk assessments were in place to address all activities of daily living. EVIDENCE: Care plans of those residents included as part of the case tracking were inspected. Care plans outlined physical and mental health issues as well as the specific area of rehabilitation, where support was needed. The intervention sections were well completed and would provide staff with comprehensive information on which to provide support to residents. Sandford Road,4 DS0000006910.V372960.R01.S.doc Version 5.2 Page 11 Care plans work in conjunction with the CPA care plans so that a consistent approach is maintained between the teams. In the files seen recent CPA reviews were retained and the information reflected in care plans. Community Options care plans do not state what the expected outcome is and this has been referred to in other Community Options facilities. The care plans provides information on physical and mental health needs although did not indicate what the objective or goals were in respect of the identified issues. Without an objective it would be difficult to identify what the home was trying to achieve, in respect of that issue. The manager stated that these were reviewed as part of the daily entry in the record master and the progress reflected in these entries. The Community Options support package, which is a document detailing aspirations goals etc, was blank in one file inspected. Within the files there was an over view of risks. Specific risk assessments were then developed for missing person and those individual to the resident, such as fire, self neglect and pertinent mental health problems. Residents in this home are supported to attend services in the community accessing GP’s, dentist and other health care through community settings. This encourages engagement with the community as well as promoting rehabilitation. Sandford Road,4 DS0000006910.V372960.R01.S.doc Version 5.2 Page 12 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. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Residents are well supported with all activities of daily living to maximise personal development and enhance rehabilitation for more independent living. Open visiting promotes and encourages residents to maintain social networks. EVIDENCE: Residents were spoken to as part of the site visit. They said that they were supported in activities of daily living especially those relating to household chores, cooking and budgeting. During the site visit the residents were observed to be taking part in various activities including cleaning of the home, preparing for shopping and going out to local amenities. Residents confirmed that they attended external clubs and events and were free to come and go within reason. The residents spoken to said that weekend leave was encouraged and that they spent time with their family. Two Sandford Road,4 DS0000006910.V372960.R01.S.doc Version 5.2 Page 13 residents in this home take it in turns to cook for one another, which works well and they have established a good relationship. A curry night is organised weekly where a film is hired and residents have a take away in the home. The residents are encouraged and supported to be part of the “Service User Involvement Group”, which meets bi monthly. Residents are also encouraged to be active in the organisation and attend the Annual General Meetings. Residents can if they wish join local facilities and there is a gym near by. The home organises in house meetings which residents are expected to attend and input. Minutes of these are retained. Newspapers are provided as well as games and magazines. Rehabilitation support was referenced in comment cards. Within one comment card a resident stated, “It will be a stepping stone to getting a flat “. Within a staff survey the following was written: “Supporting service users on a daily basis, helping them to move towards more independent living”. Visiting is open and encouraged. Residents can see their visitors in private or in communal areas as they wish. Community Options organise events such as the Christmas party where all residents in their facilities can get together as many of them know on another having been in the service for some time. Sandford Road,4 DS0000006910.V372960.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Health care is provided through the local community, which promotes resident’s rehabilitation and engagement with services. Medications are safely managed by staff that are trained and proficient to do so. However, that medication which is for use during home leave, must be reviewed in light of recent good practice guidance. EVIDENCE: Residents in this facility are mainly younger and physically able and address their own personal care. All residents in this home must be mobile as there is no lift or other equipment to deal with physical disability. The residents care file included information on health care in the form of appointment letters including those for CPA reviews. As residents attend local community health settings some of the healthcare information was limited, although staff are aware of appointments and where needed follow these up. Sandford Road,4 DS0000006910.V372960.R01.S.doc Version 5.2 Page 15 Feedback obtained from one visiting health professional included the following “My client has moved on significantly. The staff are responsive and always follow care plans. Since going to Sanford Road he now goes out all around Bromley before he could only get as far as the corner shop. There is a consistent team approach who are supportive and responsive”. The medications were inspected. Medication policies are located in the home and include a section on self-medication procedures. The charts had clear photographs of residents and allergies recorded. Those medications, which are to be administered “as required”, had confirmation by the GP and individual guidance for the medications. Residents who are in the process of self administering their medications go through a staged process before they are fully self medicating. The GP also confirms that they are undergoing self-administration. Weekly spot checks are undertaken by staff to ensure compliance with the medication regime. Staff are also alerted to any unusual behaviour, possible side effects or evidence of possible non-compliance. There was some query as to whether the current method of providing residents with their medication for weekend leave was satisfactory. The staff in the home describe the following practice: We do not remove the tablets from the packaging; however we do cut the appropriate days tablets from the blister pack and give the resident that strip of tablets. Advice was sought from the inspecting pharmacist who said the following: “In the interests of safe medication handling all medication must be administered directly from the original labelled container to the service user and not placed into any secondary container for later administration by another carer. Medication is supplied to the home in a monitored dosage system. Medication is then transferred from this original pharmacy supplied and labelled container and placed by a member of the staff, on a daily basis, into another container for later administration by another carer. This is an outdated and unsafe practice and is not in line with best practice as described in The Administration and Control of Medicines in Care Homes and Children’s Services, produced by The Royal Pharmaceutical Society of Great Britain. This practice was also described as frequently associated with medication errors in a report by the Department of Health, Building a safer NHS for patients. This is an outdated and unsafe practice and is not in line with best practice as described in The Handling of Medicines in social Care, produced by The Royal Pharmaceutical Society of Great Britain. This practice was also described as frequently associated with medication errors in a report by the Department of Health, Building a safer NHS for patients”. Sandford Road,4 DS0000006910.V372960.R01.S.doc Version 5.2 Page 16 In addition the following advice was extracted from the Royal Pharmaceutical Society: You should ask the supplying pharmacist for help and advice in dealing with the specific circumstances. These may include: • Having a separate container of medicines specific to the time of day that the person takes Regular leave, for example, lunch-time medicines for a person attending an adult training Centre. • Having a separate supply of medicines for the full period of a holiday. If the person regularly goes to spend weekends with family, there is no reason why their medicines should not go with them. The medicines are the person’s property, not the care homes. The home needs to amend their procedures to include the advice as stated above to ensure residents medication is safely managed for all parties. Please see requirement 1. Sandford Road,4 DS0000006910.V372960.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.People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Complaints information is available for residents, staff and visitors to access. Complaints are taken seriously and responded to appropriately. Staff had a working knowledge and understanding of adult protection and whistle blowing, which provides safeguards to residents. Regular updating is required in these areas, to ensure that they are familiar with current guidance and in particular external contact points. EVIDENCE: Community Options have comprehensive polices and procedures on abuse and whistle blowing. The company have specific forms for recording complaints and other information obtained. The CSCI have received no information relating to complaints or adult protection matters raised regarding this service. In the homes own record of complaints there were no entries since 2006. The home is reminded that all complaints must be recorded no matter how trivial. The staff on duty were asked about adult protection and whistle blowing procedures. They all had a good knowledge of the subject, including what constitutes abuse, what action to take and who to report it to. They were asked a couple of scenarios regarding abuse by staff towards a resident; Sandford Road,4 DS0000006910.V372960.R01.S.doc Version 5.2 Page 18 through their answers they demonstrated a working knowledge of abuse as well as compassion for the residents. Staff need to be aware of external single points of contact which are in operation for most Local Authorities when reporting abuse. It was evident that an open culture exists, which includes all management tiers. Staff felt confident that they could raise issues in a confidential manner and without fear of reprisals. Residents also felt able to raise concerns with staff in the home or those externally, namely care managers and social workers. Staff spoken to confirmed training in adult protection and this was evidenced in the training records. In respect of whistle blowing they again had a good grasp of what this entailed. Sandford Road,4 DS0000006910.V372960.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 and 30. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The environment is maintained to a good standard, clean and hazard free. Residents have sufficient space in their bedrooms to personalise them to their own specifications. Comfortable communal areas provide space for socialising and relaxation. EVIDENCE: The home is a domestic house located in a residential area of Bromley close to transport and shops. It has a large back garden and a small front area. Communal areas are on the ground floor as is the staff office. The staff office is also the sleeping in room. This is very cramped and with the amount of equipment in it, this leaves little room for staff or residents. In addition medication cabinets and files are located in this area. A revision of this space and /or re-location of the medications should be considered. Sandford Road,4 DS0000006910.V372960.R01.S.doc Version 5.2 Page 20 The home was well maintained in a homely fashion. It was clean tidy and hazard free. Two bedrooms were inspected and found to be clean tidy and personalised in the resident own taste. One resident requested that her bedroom mirror was repositioned for another bought, as it was too low and had to sit on the floor to see herself. This was referred to the manager for action. All residents are supported on a individual basis to maintain their rooms. Residents share in the housework on a rota basis with the support depending on the individual needs, this gives a sense of ownership and community to residents.Staff also ensure the general environment is kept to a good clean and hygenic standard. Daily checks are conucted to ensure the envorment is kept clean and satisfactory including those on the fridge/ freezer daily checks and water checks to ensure tesare safe for residenstand potential hazards identified and eliminated. Sandford Road,4 DS0000006910.V372960.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Staff are subject to robust recruitment procedures, which affords protection to residents. Staff are provided in sufficient numbers to meet resident’s needs. Staff receive training on the mandatory topics as well as those, which are related to the current resident population, this ensures that staff are competent and capable to care for residents. EVIDENCE: As we arrived there was one staff on duty the other staff member was at the supported house which the home staffs, and the manager was at head office. Of the current staff group there are three male and five female. One worker is African and this staff, key works the resident who is from a similar cultural background. The staff on duty met with the inspector. They were asked questions on their training and support provided by the organisation. In addition their knowledge of residents in the home, including their conditions, background etc. was Sandford Road,4 DS0000006910.V372960.R01.S.doc Version 5.2 Page 22 explored. Those staff, who were key workers, were asked specifically about their key residents including their needs family links hobbies etc. They demonstrated a good knowledge of the residents and confirmed that they were always kept informed of changes and that information available was comprehensive. They all indicated that there was good training opportunities provided, with both internal and external courses offered. Staff have individual training plans developed around their needs. It was positive to note that training in respect of deaf awareness had been provided to staff – one staff was taking further training on the subject. This was in relation to the specific needs of one resident and this should be commended. Staff meetings are held monthly and minutes are retained for staff that cannot attend, so that they can read them. The staff personnel files were inspected at the head office July 2000. Two staff files were selected from each service, including some manager’s files. These were inspected to identify evidence of recruitment procedures and those checks made prior to employment. In the main, those staff that had been recently appointed were selected as other files have been checked at previous inspections. Overall files were to a good standard. Evidence in respect of staff recruitment, and the checks made prior to employment were sufficient to ensure that staff are safely recruited for the protection of residents. The following is a summary of the findings: The staff personnel files were organised with information easy to access. Sections indicated where items could be located. The standard of information included was good. Evidence that recruitment checks are made prior to employment were on file including application forms, interview information, two references, CRB clearance, offer letters and contracts. Information relating to the CRB was retained in a separate file and in addition evidence recorded on the staff file that included the reference number, date of issue and an indication of whether it was satisfactory. Community Options are undertaking the recommendation that CRB’s be repeated every three years. Any gaps in application forms or conflicting information included within it, are now subject to further investigation by the personnel officer who sits on the interview panel. Sandford Road,4 DS0000006910.V372960.R01.S.doc Version 5.2 Page 23 It was discussed at the head office with the training officer, the need to acquire more mental health training; this was something, which she was in the process of dealing with. Community Options invest in their staff and support team and company away days to assist wit team building. In addition the company have an annual awards ceremony where individuals are recognise for their contributions to the residents and their work. Sandford Road,4 DS0000006910.V372960.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 and42. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home is managed by an experienced individual supported by other managers in the company and senior personnel of Community Options. Health and safety measures provide residents with a safe home for them to live in. Quality assurance measures include the views of resident’s, relative’s staff and other parties involved in the home, whose opinions help to further develop a better service. EVIDENCE: The manager has been on maternity leave and is now back in her full time role. The home has appointed a new deputy who has been in her position since Sandford Road,4 DS0000006910.V372960.R01.S.doc Version 5.2 Page 25 December 2007. The deputy was on site and interviewed as part of the key inspection. She demonstrated a good knowledge of the workings of the home and her management responsibilities. She was confident that he had enough support in her role, both from the manager and head office personnel. A selection of health and safety records were inspected and found to be satisfactory. The file containing the documents was well organised. Due to the hearing impairment of one resident in the home, the fire system had been adapted to include a vibrating pad and a light activator linked to the fire alarm. In addition a new doorbell had been fitted to enable ease of access to the building. The fire risk assessment had been updated to include the needs of this resident. Weekly fire alarm testing is conducted as well as regular checks on emergency lighting. Fire drill records evidenced regular training although those attending were not indicated, all staff and residents who attend fire training should sign for the training to evidence that they have attended. Records of hot water temperature checks were retained although they had not been addressed since 19 August 2008. This needs to be addressed. Regular health and safety audits are conducted and a report on the findings left. A number of other internal audits are in operation to monitor practices and ensure they are following current guidelines and policies. Community Options has an annual development plan for the organisation in general and a specific one for each home. Community Options had conducted their annual quality survey “ Service User Satisfaction Survey”, some months previous. There had been four out of the five residents in the home had responded. The manager had received verbal feedback indicating a positive response to most areas. Manager’s meetings are held for all managers in the company. Regulation 26 reports were on file dated October 08 July 08 and April 08 others could not be located. Residents have their own budgeting plan, which is included in their care plan. This assists them with their finances should they require that level of assistance. All financial transactions are signed for. One resident has a financial appointee. And another is going through the process. All residents have their personal bank accounts. Finances are checked twice daily. Please se requirement 2. Sandford Road,4 DS0000006910.V372960.R01.S.doc Version 5.2 Page 26 Sandford Road,4 DS0000006910.V372960.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 X 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 3 25 X 26 x 27 X 28 x 29 X 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 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 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 x X 3 X 3 X X 3 x Sandford Road,4 DS0000006910.V372960.R01.S.doc Version 5.2 Page 28 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA20 Regulation 13( 2) Requirement Timescale for action 2. YA39 26 In the interests of safe 30/11/08 medication handling all medication must be administered directly from the original labelled container to the service user and not place into any secondary container for later administration by another carer. Regulation 26 visits must be 30/11/08 undertaken and a report on the findings left . The report must include findings and where possible input from staff, residents and visitors. 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 YA40 Good Practice Recommendations The Registered Person should ensure that all policies are reviewed on a regular preferably annual basis or when good practice or legislation changes. Sandford Road,4 DS0000006910.V372960.R01.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 Sandford Road,4 DS0000006910.V372960.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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