Care Home: St Joseph`s

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What the care home does well The service meet the needs of people who come to live at St Joseph`s through the way in which their needs are identified before they go to live there. People`s needs are met by the way care plans covers all areas of their daily lives. Individuals can make decisions about their lives and any risks faced by them through making these decisions are taken into account. The service ensures that individuals have the opportunity to access the wider community and ensures that people are able to maintain contact with their families and friends. People`s rights are respected and they have their nutritional needs met. The practices of staff and the equipment within the environment ensure that individuals are supported in the manner they wish. People are kept healthy. People who use the service and their families are able to influence the running of the service through the complaints procedure and through the way in which the service assesses the standard of support it provides. People are protected from abuse and are protected by the way in which staff are checked before they support individuals. The people who use the service benefit from living in a building that is clean and hygienic yet designed with their needs in mind.People are supported by staff who are trained to meet their needs and, as a result, have their needs met. The people who use the service benefit from it being managed by an experienced and qualified individual. The health and safety of the people who use the service is promoted. Comments received before and during the visit included: `I am able to make decisions` `Staff support is alright` `I have my privacy, they listen to me and I am happy with the support I get` `I am happy here with no complaints-I think they would listen to me if I did have any` `I feel safe `Food is not bad-I get a choice and have to have my meals blended but I am happy with that` `The new building is ok` `I am happy with my room and the bathroom-definitely. `I am happy with my room, there is more room and there are no stairs or lifts` `I likes my en suite shower` `I want the Internet in my room and this is being sorted` `I can make decisions, I was able to go to Germany with two staff members` `Meals are lovely` `I have no complaints` `Staff are nice-I know they are there, I feel safe`` `I hope to use a walking frame at some point so I can get around the building` `The new building is alright` `Meals are alright` `I get support from staff` `The place is all right` `I can visit when I want to and they always let me know if there is a problem with my relative`s health` `Everyday is different and that there is a move towards making people independent. It is good to see people progress and there is an improvement with people. I cannot think of anything that needs to be done better` `The manager is supportive and approachable. The best thing is that is now a clear sense of purpose in the building as well as an enabling philosophy` `The service treats each person as an individual with their own needs, treat each person with respect, provides a clean, calm and safe environment` `Staff are treated with respect` Residents are not left in their rooms but are encouraged and enjoy socialising with each other in communal areas` St Joseph`s DS0000072499.V374138.R01.S.doc Version 5.2 Page 7`We have up to date; personal centred planning and daily report books to keep staff updated. Staff are encouraged to read these regularly and are informed of any changes-I was given a full induction when I started and a week supernumerary to get to know residents better before I could be able to support service users on my own` `I had full and up to date training-I have regular supervision and team meetings with my manager. I also have daily access to manager if needed` `There is always training available if needed to help support and add to my knowledge` `The service is continually updating training and discussing new ideas with staff families and residents`. `Staff are asked on a regular basis to update all relevant training and receive specialist training with brain injuries` `We are always trying to improve the service` What has improved since the last inspection? This is the first inspection of St Josephs to take place. What the care home could do better: The management team of the service must ensure that once medication is administered, that this is recorded consistently. This is so that the management of medication promotes the health and safety of the people who use the service. One recommendation is raised relating to the availability of the complaints procedure for the people who use the service and their families. CARE HOME ADULTS 18-65 St Joseph`s Woodlands Road Aigburth Liverpool Merseyside L17 0AN Lead Inspector Mr Paul Kenyon Unannounced Inspection 9th February 2009 10:00 St Joseph`s DS0000072499.V374138.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 St Joseph`s DS0000072499.V374138.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. St Joseph`s DS0000072499.V374138.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Joseph`s Address Woodlands Road Aigburth Liverpool Merseyside L17 0AN 0151 261 2000 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) Nugent Care Michael Richmond Care Home 18 Category(ies) of Physical disability (18) registration, with number of places St Joseph`s DS0000072499.V374138.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of 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: Physical disability - Code PD. The maximum number of service users who can be accommodated is: 18. Not Applicable Date of last inspection Brief Description of the Service: St Joseph’s is a newly registered service and replaces a former service located within the Childwall area of Liverpool. The new building was ready for individuals to live in from October 2008. The building is a purpose built structure, which has no upper floors. It supports 18 individuals, all of whom have a degree of physical disability, which has been the result of an acquired brain injury. Eighteen bedrooms are available, all of which have en-suite shower facilities. Lounge areas are available, as well as a small kitchenette for use by the people who use the service. The building is located in the Aigburth area of Liverpool within a residential area. The service is operated by Nugent Care and is managed by Mike Richmond who was the Manager of the previous service. Fees are charged at £900 per week, although additional funding would be determined by the needs of individuals. St Joseph`s DS0000072499.V374138.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This was the first inspection of the service to take place. The staff were not aware that an inspection was to take place beforehand. The visit included a tour of the premises and the examination of records relating to the support of individuals. In addition to this, interviews were held with four people who use the service, as well as a relative who was visiting. Two members of staff were also interviewed and the Manager was provided with information on the outcome of the visit. Staff surveys were sent out prior to the visit and two were returned. An additional visit to view personnel records was made soon after the visit. The visit took place over the morning and afternoon periods. Comments made by the people who use the service, their families and staff are included within this report. What the service does well: The service meet the needs of people who come to live at St Joseph’s through the way in which their needs are identified before they go to live there. People’s needs are met by the way care plans covers all areas of their daily lives. Individuals can make decisions about their lives and any risks faced by them through making these decisions are taken into account. The service ensures that individuals have the opportunity to access the wider community and ensures that people are able to maintain contact with their families and friends. People’s rights are respected and they have their nutritional needs met. The practices of staff and the equipment within the environment ensure that individuals are supported in the manner they wish. People are kept healthy. People who use the service and their families are able to influence the running of the service through the complaints procedure and through the way in which the service assesses the standard of support it provides. People are protected from abuse and are protected by the way in which staff are checked before they support individuals. The people who use the service benefit from living in a building that is clean and hygienic yet designed with their needs in mind. St Joseph`s DS0000072499.V374138.R01.S.doc Version 5.2 Page 6 People are supported by staff who are trained to meet their needs and, as a result, have their needs met. The people who use the service benefit from it being managed by an experienced and qualified individual. The health and safety of the people who use the service is promoted. Comments received before and during the visit included: ‘I am able to make decisions’ ‘Staff support is alright’ ‘I have my privacy, they listen to me and I am happy with the support I get’ ‘I am happy here with no complaints-I think they would listen to me if I did have any’ ‘I feel safe ‘Food is not bad-I get a choice and have to have my meals blended but I am happy with that’ ‘The new building is ok’ ‘I am happy with my room and the bathroom-definitely. ‘I am happy with my room, there is more room and there are no stairs or lifts’ ‘I likes my en suite shower’ ‘I want the Internet in my room and this is being sorted’ ‘I can make decisions, I was able to go to Germany with two staff members’ ‘Meals are lovely’ ‘I have no complaints’ ‘Staff are nice-I know they are there, I feel safe’’ ‘I hope to use a walking frame at some point so I can get around the building’ ‘The new building is alright’ ‘Meals are alright’ ‘I get support from staff’ ‘The place is all right’ ‘I can visit when I want to and they always let me know if there is a problem with my relative’s health’ ‘Everyday is different and that there is a move towards making people independent. It is good to see people progress and there is an improvement with people. I cannot think of anything that needs to be done better’ ‘The manager is supportive and approachable. The best thing is that is now a clear sense of purpose in the building as well as an enabling philosophy’ ‘The service treats each person as an individual with their own needs, treat each person with respect, provides a clean, calm and safe environment’ ‘Staff are treated with respect’ Residents are not left in their rooms but are encouraged and enjoy socialising with each other in communal areas’ St Joseph`s DS0000072499.V374138.R01.S.doc Version 5.2 Page 7 ‘We have up to date; personal centred planning and daily report books to keep staff updated. Staff are encouraged to read these regularly and are informed of any changes-I was given a full induction when I started and a week supernumerary to get to know residents better before I could be able to support service users on my own’ ‘I had full and up to date training-I have regular supervision and team meetings with my manager. I also have daily access to manager if needed’ ‘There is always training available if needed to help support and add to my knowledge’ ‘The service is continually updating training and discussing new ideas with staff families and residents’. ‘Staff are asked on a regular basis to update all relevant training and receive specialist training with brain injuries’ ‘We are always trying to improve the service’ 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. St Joseph`s DS0000072499.V374138.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Joseph`s DS0000072499.V374138.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The people who use the service have their needs met by the way in which their needs are identified before they come to live at St Joseph’s. EVIDENCE: One person has come to live at St Joseph’s since the service was registered in October 2008. Other individuals have come to live at the new service from the previous service and care plans indicated that they had lived there for a number of years. The person who had come to live there had had their needs identified by both the service and the Local Authority who pays for their support. There was also evidence available suggesting that some individuals who have received support for longer have been re-assessed and have had their needs reviewed. These assessments had taken place in December 2008 and January 2009 and had involved the individual, their keyworker and their family. The reasons for these reviews have been to ensure that as needs change; the service has still been able to meet the needs of the individual. St Joseph`s DS0000072499.V374138.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 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The people who use the service have their needs outlined in a care plan that contains detailed information about the support they require and their aspirations. They are able to make decisions about their lives and risks they face as a result of these decisions are taken into account by the service. EVIDENCE: Five care plans were examined. All care plans are presented in such a way that they are recorded in the first person and cover all aspects of the person’s daily life. There was evidence that where individuals are able to contribute to their care plans and can communicate their needs then they are assisted in contributing to their care plan. For others there was evidence that their care plans are devised with consultation with families and their keyworker. The care plans include reference to the skills individuals have in respect of daily life. The plans also outlines the preferences of individuals, what is important to them and their skills in domestic and social skills as well as any medical needs. St Joseph`s DS0000072499.V374138.R01.S.doc Version 5.2 Page 11 In relation to domestic tasks, the ability of individuals and the level of support they need is rated and this indicates their abilities to complete tasks on their own or with staff help. All care plans sampled had been reviewed during the past two months. One person has used an advocacy service and this continues. Others have been offered an advocacy service but have relied on their families to assist in any matters. For one person, there was written evidence of the use of a solicitor to deal with recent financial issues deal independent of the service. Communication needs of some individuals are complex due to the acquired brain injury that they have. Their communication needs are included within the care plans. There are detailed recorded on how staff can give people the opportunity to communicate and in what settings people feel more comfortable to express their needs. The financial affairs of five people were examined. Some people are more independent with their monies and are able to deal with their affairs. They use the service to keep their monies safe and to provide secure storage for them. Others rely on their families. Where monies are kept on their behalf, a secure and accountable system is in place. The Manager acts as appointee for two people, yet stated that he is seeking to pass this over to either the family or the individuals themselves where possible. All systems for the safekeeping of money are audited independently on a regular basis. There is a residents committee in place in the past. The service’s Activities Co-ordinator has facilitated this and minutes were available. This occurs monthly. Five risk assessments were viewed. These have been reviewed within the past 12 months. Risks identified cover risks faced by people in the environment, in the support they receive as well as any challenging behaviour that may be displayed. Risk assessments also cover issues in relation to the transferring of individuals through manual handling. St Joseph`s DS0000072499.V374138.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 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The people who use the service benefit from being able to access the community and maintain contact with their families and friends. They have their rights respected and their nutritional needs are met. EVIDENCE: Individuals pursue leisure activities rather than any formal education or occupation. Efforts were made to enable one person to access education but this was not successful. The previous occupations of individuals are recorded in care plans, however the disability of individuals means that they can no longer maintain the occupations they pursued. St Joseph`s DS0000072499.V374138.R01.S.doc Version 5.2 Page 13 Many people originate from the Liverpool area and are aware of the local facilities in the community. There was evidence that individuals have bus passes and there was evidence that other community facilities are used by people, for example, library cards. Records suggested that people attended leisure centres. Another person attends a day centre, which caters for people of a certain ethnic group. Another person is supported by a local organisation that provides one to one support in accessing leisure opportunities in the community. Another person is a member of a local football team supporters club. There was evidence that a local transport service Merseylink is used by individuals. There was also evidence that people have been included on the electoral list enabling them to vote when there is an election. There was evidence in one care plan that one person has formed a relationship with another individual living at St Joseph’s. This relationship is sustained and is built into the person’s routines in their care plan. An interview with a family member noted that they are able to visit whenever they wish and can visit their relative in private. The significant family links people have with families and friends are included in care plans. Telephones are available in bedrooms. One person wants to have an Internet connection put into their room and this is being arranged. Where they are able to use them, individuals have keys to their bedrooms. The preferred terms of address are included for each person in their care plan. There was evidence during the visit of staff knocking on bedroom doors before they entered and while people spoke with the Inspector, they were afforded privacy. Comments from both people who use the service and staff noted that the provision of en-suite facilities within each bedroom had greatly enabled individuals to be support with their personal hygiene in private. Staff interact with the people who use the service in a positive manner and do not exclusively interact with other staff. People either prefer their own company or to socialise with others and this was respected. One person stating that he preferred to remain in his bedroom and that staff let him do this evidenced this. People are able to access all parts of the building and rules are in place for smoking. This promotes the health of those who do not smoke. Interviews with individuals noted that they are happy with the meals provided and are able to have alternatives if needed. Some individuals are on specialist diets, for example, to cater for diabetes. Catering staff are aware of these dietary needs. A record of food provided is recorded mainly in care plans and linked to those instances were dietary needs are impacting on a person’s health. St Joseph`s DS0000072499.V374138.R01.S.doc Version 5.2 Page 14 Some individuals are fed artificially and staff have received training in this and the process for doing this. Health professionals monitor this. Some rely on blended or softer food. One person confirmed this and stated that he was happy with the presentation of the food provided. A dining room is available and this is used for meals with sufficient space for individuals to have their meals. A kitchen is available which is well stocked with foodstuffs and is well equipped. Catering staff are employed and have received training in food hygiene (as evidenced through training certificates). The people who use the service are reliant on catering staff for the provision of meals in the main, although a small kitchenette is available for the preparation of snacks and drinks prepared by individuals. The use of this is included within risk assessments and in care plans where their abilities in such tasks are recorded. Menus cover a four-week period and indicated choice as well as the provision of at least two to three cooked meals a day. St Joseph`s DS0000072499.V374138.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The people who use the service have their needs met and are supported in line with their wishes. This is achieved by the extent to which they are consulted about their support, staff practice and the design of the building they live in. They have their health maintained. The management of medication does not fully promote their health and safety. EVIDENCE: All individuals whose support was examined during this visit have an acquired brain injury. This limits their ability to maintain a daily independent lifestyle. In turn, this has either affected their memory or their mobility. For those whose mobility has been affected, lifting hoists are in place as well as other lifting aids, such as overhead tracking (this is lifting equipment that is secured to any ceiling). Interviews with individuals stated that they were happy with the support staff provided. St Joseph`s DS0000072499.V374138.R01.S.doc Version 5.2 Page 16 The building has been purpose built and the improvements to assist mobility for people were commented on during interviews; especially the provision of en-suite facilities to promote their privacy. The preferences of individuals and the support they require have been included within care plans and agreed by individuals, as far as possible. Interviews with individuals confirmed that they considered that they could get up and pursue their own routines when they wanted. The amount of support provided is outlined in care plans relating to personal hygiene, for example. Staff interviews confirmed that they are seeking to enable individuals to do things for themselves, rather than do things for them. Where physical health requires the input of health professionals, this is provided by District Nurses and in cases where the involvement of a psychiatrist is needed; this is provided. This was evidenced through letters available on file. A key worker system is in place. All individuals registered with a Doctor. Interviews held with one person confirmed this. Others interviewed stated that they felt well at the moment but if not they attended hospitals or medical help was provided. Evidence was available in files to suggest that individuals have been to hospital of late and have received specialist input from other health professionals. Evidence was available of visits to opticians, dentists and chiropodists, as well as visits from district nurses in some cases. Individuals receive health care from professionals, such as speech therapists. These professionals seek to assist and provide advice about the food that people are provided with. Letters confirmed that one person had been placed on a pureed diet following advice from a speech therapist. Another person had been referred to a department, which assists with stomach problems. Weight records for five people were looked at, which suggested that their weights are monitored on a regular basis. Other health issues included medication reviews. Evidence was available that St Joseph’s use a local acquired brain injury unit for assessment and advice. Medication is stored in a purpose built medication room, which is locked at all times. A controlled medication cupboard is in place and this is in use storing one controlled medication. Controlled medication requires strict measures by law. A controlled drugs register is in place and signatures in this were consistently applied, with two people signing at all times. A main medication cupboard is available. This is lockable and medication is contained in a blister pack. Other medication is stored in a refrigerator. Medication to be used for those who have epilepsy is stored in this. Staff have received training in this and Doctors have devised care plans indicating when and how it should be used. Refrigerator temperatures are monitored daily to ensure that the medication is useable when needed. St Joseph`s DS0000072499.V374138.R01.S.doc Version 5.2 Page 17 Records show that when medication is received, staff signed to acknowledge this. In addition, there is a book to confirm when medication has been returned to the Pharmacy. Staff responsible for medication have been trained and this was confirmed by training records, certificates and through staff interviews. No individuals self-medicate at present. Any support required with medication is outlined in care plans. Medication records do not always have signatures confirming that medication has been administered. The Manager is aware of this and this is raised as a requirement in this report. St Joseph`s DS0000072499.V374138.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The people who use the service are able to influence the running of the service through the complaints procedure. The people who use the service are protected from abuse. EVIDENCE: There is no complaints procedure on display. This is raised as a recommendation in this report. Interviews with service users noted that they are happy with the support they receive and have not had to make a complaint but felt confident that any concerns would be dealt with. One relative stated that they were aware of her right to make a complaint and has raised some concerns with the Manager that she does not consider to be full complaints. Complaints records are maintained. We have received no complaints since the service was registered. One person’s care plan noted that they do display challenging behaviour at times and, as a result, are a risk to themselves and others. This has been included in their risk assessment. This has recently been reviewed with a psychiatrist involved and a management plan has been devised. St Joseph`s DS0000072499.V374138.R01.S.doc Version 5.2 Page 19 A Local Authority procedure is in place for making abuse referrals to them in the event of any allegations being made. No allegations have been made since the service was registered. A procedure is in place preventing staff’s involvement in the financial affairs of individuals. Staff interviews confirmed that they are aware of the whistle blowing procedure and have received training in the prevention of adult abuse. St Joseph`s DS0000072499.V374138.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The people who use the service live in a building which meets their needs and which is clean and hygienic. EVIDENCE: The building has only been in use since October 2008. A tour of the building was made mainly to determine the facilities on offer, given that the building had been subject to a visit by us before it was opened. Comments from residents were positive about the new facilities, in particular, the provision of en-suite facilities. This view was echoed by staff who considered that they could uphold the privacy of individuals while they were being helped to bathe or wash. Other comments suggested that the older building was on two floors and that this did not meet the mobility needs of individuals. The new building has wide corridors that can easily accommodate the use of aids and adaptations. St Joseph`s DS0000072499.V374138.R01.S.doc Version 5.2 Page 21 There is sufficient lounge space and there is an area available which includes a kitchenette area where people can prepare drinks/snacks and receive visitors if they wish. Several bedrooms were viewed. All have en-suite showers with doors that are wide enough to accommodate those who use wheelchairs and this was witnessed during the visit. Overhead tracking (lifting devices attached to the ceiling) is in place in all areas and en-suite showers include fittings which are at a low level for individuals as well as the provision of a shower chair. There were no decorative issues, although it was explained that there has been a period where maintenance staff have had to deal with some initial problems. There is a system in place for repairs. There were no issues with the environment. No offensive odours were noted during the visit and the building remained clean and hygienic. Domestic staff are employed. A laundry facility is available. This has an impermeable floor as well as hand wash facilities. Industrial appliances are used for the laundering and drying of clothes. A sluice room is available but this is separate from toilet areas used by the people who use the service. Protective clothing is available as well as system for the storage and disposal of clinical waste. Soap and paper towels are available in all hand washing areas. St Joseph`s DS0000072499.V374138.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The people who use the service are protected by the recruitment procedure and are supported by staff that are trained to meet their needs. EVIDENCE: One person has come to work at St Joseph’s since it was newly registered. Personnel records are retained separately in the main offices at Nugent Care. A separate visit was made to view them. It was found that all appropriate checks had been made on this person before they came to work at St Joseph’s. Checks included two references, a criminal records check and a check to ensure that the person had not been barred from supporting people in the past (known as a POVA First check). St Joseph`s DS0000072499.V374138.R01.S.doc Version 5.2 Page 23 Training records were examined. Training has consisted of health and safety topics such as infection control, fire awareness, food hygiene and first aid. Interviews with staff confirmed that they had received training in the protection of vulnerable adults. Other training included medication training, training in supporting people to be fed artificially, training in the administration of rectal diazepam (an emergency medication used to assist people who have epilepsy), diabetes awareness and epilepsy awareness. Staff confirmed their attendance at training in the next few weeks. This related to acquired brain injury, which relates to the needs of all individuals living at St Josephs. Certificates were available to confirm the training received. A team leader is responsible for training. She stated that the next wave of training was in ensuring that mandatory training was up to date. All future training is recorded in a diary and is to take place in the next few weeks. An interview with the Manager noted that he attends the same courses as staff and will attend the acquired brain injury training in the near future. He also attends training catering for managers, for example, Leadership Training. St Joseph`s DS0000072499.V374138.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The people who live at St Josephs receive support from a service that is managed by an experienced and qualified individual so that their needs can be met. They are able to influence the running of the service and have their health and safety promoted through the practices of the service. EVIDENCE: The Manager was previously the registered manager for the service when it was located elsewhere. The Manager is a registered Social Worker and has a background in care. He has achieved a National Vocational Qualification at Level 4 as well as a registered manager’s award. St Joseph`s DS0000072499.V374138.R01.S.doc Version 5.2 Page 25 The Manager is registered with us and his management registration has transferred over from the previous registered service. He attends training courses were possible yet has attended further courses in management issues such as Leadership training both within the service and externally. He is booked to go on the acquired brain injury course with other care staff within the near future. There was evidence that questionnaires had been sent to families and friends of those who live at St Joseph’s. In addition, there was evidence that service users are given the time to be consulted in respect of questionnaires. A representative of the organisation had visited recently to discuss the quality of the service provided with the people who use the service. We were able to interview staff and individuals in private and we were given full co-operation through the visit to access records and tour the premises. No previous requirements needed to be examined since this was the first inspection of this service. Reports were available for the past two months suggesting that a representative of the organisation had visited to assess the quality of support provided. This process involved interviewing those who use the service, staff and touring the building. Training records confirmed that staff have received health and safety training in manual handling, infection control, first aid and fire awareness. This was also confirmed through interviews with staff. Further training in health and safety has been scheduled for the next few weeks as noted in the future training programme. Fire records are in place indicating that fire alarms and emergency lighting had been tested weekly and monthly respectively. Fire extinguishers have been checked. Fire procedures are on displayed throughout the building including fire procedure for the people who use the service. Accident records are maintained and recorded appropriately. Information is in place for the reporting of adverse incidents. The Manager is aware of the need to notify us of any adverse incidents and this has been done in the past. Covered radiators are in place. Records are maintained for the testing of all water temperatures on a monthly basis. Records are in place relating to the control of substances used that may be hazardous to people’s health. General risk assessments are being transferred over to a new format. The old format in place indicates that the main risks to everyone relates to the environment and through work practice. These were last reviewed in 2008. Information sent to us before the visit suggested that electrical wiring and gas systems had been tested in October 2008. The same applies to portable electrical appliances. There was evidence that all lifting equipment had been serviced in 2008. The service’s Certificate of registration is on display as well as a current insurance certificate. St Joseph`s DS0000072499.V374138.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 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 X 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 3 2 X 3 X 3 X X 3 X St Joseph`s DS0000072499.V374138.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? Not Applicable 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 Timescale for action Medication records must be 09/02/09 consistently signed to ensure that the health and safety of the people who live at St Joseph’s is promoted. Requirement 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 YA22 Good Practice Recommendations The complaints procedure should be put on display within the building in order to ensure that both the people who use the service and their families are provided with the information they need to make a complaint. St Joseph`s DS0000072499.V374138.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection NW Area Office Unit 1 Third Floor Tustin Court Port Way Preston PR2 2YQ 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 St Joseph`s DS0000072499.V374138.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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