Care Home: Star Road Respite Service

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What the care home does well The respite service provides carers with a break from caring responsibilities and provides people with the opportunity to socialise with others. It aims to provide a welcoming and stimulating environment for the people using this service. Staff are committed to encouraging independence and providing daily choices. What has improved since the last inspection? There were no previous requirements. What the care home could do better: To ensure the service continues to be welcoming and inviting for people, some of the bedrooms and hall need to be painted. CARE HOME ADULTS 18-65 Star Road Respite Service 49 Star Road Isleworth Middlesex TW7 4HU Lead Inspector Sarah Middleton Key Unannounced Inspection 27th August 2008 10:05 Star Road Respite Service DS0000034931.V368581.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 Star Road Respite Service DS0000034931.V368581.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. Star Road Respite Service DS0000034931.V368581.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Star Road Respite Service Address 49 Star Road Isleworth Middlesex TW7 4HU 0208 568 5133 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) hm49Bstar@ealing.org.uk www.supportforliving.org.uk Support for Living Ms Stephanie Elaine Elvidge Care Home 7 Category(ies) of Learning disability (7), Physical disability (7) registration, with number of places Star Road Respite Service DS0000034931.V368581.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Support for Living be registered to carry on a care home for seven adults with learning and physical disabilities. 18th July 2006 Date of last inspection Brief Description of the Service: Star Road is a purpose-built seven-bedded short break service for people with learning disabilities, who may also have physical disabilities. The home is managed by Support for Living (formerly known as Ealing Consortium) and the Dominion Housing Association carry out the housing management. It is located off the London Road in Isleworth, where there are bus routes to Hounslow Town centre and Brentford. Approximately seventy-nine people currently access the respite service. Each person can have up to thirty days annually for either short break stays in Star Road or other types of respite support. The service is funded by the London Borough of Hounslow, who makes the referrals to this service. There is a small payment made by the carer or person using the respite service of £3.52 for an overnight stay. This payment is for the London Borough of Hounslow not the respite service. The service is a single storey building, which has an adjoining supporting living scheme, also managed by Support for Living, and an administration block. All have separate entrances. The service can be divided into two separate units, if required, of three and four bedrooms to provide for same gender stays or where smaller groups would be more appropriate. All of the bedrooms are single. There is one lounge/dining room, one lounge/games room, two kitchens and two bathrooms. Each unit has separate, enclosed gardens. The service was registered in March 2004 but not all of the bedrooms meet the National Minimum Standards for room sizes. They have been permitted because the service is for respite use only and all are over 10 sq. metres. There are two rooms suitable for people who use wheelchairs and there is tracking for overhead hoists in some bedrooms and bathrooms. The majority of people do not require these facilities and many are very physically able. The staff team consists of the Registered Manager, two Deputy Managers and a team of support workers, who are augmented by bank and agency staff. There is also domestic assistance. Star Road Respite Service DS0000034931.V368581.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 star. This means the people who use this service experience good quality outcomes. This was an unannounced inspection visit that took place between 10.05am6pm. We received seven relative postal surveys and spoke with one relative on the telephone. Two staff and four of the people using the respite service were spoken with during the inspection visit. Some comments from the surveys and the discussions have been included into this report. The inspection also involved touring the service and examining documentation. The Registered Manager had completed the Annual Quality Assurance Assessment, which is a self assessment looking at the outcomes for the people using the respite service. The Registered Manager was present for part of the inspection and other staff also assisted with the inspection process. The Registered Manager will be referred to in this report as the Manager. The term “we” in the report refers to the Inspector who carried out the inspection. There had been no previous requirements and one requirement was made from this inspection visit. All of the key National Minimum Standards were inspected. What the service does well: The respite service provides carers with a break from caring responsibilities and provides people with the opportunity to socialise with others. It aims to provide a welcoming and stimulating environment for the people using this service. Staff are committed to encouraging independence and providing daily choices. Star Road Respite Service DS0000034931.V368581.R01.S.doc Version 5.2 Page 6 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. Star Road Respite Service DS0000034931.V368581.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Star Road Respite Service DS0000034931.V368581.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New people wanting to use the service are assessed prior to being accepted into the service. EVIDENCE: The Local Authority has a respite co-ordinator who sends referrals to the service. At times the referrals can also come from the Care Management teams. These are redirected back to the respite co-ordinator to ensure fairness in the process and accurate logging of data. The Manager provided evidence of the type of assessments and information received before a decision is made about offering a service. The assessments look at the carer’s needs, such as their health and social needs and the person needing the respite. Potential risks are considered so that the service is fully aware of particular needs. The Manager described the induction process, whereby there is a meeting with the carer and person to gain further more specific information and if agreed, tea visits are thereafter arranged. There is a tea visit form completed so that the carer can see how the visit went. The process of introducing the person to the service can take sometime and this is based on the individual’s needs. Overnight stays are also then planned. Star Road Respite Service DS0000034931.V368581.R01.S.doc Version 5.2 Page 9 Initial care plans and risk assessments are then completed and added to as the staff team get to know the person. There has been the rare occasion when emergency referrals have been made. Usually this is relating to people that the service knows and is familiar with the person’s needs. Where possible the service makes every attempt to accommodate the emergency referral. There had been an issue last year where three people stayed in the service for a long period of time. This had an impact on the service as carers received a reduced service. The Manager ensured that carers and the people using the service were kept informed of the progress to move the three people on to more permanent accommodation. This issue was resolved and there are now the seven usual respite beds available. Star Road Respite Service DS0000034931.V368581.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 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans and risk assessments reflect current needs of the people using the service. People have the opportunity to make daily decisions about their lives whilst they stay in the service. EVIDENCE: We viewed three files on the people who use the service. Those files viewed outlined the person’s health, social and personal care needs. Each person has different needs and this was reflected in the three files viewed. All three files had a personal profile that recorded the various areas of a person’s life, such as their relationships, how they communicate and their likes and dislikes. Care plans are completed by an allocated keyworker and are reviewed every six months or when there has been a change in needs. Star Road Respite Service DS0000034931.V368581.R01.S.doc Version 5.2 Page 11 We also viewed a draft version of a new support plan that once amended to suit the service, will be introduced and used. This document is more designed with the person at the centre of the plan and their specific needs would be clearly recorded. Staff would receive training and information on using this new plan. Samples of daily records were seen and these recorded what the person did, what they ate and any other significant information. Some people are able to manage their money and are supported to do so whilst they stay in the service. The Annual Quality Assurance Assessment stated that the service encourages the people to make decisions. Both staff and those people spoken with confirmed this. One carer commented from a postal survey that the people receiving respite are “treated as individuals”. We also observed throughout the inspection that the staff offered people choices, such as what they ate and the activities they took part in. Risk assessments were also seen. These were specific to the person, such as moving and handling risk assessments that recorded how to move the person safely. Risk assessments, as with care plans were updated every six months. The Manager is looking to provide information in other languages and in easy read versions to ensure that those people, who can read, along with their carers, can access information. Star Road Respite Service DS0000034931.V368581.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 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social activities are on offer in the service and people can take part in these both in and outside of the home. The rights of the people using the service are respected and acknowledged. The meal provision offers a variety of choice and a well balanced diet. EVIDENCE: Many of the people using the service either attend a day centre or College. The service offers a variety of activities both in the home, such as playing games, art or baking. Also community resources are accessed, such as the cinema, parks and shops. Evidence was seen that each week a member of staff, who is aware of the people coming that week for respite, plans a variety of things for the service to Star Road Respite Service DS0000034931.V368581.R01.S.doc Version 5.2 Page 13 offer. This plan is in the dining area so that everyone can see what is on offer. This plan is flexible, but enables staff to consider the activities to offer that should interest those staying in the service. Often there is the opportunity to go out either with one member of staff or in small groups. The service does have its own transport, although there is a current shortage of drivers working in the staff team. Those people asked said they are able to take part in whatever they want to do. One person said they liked to “relax and watch television or use the computer”. A relative commented in a survey that the service was aware of the person’s “preferences of activities”. We observed during the inspection that a person went out to the local shops, as they can go out independent of staff. Others watched television, used the computer or were talking with staff. Overall the impression was that people had the chance to talk amongst themselves or with staff in a relaxed and informal atmosphere. The aim of the respite service is to provide a break for carers. Often carers are family members and they can telephone or visit the respite service as they so wish. Staff explained that if the person is able to and wants to speak with their family/carers they could use the office telephone. Contact is regular with carers, with information recorded about the visit available for carers to read. This information is sent home with the person. We were informed that people could lock their bedroom doors if they want privacy. The member of staff explained that carers would be informed that this is the person’s preferred choice. However should staff have any concerns then they would be able to open the bedroom door from the outside. Throughout the inspection, staff were seen to interact with the people using the service and were not exclusively talking amongst themselves. We viewed a sample of menus and a member of staff completes these each week. As staff know who is coming to stay in the service, the menus can reflect individual’s preferences. Those people asked said they enjoyed the food provided by the service. For those people with particular religious beliefs and practices, separate cutlery and cooking utensils are used. Halal food is purchased and cooked separately. Fresh produce is used where possible and food that had been opened had been covered and dated when kept in the fridge. We were informed subsequent to the inspection that a list of allergies is also currently being drawn up to highlight risks in the kitchen area to ensure easy reference and staff awareness at all times when preparing meals. Temperatures of hot food had been taken and recorded and fridge/freezer temperatures were taken on a daily basis. Star Road Respite Service DS0000034931.V368581.R01.S.doc Version 5.2 Page 14 It was noted that the kitchen chopping boards were very scratched. This was brought to the attention of a member of staff and subsequent to the inspection we were informed that new boards had been bought and that the service had received a 4 star quality rating from the food standards agency inspection carried out in June 2008 for very good food safety management and hygiene. The evening meal was observed. Fresh vegetables were on offer but many people refused to eat these. The member of staff said that this can prove difficult for some people who do not like or enjoy eating vegetables. It was noted that one person had to sit on the sofa to eat their meal, as there were only six chairs around the dining room table. The service can provide accommodation for seven people and it was explained that often one or two people might be in a wheelchair and then the seating arrangements were not a problem. On the day we inspected there were no people using a wheelchair. Subsequent to the inspection we were informed that there are more chairs available in the service for the dining table and that individuals are encouraged to eat at a time and place that suits them. Staff were seen to assist some people with cutting up their food. The mealtime was unhurried and relaxed. Star Road Respite Service DS0000034931.V368581.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 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive personal care support in their preferred way. Health needs are recorded and addressed by the service. Medication systems are robust and safeguard the people staying in the service. EVIDENCE: The personal care support provided depends on the person staying in the service. Some people are independent and need little support to carry out their personal care tasks, whilst others need full support from a member of staff. The care plans viewed outlined the type of support the person would need. Those people spoken with confirmed they could get up and go to bed when they wanted to. The Manager explained that every four to five weeks there is a week dedicated to providing a service for females. Star Road Respite Service DS0000034931.V368581.R01.S.doc Version 5.2 Page 16 This has been at the request of some carers and when this occurs, the staff team providing the support are all female. A carer commented positively in a survey that the service listens to carers who have asked for same gender care. In addition, if a person has a preference for same gender care then this is noted on their files. The Manager stated that where possible the rota is arranged to match the gender and preferences of the people staying in the service. One survey commented on the lack of male staff working in the service. This was discussed with the Manager who acknowledged there had been staff changes, but that there were male regular agency workers who worked in the home. One agency male worker works approximately forty hours a week in the service. The hope is to employ a male worker, although this depends on the suitability of the applicant. One member of staff described how staff communicate with those people who are non-verbal. For example for staff trying to establish what a person wishes to wear that day, the person might point at the clothes they like or make a gesture to show they agree to wear what the member of staff has suggested. Staff also receive training on using Makaton, which is another form of communication often used by the people using the service. We were informed that should a person become unwell their own individual GP would be contacted or the local hospital. If there were any health concerns then these would be fed back to the carer and community disability team. Health needs are recorded on care plans and staff are made aware of specific health requirements. The Manager is looking into specialist training for the staff team, such as training in assisting people who have a catheter. A sample of medication was examined. All staff receive medication training when they first start working in the service. They also have time to observe medication being administered by experienced trained staff. We also viewed a medication competency document that all staff complete to show their awareness of medication practices and issues. Refresher training is also being booked for the staff team. All medication was stored in a suitable locked metal cupboard. Medication is counted and checked on a daily basis and this is recorded. Medication that comes into the service is noted on the person’s medication administration records and records are also kept of medication that is discharged when the person is leaving the service to go home. Each person has a medication care plan and it is clearly recorded what medication a person takes and the reasons why they take it. It was noted that some of the medication administration records did not have the person’s allergies written on them. It is noted that allergies had been noted on the front of each person’s file. This was brought to the attention of the member of staff and subsequent to the inspection the Manager confirmed that this would be addressed. Star Road Respite Service DS0000034931.V368581.R01.S.doc Version 5.2 Page 17 The medication file should also have an up to date list of all the names of staff who can administer medication along with their signatures. It is recommended for this to be carried out. Subsequent to the inspection we were informed that the list was almost up to date. We checked two people’s medication and found that all were correct at the time of the inspection. Star Road Respite Service DS0000034931.V368581.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 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s views are listened to and acted on. Systems are in place to safeguard people from abuse. EVIDENCE: The Annual Quality Assurance Assessment recorded the service had received fourteen complaints in the past year. The majority of these were relating to the local community disability team and not in relation to the service. Copies of the complaints were seen and appropriate action had been taken to advise carers who to talk to with their concerns. The Manager confirmed that any sensitive or confidential complaints would be locked in a secure place. Those people asked said that they would speak with a member of staff if they were unhappy. There had been no safeguarding concerns and there was visible evidence of how to report any safeguarding concerns with flowcharts seen around the service. The service has the Local Authority’s safeguarding policy and procedure available for staff to access. Staff receive safeguarding training and the Manager is keen for this to be updated on an ongoing basis. Those staff asked knew how to respond if they had any safeguarding concerns and would report such concerns to the Manager. Star Road Respite Service DS0000034931.V368581.R01.S.doc Version 5.2 Page 19 We looked a sample of people’s personal finances. Staff record the money each person brings into the service and receipts are obtained and financial transactions noted. The Annual Quality Assurance Assessment stated that money is counted and checked on each shift. This was confirmed during the inspection. We counted three people’s money and this was correct at the time of the inspection. Star Road Respite Service DS0000034931.V368581.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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Certain rooms need painting to ensure the service is appealing and welcoming to those who access the service. The service is clean and free from odours. EVIDENCE: We toured the service and viewed the rooms. The Manager acknowledged that certain rooms, bedroom numbers three, four and six were in need of painting as were the communal hallways. The sink in bedroom six had exposed pipes underneath and needed to be covered up. We were informed subsequent to the inspection that this had been reported to the housing association prior the inspection visit. The kitchen ceiling had been painted and the walls were due to be painted in the near future. Star Road Respite Service DS0000034931.V368581.R01.S.doc Version 5.2 Page 21 It is the responsibility of the housing association to maintain the building and currently there were no fixed dates to carry out any other work on the service. A requirement was made that the rooms needing attention are addressed. The Manager said that the hall carpets were due to be professionally cleaned. This was carried out subsequent to the inspection on the 15.09.08. Many of the bedrooms had a television in the bedrooms and were appropriately furnished. Other areas of the service were bright and welcoming. We saw the housekeeper who keeps the service, along with the main staff team, clean and presentable. A comment from a carer in a postal survey stated that the service was clean. There were no offensive odours at the time of the inspection. Star Road Respite Service DS0000034931.V368581.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported by staff who are qualified and experienced. Robust recruitment procedures protect the people using the service. Appropriately trained staff supports people. EVIDENCE: The majority of the staff have obtained an NVQ in care. New staff commence with studying for the Learning Disability Qualification (known as LDQ). Those staff spoken with said the team works well together and that there is good communication between each other. We observed staff working together on the day of the inspection. Staff were seen to share out tasks and to show the new member of staff how certain things are done on shift, for example how to prepare a discharge for a person who would be going home the following day. Star Road Respite Service DS0000034931.V368581.R01.S.doc Version 5.2 Page 23 We viewed the rota and saw that staffing levels are flexible to meet the needs of the people coming into the service. The majority of staff work first thing in the morning and then during the day there is minimal staff, as most of the people are not in the service. The usual number of staff is three in the morning and four in the afternoon and evening. For those people needing one to one support, this is arranged with the Local Authority to ensure there is funding available. The Manager spoke of the staff changes and that previous staff had spoken a range of different languages, whereas currently only a few other languages were now spoken. This has had some impact on some of the people using the service, whose first language might not be English. The Manager is hopeful that new staff who join the team might be multi-lingual. There is currently one Deputy Manager vacancy and the aim is to hold back twenty staffing hours so these can be used for agency staff to work where needed. Regular bank and agency staff work in the service, as they are familiar with the routine and expectations in the service. Regular team meetings are held. We viewed three staff employment files. The most recent member of staff to join the team (who started approximately two weeks ago) did not have a completed pro-forma. Subsequent to the inspection the Manager contacted the Human Resources Department to obtain this information and this was forwarded on to the Commission. This new member of staff has had a POVA first check and is waiting for their Criminal Record Bureau check. This new staff member does not work alone with the people using the service. There were two other completed forms and these confirmed the member of staff’s Criminal Record Bureau Check, two references, health declaration and full employment history. Although not all files had a staff photograph, in the communal areas there were staff photos. We viewed the induction new staff work through, which is arranged by the Provider. This covers core-training subjects, such as moving and handling. The service also has an in-house induction that new staff go through to understand how the service operates. Staff can then shadow experienced staff and become familiar with the service. Although not all training was up to date for all staff, the Manager had booked training for the forthcoming months. Training for staff covered the main subjects, such as moving and handling, fire awareness and food hygiene. Additional training is provided, such as cultural awareness and sexuality. Training is mainly accessed through the Provider, although the local community disability team also offer staff the opportunity to attend the training they offer, on subjects such as Communication and Autism. Star Road Respite Service DS0000034931.V368581.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 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from the service being well managed. Peoples’ views are obtained and form part of the development of the service. The health and safety of the people is promoted and protected. Star Road Respite Service DS0000034931.V368581.R01.S.doc Version 5.2 Page 25 EVIDENCE: The Manager has been in post for several years and has gained an NVQ level 4 in Management and is currently studying for an NVQ Level 4 in Care. The service is well managed with the Manager understanding the role of the service and the need to run it in an effective and organised way so that both carers and the people receiving respite can fully benefit from a break. The service gains the views of the carers and the people using the service on an ongoing basis. Staff attend reviews at day services and College. People are involved in what the service offers them. Annual surveys are sent to carers and for the people who use the service. Recently a member of staff designed a survey for carers and the people using the service. The results are currently being analysed and were not available to view. We were informed the Manager had completed an assessment of the home; the results of this were not available. The Manager completes a report every month for the Local Authority. This looks at various areas, such as staffing, complaints and numbers of referrals. We viewed one of these reports. The staff team had a recent away day where the aims and objectives of the service were looked at. Evidence of this day was seen and highlighted that the staff team are encouraged to focus on their roles and responsibilities. The service has a business plan to work towards over the next three years. Regular coffee meetings are held that are open for carers to attend and meet with the Manager and other staff. Comments from a carer in a postal survey said that the service “has meetings to relate any changes and listens to any issues carers have”. Overall the service makes every attempt to gain the views of those involved with the service. Samples of maintenance records were viewed. The Manager explained that the housing association had informed her that they would keep copies of the health and safety checks that had been carried out. Evidence on equipment was seen that the Portable Appliance Test had been carried out in January 2008. There was no up to date Gas Safety Record or test for Legionella. Evidence was seen that the Manager had tried to obtain these certificates from the Housing Association. It is important to have these as evidence of the checks that have been carried out in the service. Evidence was seen that an external organisation visits the home monthly to check the water temperatures. The fire risk assessment was available covered the main potential risks presented in the service. Star Road Respite Service DS0000034931.V368581.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 1 2 3 4 5 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score x 3 x x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 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 3 x 3 x 3 x x 3 x Star Road Respite Service DS0000034931.V368581.R01.S.doc Version 5.2 Page 27 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 Regulation 23(2)(d) Timescale for action To ensure people are staying in a 29/12/08 clean and welcoming service bedrooms 3, 4 & 6 need to be painted. Hallways also need to be painted. 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. 2. Refer to Standard YA20 YA42 Good Practice Recommendations It is recommended that a list of staff with staff signatures is available showing who can handle and administer medication. Evidence of maintenance checks should be available in the home. Star Road Respite Service DS0000034931.V368581.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Star Road Respite Service DS0000034931.V368581.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. 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