Care Home: Shawe Road Short Break Service

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What the care home does well The registered person ensures that peoples needs are assessed so that staff know what to do to support people to reach their full potential and receive personal care and support they choose. The registered person ensure that care plans are updated and that there is effective communication between the staff, the guest, their relatives or carers and health and social care professionals. The registered person ensures that medication is safely stored. The registered person ensures that people have a choice of activities in which to participates when they spend time at Shawe Road so that they have an enjoyable time. The registered person ensures that complaints and concerns are taken seriously and dealt with fairly and openly. The registered person ensures that the environment is clean and appropriately maintained. The registered person ensures that staff are recruited through a robust recruitment policy which means that people employed are suitable for working in the care sector with vulnerable people. The registered person makes sure that the day to day running of Shawe Road is effective and promotes the wellbeing of those involved with the facility. What has improved since the last inspection? Since the previous inspection the meals provided at Shawe Road has improved because a two weekly menu has been developed and staff have been shown how to cook the dishes and received food safety training, and peoples food preferences are recorded. Since the previous inspection some aspects of medication management has improved. Pictures of people are now put on their medication record sheets so that the identification of people can be more easily confirmed. Since the previous inspection the manager has brought together care plans and assessment into a single file so that the majority of information about a person is contained in a single file. Since the previous inspection senior staff have received accredited medication training. What the care home could do better: The registered person needs to makes sure that all the information that they have about people is written down. This is so that everyone is aware of what the person needs and what steps have been taken. This provides reassurance to the person, the relatives and staff, it prevents duplication and keeps managers and carers aware of issues that need to be followed up.The registered person needs to make sure that staff always manage medication in keeping with the medication policy that is in place. This is so that it can be proved that people always receive or are offered, the correct medication, in the correct dose, at the correct time and that all staff receive accredited medication training so that they can discuss these issues with people who are expert in this area. The registered person needs to make sure that all staff training is recorded so that they can be certain that staff have been given the information and have the competency to meet individual needs and to do the job expected of them in a safe manner. The registered person should look at the agencies policies and procedures and review those they consider relevant to ensure that, the information is in keeping with new legislation such as the Mental Capacity Act 2007 or Deprivation of liberty safeguarding guidelines. The registered person should introduce an official means for people to comment on the quality of the service provided and what they say should be assessed and made readily available. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Shawe Road Short Break Service 10 Shawe Road Flixton Manchester M41 5DL     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Kath Oldham     Date: 2 8 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: Shawe Road Short Break Service 10 Shawe Road Flixton Manchester M41 5DL 01617943764 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): jpilkington@iasservices.co.uk IAS (Services) Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 6 The registered person may provide the following categories of respite service only. Care home only - code PC, to service users of the following gender:- Either. Whose primary care needs on admission to the home are within the following categories: Learning disabilities -Code LD The maximum number of service users who can be accommodated is: 6 Date of last inspection Brief description of the care home Shawe Road is a short break service, which has been established for a number of years, initially owned and staffed by Trafford Borough Council. In March/ April 2007 the staffing of this respite service was awarded to IAS Services Ltd. Jill Pilkington from IAS Services Ltd manages the service and staff are employed directly by IAS. The property is owned by Trafford Council and responsibility for the upkeep of the building remains with the council. Shawe Road provides up to six short-term places for younger adults with learning and physical disabilities. Trafford Council determines the days allocated to the people using Care Homes for Adults (18-65 years) Page 4 of 32 Brief description of the care home the service. Many of the people using this service have attended for a number years. The days allocated at Shawe Road range from overnight stays, a couple of days or longer periods. These times are chosen by the people using the service, their relatives or person providing support to them on a day-to-day basis and are usually booked in advance, in discussion with Shawe Road. The unit is situated in an established residential area, close to Flixton and near to public transport and other amenities. Care Homes for Adults (18-65 years) Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We conducted this key inspection without informing the manager before hand and looked at all of the most important or key care Homes for Adults (18-65) National Minimum Standards (NMS). This is called a Key Inspection. The inspection involved looking at the information we had received about the service during the previous year and before visiting the service. This included notifications or events that the manager has told us about, information from other sources such as social services, health workers or people using the service. We received six completed Care Quality Commission (CQC) surveys from staff. Care Homes for Adults (18-65 years) Page 6 of 32 We spent time at Shawe Road between 07:50 and 14:50 on the day of inspection and checked through written information, including service user care files and staff employment records. We read through policies, guidelines and other documents concerned with running the short staff facility. We interviewed staff and quests at Shawe Road and observed the way that staff related to people. The manager returned to us the CQC Annual Quality Assurance Assessment (AQAA). The information requested included data about staff training, development of policies and procedures and compliance with health and safety checks when applicable. This information also influences the outcome of the inspection. On the day of inspection the another manager stood in for the registered manager Julie Pilkinton and assisted with the inspection. What the care home does well: What has improved since the last inspection? What they could do better: The registered person needs to makes sure that all the information that they have about people is written down. This is so that everyone is aware of what the person needs and what steps have been taken. This provides reassurance to the person, the relatives and staff, it prevents duplication and keeps managers and carers aware of issues that need to be followed up. Care Homes for Adults (18-65 years) Page 8 of 32 The registered person needs to make sure that staff always manage medication in keeping with the medication policy that is in place. This is so that it can be proved that people always receive or are offered, the correct medication, in the correct dose, at the correct time and that all staff receive accredited medication training so that they can discuss these issues with people who are expert in this area. The registered person needs to make sure that all staff training is recorded so that they can be certain that staff have been given the information and have the competency to meet individual needs and to do the job expected of them in a safe manner. The registered person should look at the agencies policies and procedures and review those they consider relevant to ensure that, the information is in keeping with new legislation such as the Mental Capacity Act 2007 or Deprivation of liberty safeguarding guidelines. The registered person should introduce an official means for people to comment on the quality of the service provided and what they say should be assessed and made readily available. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 32 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using Shawe Road short stay facility have their wellbeing and individuality promoted as staff are made aware of their physical, emotional and social preferences and needs through detailed assessments. Evidence: We visited the respite service at Shawe Road and looked at the care files for four of the guests who used the facility on the day of the inspection. The files looked at included a person staying for recuperation and reassessment following a hospital admission. We found that each person had a full assessment that had been completed using information obtained from the person, the social worker making the referral, the persons relatives and others involved in the persons life. This included physiotherapists, speech and language therapist and nurses. We found that senior staff from Shawe Road also attended meetings and became acquainted with the person before they received respite. Care Homes for Adults (18-65 years) Page 11 of 32 Evidence: We found that information about people included the type of personal support needed, activities and interests, family contact, assessment of risks, physical and emotional health, information about specific health conditions such as epilepsy, communication and the type of environment enjoyed by the person. We also found, through looking at the policy and discussion with the manager, that guests were gradually introduced to the service through mealtime and other visits. These visits become longer so that the overnight stay seemed a natural progression. We found that an improvement in this area would be to include, as standard, more information about the money guests should bring with them. This will avoid confusion about how excursions are paid for and also provide guests with more freedom if they want to go shopping for items themselves. Six members of staff returned Care Quality Commission surveys and all confirmed that they were always provided with enough information to meet the needs of the guests who stay at Shawe Road for respite care. They said What the home does well is introduce guests and new staff and making them very welcome. Care Homes for Adults (18-65 years) Page 12 of 32 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using Shawe Road short stay facility benefit from having care plans that identify their preferences and ensures that the support provided is in keeping with their choice and are as individualised as possible. Evidence: We read through four care plans and found that each provided enough information for staff to know how to support people to meet their assessed needs. We found that there was clear and provided information about peoples preferences and how to support guests in the manner they preferred. We found that preferences concerning rest and sleep, going to work, support for medical attention and activities was recorded. We saw that the care plans pulled together information from different sources including the person themselves and their carer, other professionals involved and also observations made by staff through spending time with the guest. We found that most of the information about a person was kept in single file and this is an improvement since the previous inspection. Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: We found that although each person had a care plan in place, some were more detailed and precise than others. It would be an improvement if care plans relating to the most significant aspects of peoples lives were written in more detail. At the previous inspection we found that staff held a lot of information about the guests but this was not always written down. At this inspection we found that there is still a tendency for senior staff to take action but not always record what they have done. It is important that all staff develop the habit of recording the interactions they have been involved in on behalf of guests or their representatives, so that everyone is aware that action has been taken to try and deal with any issues. We observed staff being spontaneous and natural in supporting guests to make choices about what they did at different times of the day. We looked at the risk assessments in place for each person and found that people were supported to make informed decisions, and that risk assessments enabled people to carry out the activities they wanted as independently as possible. We found that the risk assessments were enabling and did not hinder. The risk assessments we looked at included dealing with the risk of mobilising independently, nutrition, accessing the local community independently and using the bus. We discussed the Mental Capacity Act 2007 and Deprivation of Liberty safeguards (DoLs) with the manager. She confirmed that the team leader for Shawe Road had completed the training, that all the paperwork was in place and the Responsible Person who would lead the application for its application was identified. The manager confirmed that IAS directors had attended all the training and meetings concerning this issue in Trafford Metropolitan Borough. And they had been instrumental in developing the DoLs policy in the IAS organisation. We were informed that none of the guests at Shawe Road were subject to the DoLs process at present. Comments from staff about choice and lifestyle for guests at Shawe Road included: We encourage the guests to make choices and have the lifestyle they want for example with activities and assistance with personal care. And I love working here we give people choice, what they eat, what clothes to wear, where they would like to go- choice in everything we can. Care Homes for Adults (18-65 years) Page 14 of 32 Care Homes for Adults (18-65 years) Page 15 of 32 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Guests spending time at Shawe Road are offered support that meet their lifestyle choices and which broaden their experiences, and so people have an enjoyable stay at the facility. Evidence: We looked at the information in the care plans and assessments for four people and found that for three people there was a clear description of what they would like to do during the day and how this was to be facilitated by staff. We saw on the day of the inspection that people were supported to attend the day activity of their choice. People went to day centres, college and work. We noted that the person who did not leave Shawe Road was encouraged and supported to go shopping locally and so accessed the local community. We also observed that this person was supported to enjoy activities identified in his care plan. Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: Discussion with the staff and information written in the daily records confirmed that at the weekend people were supported to enjoy a variety of recreational activities, this included musical and sporting events in the local community. People also enjoyed staying at Shawe Road where activities included pamper sessions, playing board games and arranging themed evenings. In the information returned to us the manager stated that: There are opportunities for people to try new recreational activities such as carnivals, theatre and what ever they would like to do. We found that an improvement in this area would be to include, as standard, more information about the money guests should bring with them. This will avoid confusion about how excursions are paid for and also provide guests with more freedom if they want to go shopping for items themselves. We found that daily records and communication books confirmed that relatives were kept informed of significant events in keeping with what was agreed at the time of the assessment. We noted that carers or relatives were able to visit and spend time with people. However this is a respite facility and so people tend to make phone calls to check on how people have settled. We were told by the manager that friendships are encouraged and that this and other compatibility issues were taken into account when booking guests in for their stay. We observed that staff related well to the guests spending time talking to people, finding out what they like to do and making general conversation about what was happening at Shawe Road, on television and other topics. During the tour of the building we found that the rooms in use were locked and that people were encouraged to hold a key. We found that since the last inspection the manager has devised a menu for staff to follow. This is because it was previously found that meals were not balanced, varied or enjoyed by the guests. The manager said that all the staff had received lessons in how to cook the items on the menu and were also provided with recipes to follow. The manager explained that staff did not always know what food should be put together and so a menu helped to deal with this issue. The manager stated that although the menu was in place choices were also available but in order to ensure that meals were wholesome, varied and culturally acceptable staff were been encouraged to keep to the menu until they were more confident with cooking. The menu is fortnightly so that Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: people who stay on the same day do not always have the same choices. The menu included: cereal, scrambled egg, bacon, and toast at breakfast. The lunchtime choices included: soup, a choice of sandwiches, salad or beans on toast. At dinner or teatime the choices included: beef casserole, fresh vegetables and mash, homemade tuna bake, fish pie, shepherds pie, roast chicken, fish and chips, chicken curry and rice, gammon, lamb hotpot, pizza, home made salmon fishcakes and meat balls. We saw that during the day people were offered drinks and snacks regularly. Snacks included fresh fruit as well as crisps or biscuits. We found that nutritional screening had been completed and that the information concerning meals, positioning, likes and dislikes was followed. We found that special instructions concerned with the consistency of food and drink was understood and diligently adhered to by staff. In relation to the lifestyle experienced by guests at Shawe Road short stay facility one person spoken to said: The food is very nice and I eat it all up and Ive been out today. Care Homes for Adults (18-65 years) Page 18 of 32 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Guests at Shawe Road receive personal and health care support in keeping with their needs and preferences, treatment is provided promptly so that people remain as healthy and comfortable as possible. Evidence: We noted from observations and records kept that all personal and health care was provided in privacy and with discretion. The assessments, care plans and daily records about how to meet peoples needs included information about their preferences in relation getting up, going to bed, mealtimes and other aspects of life. And daily records showed that staff were aware of these preferences and supported people accordingly. We found no evidence of rigid rules in relation in offering individualised support to guests. People we spoke to were clear that people had a right to make choices about their personal support and comments included: People have a choice in everything, what they eat, what clothes they wear. Care Homes for Adults (18-65 years) Page 19 of 32 Evidence: We examined the care files for four people using Shawe Road short stay facility. We found that there was a detailed health and medical history and any current issues or concerns were highlighted and care plan in place. Reports, letters and appointment cards confirmed that when guests are staying at Shawe Road the manager will arrange for staff to accompany and support people to hospital and dental appointments if this is agreed with their carer. We also found through looking at communication records and speaking to staff that referrals are made to specialist health workers such as continence care adviser, falls prevention specialist, the district nurse and general practitioner when necessary. We also found, however, that some staff still have a tendency not to write down all the actions that have been taken to deal with health related issues. This needs to be remedied because good communication is essential in making sure that people receive the correct medical and health support. We appreciate that in a short stay care facility it is unusual for staff to have to initiate referrals to specialists, however when this is done a written record must be kept. We found that the training calender confirmed that staff have received training in how to support people with epilepsy. We discussed additional training concerning health needs and the manager stated that this training was provided to staff in relation to individual guests. The manager also wrote in the information she returned to us: We provide training tailored to guests needs eg dysphagia. We believe that there would be an improvement in this area if all training that staff receive is recorded, this is so their training and competence can be monitored, and then the managers can be certain that all staff have received the training that is expected. We looked at the way medication is handled at Shawe Road. We found that storage of medication was safe in that items are kept in a locked cupboard. We found, through looking at a number of medication administration record sheets (MARS), that staff need to be made aware of how to record medication that they accept into the home more accurately and precisely. We found that on one occasion different dose and times for the same medication was written into the same section of the MARS, it is safer if each dose is written in to separate section. We found that medication which was to be given when needed was not entered into the MARS correctly, and neither was a clear record kept of when the medication was offered, given or refused. We also found that corrective fluid was used when staff made an errors by signing in the wrong place on the MARS. The use of corrective fluid is not in keeping with best practise for record Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: keeping. We read through the medication policy and procedures. The manager stated that this was been updated to make it more relevant to the support provided at Shawe Road. We found that if this policy as it stood were followed then medication management, administration and storage at the service would be safe. We discussed the issues concerning recording medication accepted into the home, the use of corrective fluid and recording when medication has been offered or refused with the manager. She accepted that these issues needed to be addressed and agreed to instruct staff about how to improve in these areas. The manager stated that the new medication protocol would include auditing medication. We discussed the need to make this a priority because, although improvements had taken place since the previous inspection, more work is needed to make the system as safe as possible. The manager confirmed that senior staff have received medication training however according to the training matrix this amounts to one person. Other staff have had their medication training through a process of cascading. We feel that all staff should receive accredited medication training as they will have the opportunity to discuss concerns and eventualities with an expert in the field. We noted that in each medication file the patient information leaflet was available so that staff could read about why the medication may be used and possible side effects. We found that improvement in medication handling since the previous inspection included: photographs of guests been placed on their medication files and the medication policy is under review. Care Homes for Adults (18-65 years) Page 21 of 32 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Policies and procedures are in place to support people to make complaints and they are listened to, systems are also in place to safeguard against harm and exploitation. Evidence: We found that there is a clear and accessible procedure in place which outlines the timescales for dealing with complaints and says how these are dealt with. we looked at the complaints record and found that a record is kept of concerns, complaints and comments made. The manager said in the information she returned us that: We work closely with guests and families in a very open and honest way which allows for issues to be raised and solutions found. We noted from the training matrix that there were no dates for when the majority of staff had received protection of vulnerable adult (PoVA) training. The manager stated that new staff received this training on day three of the induction training and that this was not included on the training matrix. The manager also stated in the information returned to us that: Abuse awareness training is in place for all staff. It was not possible to confirm that this was the case from the information provided, although the staff who were interviewed confirmed that they had received this during induction and completion of the National Vocational Qualification (NVQ Level 2 in care. Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: It is important that the dates of previous specialist training is recorded and available so that managers can see when updated training is due and show that this training has been provided. We the Commission have not received any reports of safeguarding matters since the previous key inspection and the manager stated that none were been investigated at the time of inspection. Care Homes for Adults (18-65 years) Page 23 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment at Shawe Road meets the needs of guests who stay there for respite or short term support because it is safe, clean and offers some flexibility. Evidence: We visited Shawe Road and had a look around the building and discussed the running of the building with the manager. We were informed that the building is owned by Trafford Council and they are responsible for its up keep. We were informed that the entire building is due to be restructured and upgraded, however no firm timescales have been agreed. We found that all parts of the building were clean and pleasant to use. The lounge and dining area are open plan. Both areas are pleasantly decorated and comfortable. The dining area is small in that if there are six guests they can not all sit around the dining table together at meal times, this is especially the case if people use specialist seating. There is only one lounge and so people tend to go to their rooms if they want to do something different to what is happening there. There is a small kitchen area were snacks and hot drinks can be made. And guests are Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: supported to do this for themselves if they want. The kitchen and laundry arrangements however are not domestic and this will be changed during of the refurbishment. Moving and handling equipment and fire safety equipment is in place and this has been serviced and maintained in accordance with the relevant legislation. Infection control is taken seriously and people are encouraged to wash their hands on entering and leaving the building. And all staff have completed infection control training. We observed one person throughout the day. He was able to spend time in the lounge, in the dining area and in his room if he wanted. We observed that when in his room he was happy, enjoying the privacy to watch what he wanted on television and enjoy his choice of music. He said I like my room, I have a telly and small radio. Care Homes for Adults (18-65 years) Page 25 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Guests who attend Shawe Road are supported by staff who receive training opportunities and who are employed in a way that enables them to do their jobs well. Evidence: We found through the information provided to us by the manager that six out of 11 staff have achieved National Vocational Qualification (NVQ) level 2 in care or above. One person we interviewed said that she had gained this qualification before working at Shawe Road but she had now been put forward to complete NVQ level 3 in care. The training matrix confirmed that courses attended by staff since the previous inspection included: fire safety, Basic Food Hygiene, medication, First Aid, moving and handling, epilepsy awareness, and Mental Capacity Act training. New staff also undertake a five day induction course which meets with the Skills for Care guidelines. Staff were satisfied with the training appetites offered by the organisation. Those who returned surveys felt that the training they received kept them up to date with new ways of working. Comments included: What the home does well is keeping staff updated with training and keeping care plans up to date. and I love my job at Shawe Road and I have learnt a lot and done many courses Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: whilst I have been at Shawe Road. We saw, through observing staff interaction with the guests and by the manner in which people were written about that, that staff were respectful and understood about treating people as individuals and supporting the choices they made. We found that all six staff who returned surveys were very enthusiastic and content to be working at Shawe Road and stated that this was because of the encouragement and guidance they received to provide the guests with the best possible support. We also found that each carer felt that there was always room for improvement. We assess that this attitude demonstrates that staff are aiming high and want to provide support in a manner that fully meets the needs of individuals. We noted that possible improvements identified by staff included, additional food preparation training and more communal areas, these matters were also highlighted by the manager in the information she sent to us. This demonstrates that the management and staff team can work together to improve the areas where they have control such as with food preparation. We found that staff are recruited using a robust and thorough recruitment and selection process. Through examining the staff files we found that potential staff completed an application form and that gaps in their work record were investigated. Criminal Record Bureau (CRB) checks and Protection of vulnerable adult checks had been completed before people took up their posts. Two references, one of which was from the most recent employer, was also taken up. Letters also confirmed that staff attended a five day induction course. Those who were interviewed explained that initially they worked with more experienced staff and given time to learn about the routines of the service and needs of the guests. Staff said that health and safety issues such as fire safety and moving and handling were covered during their induction into the service. We assess that the recruitment and selection process is followed and protects against employing unsuitable people to work at Shawe Road. Care Homes for Adults (18-65 years) Page 27 of 32 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Guests at Shawe Road benefit from a service that is managed in manner that will promote their well being and safety. Evidence: We found that the day to day management of Shawe Road was effective and people were content with the way the service is run. The registered manager Jill Pilkington obtained the registered manager award in 2005. The person in charge of Shawe Road on the day of inspection was found to be knowledgeable about how the service was run, the needs of the guests and the future development plans for the service. We found, from the information sent to us, that the majority of policies and procedures had been updated in 2008. We also noted that some need to be updated to make sure that they are in line with changes in legislation. For example the sexuality and relationship, physical intervention and safeguarding policies. It is essential to review these polices to ensure that they are in line with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguard legalisation. This is so that peoples civil rights are Care Homes for Adults (18-65 years) Page 28 of 32 Evidence: always upheld by staff. We discussed the quality monitoring of the service provided at Shawe Road and found that people are not asked their opinion specifically to this service. The manager felt that this was not too much of a problem because the service is small and so flexible. She said We are able to make changes easily and without ceremony. We accept that this a positive aspect of the service, however we also assess that having an official quality assurance system specifically for Shawe Road is necessary. This is so that everyone is given an equal opportunity to comment about the quality of service and how it could be developed. This may also help the manager to focus on developing priorities and improving the service in an organised and considered way. And this would also provide a written record of the way service users have influenced the service. In the information she returned to us the manager confirmed that all equipment and services such as gas appliances, hoists and the electrical system and equipment at Shawe Road were maintained and serviced in accordance with the relevant regulatory body. We looked at the fire safety check log book and found that for the most part checks such as alarm checks, emergency lighting and evacuation were carried out as expected. The most recent recruit confirmed that fire safety was one of the first topics dealt with when she arrived to work at Shawe Road. We found that the training record confirmed that all staff have fire safety, moving and handling and first aid training. Care Homes for Adults (18-65 years) Page 29 of 32 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 30 of 32 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 20 The registered person should ensure that staff follow the IAS medication policy and guidelines so that there is less chance of mistakes and to promote good record keeping. This will help to ensure that people receive the correct medication, in the correct dose at the correct time. The registered person should keep a record of all the training provided to staff so that they know all the training staff have received and when updates are required this will ensure that staff always have the most up-to-date information about how to do their job. The registered person should ensure the relevant policies are updated to make sure that they are in line with changes in legislation such as the Deprivation of Liberty Safeguard legalisation. This is so that staff know what to do uphold peoples civil rights. The registered person should introduce a system that provides people with the opportunity to officially comment on how the service is run so that they can be certain that everyone has an equal chance to make their views known and so influence changes. 2 35 3 37 4 39 Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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