Care Home: Station Road

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What the care home does well The home is run by a manager who is well respected by the staffOne of the support workers is responsible for all Health and Safety aspects in the bungalows. This means she has some ownership and takes pride in the job she does. People are treated with respect, and live in a homely environment that offers them safety and security. Staff, many who have worked at the home for many years, continue to work hard to ensure that the peoples` rooms are individually organised, decorated to their taste, and suitable for them. Individual cultural needs are respected and steps taken to make sure that these are met. What has improved since the last inspection? Some peoples` bedrooms have been redecorated. New kitchens are being installed in both bungalows, and decking is to be erected outside one of the bungalows following a successful planning application by the manager. What the care home could do better: Relationships between staff and the people who live there are not always positive. More emphasis needs to be placed on training, as there are certain staff that require updates in manual handling and safeguarding adults. Better records could be kept in the home of pre employment safety checks of new starters. Although formal supervision is taking place and records confirming this were seen, it was obvious the manager and his senior supporting staff need to keep a higher profile on the `shop floor` as there were many examples of weak interactions where staff were helping people with eating or getting ready for the Christmas party that afternoon. Staffs conversation with people was limited and for one person we observed, there were only two interactions throughout the observation period. More supervision on a daily basis would help negative practices like these to be eliminated and therefore benefit the people in a positive way. Staff spoke to each other to inform about progress and to check whether individual clients had had a drink etc. however there were a significant number of missed opportunities for positive interaction, for example staff sitting at the table with people, staff assisting with dressing and with eating. CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Station Road 2b/2c Station Road Clayton Bradford West Yorkshire BD14 6JA Lead Inspector Pamela Cunningham Key Unannounced Inspection 13th December 2007 10:10 Station Road DS0000068469.V357322.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 Station Road DS0000068469.V357322.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 Older People and 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. Station Road DS0000068469.V357322.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Station Road Address 2b/2c Station Road Clayton Bradford West Yorkshire BD14 6JA 01274 884424 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) www.sjog.co.uk Saint John of God Care Services Mr Peter John Carter Care Home 12 Category(ies) of Learning disability (12), Learning disability over registration, with number 65 years of age (12) of places Station Road DS0000068469.V357322.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th October 2006 Brief Description of the Service: 2b and 2c Station Road are two bungalows registered as one home, each with six single bedrooms offering nursing care and support for people with severe learning and physical disabilities. The bungalows, which are purpose built and designed and equipped to a high specification, are located within the community of Clayton. Clayton is ideally situated, having easy access to all facilities within Bradford, and is only a few miles from open countryside. The buildings are well maintained externally. It is situated in a quiet residential area, and is surrounded by well-tended gardens. The home has two mini buses, which have tail lifts to enable the wheelchair bound service users to use the transport facilities and take them on organised outings. Each individual has their own private room decorated to their own personal taste, and which is provided with all necessary aids and adaptations to suit individual’s requirements. Every room is fitted with a nurse call facility. In each of the bungalows the service users share the communal lounge, dining room and patio areas. All service users have access to local day care activities according to their abilities and individual needs. They are also supported to use the local community facilities within Bradford and Clayton and everyone enjoys an annual summer holiday. Care is provided by a team of registered nurses with learning disabilities qualifications, and trained support workers. The charges made for nursing care provided on 13/12/07 are £948.31 per week. Station Road DS0000068469.V357322.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One visit was made on 13th December 2007. The home did not know that this was going to happen. Feedback was given to the manager during and at the end of the visits. This inspection was prompted as a result of a visit to the home by an independent advocate whose observations raised concerns about the way people in the home were being spoken to. During this inspection we used a new tool called the Short Observational Framework for inspectors or SOFI. This is a framework for understanding and recording the levels of staff engagement and activity at the home. It gives us an insight into the wellbeing and quality of care experienced by people who live at the home. One inspector carried out this observation and recorded what she saw for 1hour 15 minutes. The purpose of the visit was to make sure the home was being managed for the benefit and well being of the residents. Before visiting the home the inspector asked for information from the manager (AQAA) Quality Assurance Assessment which asks about what policies and procedures are in place and when they were last reviewed, when maintenance and safety checks were carried out and by who, menus used, staff details and training provided. Other information such as what has been done by the home to ensure quality of care, what barriers to improvement if any, and what their plans for maintaining improvement are. Comment cards were sent to their relatives and other visitors to find out what their views of the home were. The views of doctors and district nurses who visit the home were also asked for. At the time of writing this report four relatives responses and one health care response had been received In order to find out how well staff knew residents, care plans were looked at during the visit and staff were spoken to. Other records in the home were looked at such as staff files, training records and complaints received. What the service does well: The home is run by a manager who is well respected by the staff. Station Road DS0000068469.V357322.R01.S.doc Version 5.2 Page 6 One of the support workers is responsible for all Health and Safety aspects in the bungalows. This means she has some ownership and takes pride in the job she does. People are treated with respect, and live in a homely environment that offers them safety and security. Staff, many who have worked at the home for many years, continue to work hard to ensure that the peoples’ rooms are individually organised, decorated to their taste, and suitable for them. Individual cultural needs are respected and steps taken to make sure that these are met. 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. Station Road DS0000068469.V357322.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Station Road DS0000068469.V357322.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 4 and 5 Quality in these outcomes is excellent. This judgement has been made through using available evidence including a visit to this service. Prospective residents and their carers/parents can be sure that the home will meet their needs, and wishes. EVIDENCE: Prospective residents know that the home they choose will continue to meet their needs and wishes. This is assured by the in depth multidisciplinary pre admission process that continues to take place. Trial visits take place, and no permanent placement is agreed until the staff at the home are assured they can meet their needs, and that they will “fit in” with the other people living in the home. Station Road DS0000068469.V357322.R01.S.doc Version 5.2 Page 9 Residents meetings still take place so that they can be consulted on the running of the home. Station Road DS0000068469.V357322.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14 and 33 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6. 7. 9 and 10. Quality in this outcome area is excellent.This judgement has been made using available evidence including a visit to this service. People know their assessed and changing needs, and personal goals are reflected in their individual life plans. They are consulted on, and participate in all aspects of life in the home, and are supported to take risks. EVIDENCE: There have been no admissions since the last inspection. Three peoples care documentation was inspected and case tracked. Station Road DS0000068469.V357322.R01.S.doc Version 5.2 Page 11 There is consistent evidence of adequate provision of health care. These are a working document for all staff, and were up to date and complete with all information needed to make sure client’s needs are assessed, and provided. This documentation continues to be kept in individual clients bedrooms and contained a full life history and pen picture. Documentation also contained evidence of care reviews, and of medication reviews The named nurse also does written monthly reviews of care given. All necessary risk assessments were in place and there was a report present on the provision of day care. Evidence was also in the file of night care protocol in the event of a fire, which had been last reviewed on 2/10/07. One set of care plan documentation however was void of religious preferences and therefore it was not possible to assess if the religious needs of the client ware fully addressed. Confidentiality is regularly addressed in supervision. The manager said confidentiality was one of the care services core values. Station Road DS0000068469.V357322.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. Service Users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. Service users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): All standards were assessed Quality in this outcome area is adequate.This judgement has been made using available evidence including a visit to this service. Station Road DS0000068469.V357322.R01.S.doc Version 5.2 Page 13 Leisure time away from the home is adequate, however more thought must be given to make sure clients social and emotional needs are met when they are in the home. EVIDENCE: There is still no day care provided. Therefore to make sure each person has some pre arranged leisure time away from the home, one member of staff has been transferred to the outreach services to make sure all people have three and a half hours pre arranged leisure time tailored to meet their individual needs once a week. The manager said one person particularly likes riding on public transport, and to fulfil this desire, they have been allocated a bus pass. . He said it is hoped this facility is to be extended to all people living in the home in the New Year. In addition to this, it is hoped all clients will be attending Stoney Ridge Day Care centre to use the hydrotherapy pool. Two of the care staff in the home have been trained to help in this facility. During the observation in the kitchen and lounge we saw some good examples of staff engaging with people. One staff member gave a person a reassuring pat on the hand as she walked past. Another staff member talked to one of the people all the time they were helping her with her coat. However there were many more examples of neutral interactions where staff were helping people with eating or getting ready for the Christmas party that afternoon. Conversation with people was limited and for one person we observed, there were only two interactions throughout the observation period. Staff spoke to each other to inform about progress and to check whether individual clients had had a drink etc. however there were a significant number of missed opportunities for positive interaction, for example staff sitting at the table with people, staff assisting with dressing and with eating. The main activity on the day of the visit was the Christmas party and staff were preparing for this. Some people were sitting in the lounge and the television was on. Also during the observation we saw people being assisted with drinking by carers who were standing up. This makes it difficult for them to drink at their own pace and for staff to engage with them fully. A small number of people received help with eating macaroni cheese. This was a snack before the Christmas party. The inspector noted that at least two of the meals seen were steaming. No food temperatures had been carried out on this meal and this puts people at risk of scalding. Station Road DS0000068469.V357322.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) 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. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): All standards were assessed. Quality in this outcome area is good.This judgement has been made using available evidence including a visit to this service. People receive support from specialist healthcare professionals. However staff in the home could be more positive in their approach, as there is limited stimulation for the people who live there. There are no people who are capable of administering their own medication. EVIDENCE: There was evidence in the AQAA that service users are registered with a local GP. Other professionals’ help, such as speech therapy and community psychiatric nurse intervention. Physiotherapy, dental and podiatry, and Community Psychiatric advice are accessed via the service users’ GP. Station Road DS0000068469.V357322.R01.S.doc Version 5.2 Page 15 Currently there is no one who is capable of controlling their own medication; this is done for them on their behalf by the team of qualified nurses. The medication system is safe and includes written information in each persons file on behaviour management strategies in relation to the giving of medication, this is good practice. However during the observation it was noted one member of staff lifted an otherwise mobile resident from a seated position on a chair into a wheelchair without using any equipment or any thought about how this person wished to be moved Station Road DS0000068469.V357322.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16-18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 22-23 (Adults 18-65) and Standards 16-18 and 35 (Older People) 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. Complaints are handled sensitively and clients are protected from abuse. EVIDENCE: There has been one complaint, and one concern since the last inspection. The complaint was brought to the attention of the registering authority by an independent advocate following an observational visit to the home. Concerns identified were of a safeguarding nature and adult protection were involved. From this information it was decided that a key inspection would be done using the expertise of a SOFI trained inspector. A review has also been done by the area manager following the independent advocate visit and a report on her findings has been forwarded to the Adult Protection team and the registering authority. The outcome of the SOFI inspection confirmed the concerns of the independent advocate. The concern was regarding the use of the managers store loyalty card for his benefit. The inspector saw evidence that shopping on line is by the approval of the provider, and all transactions regarding loyalty cards are forwarded to head Station Road DS0000068469.V357322.R01.S.doc Version 5.2 Page 17 office. The manager and staff use commission schemes for toiletries and supermarket loyalty points to help raise funds. This concern was unfounded. The home does not have a complaints book, which would help in establishing how concerns and complaints, no matter how trivial, are handled. The manager said he had already identified the need to keep a written log of concerns/complaints Station Road DS0000068469.V357322.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): All standards were assessed. Quality in this outcome area is excellent.The home continues to provide a safe, clean and well-furbished environment for the clients, with specialist equipment to meet their needs. This judgement has been made using available evidence including a visit to this service. Station Road DS0000068469.V357322.R01.S.doc Version 5.2 Page 19 EVIDENCE: The home continues to offer a very comfortable, homely environment with the fixtures and fittings being of a high standard. It was found to be clean, tidy and hygienic throughout. None of the bedrooms have en-suite facilities, however, specialist equipment is available ensuring the safety of residents and staff in some of the rooms. It was clear a great deal of thought has gone into the individual bedrooms ensuring that they suit the residents’ needs, wishes and choices Communal areas are nicely furnished and offer comfort and safety to the residents. There is a rolling programme of redecoration and refurbishment in the home, which means the client’s private and communal areas are always well decorated and furnished. Individual chairs are provided where required. Assisted bathing facilities are available for the residents in both bathrooms. Light and sound equipment is also present in some of the bedrooms. There is overhead tracking in 4 rooms, and over the baths in both bungalows. Overhead tracking and hoist facility is provided in the lounge areas to assist with client movement and safety. Certain clients have been provided with special beds and mattresses. Since the last inspection 4 bedrooms have been refurbished, two in each bungalow. Kitchens are also being replaced in both bungalows. The manager said any extra items that may be helpful or benefit the client, or any extra items they would like are paid for by the service user, and there was no evidence to support the approval of the use of their money in this way. The manager said 5 of the service users have no next of kin or independent advocate, and that the key workers act on their behalf. This is not an ideal arrangement. The manager said it was a subject St John of God Care Services are aware of, and are looking at ways of resolving. Station Road DS0000068469.V357322.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36 Quality in this outcome area is good.This judgement has been made using available evidence including a visit to this service. Staffing in the home is good, but better records need to be kept regarding training, and recruitment procedures. EVIDENCE: Staffing on the day of the visit appeared adequate to provide for the needs of the clients, although comments received from surveys from parents/relatives said they thought staff turn over was high and this caused problems with the knowledge they had of the people who live there. Station Road DS0000068469.V357322.R01.S.doc Version 5.2 Page 21 Information received in the AQAA however did not support these concerns. The manager said staff turn over had been ‘fair’, particularly on night duty when 4 new night staff have been employed. The manager also said there was one care vacancy only on day duty. Pre inspection documentation identified all staff have undertaken mandatory training. Other training has also been provided, however on the day of the visit documentation produced by the manager in support of this identified manual handling updated had not been provided for five of the staff, and that six of the staff needed updates on safeguarding adults procedures. The manager said he thought the list was not complete following recent training provided, and said he would forward an updated training schedule to the Commission. Recruitment documentation of two recently employed staff was reviewed. One contained all necessary evidence of pre employment checks including proof of eligibility of the person to work in the UK, however the second set of documentation was void of evidence of CRB or POVA. (Criminal Records Bureaux or Protection of Vulnerable Adults checks) There was also no evidence that suitable references had been sought or received prior to commencement of employment Station Road DS0000068469.V357322.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. Service users live in a home which is run and managed by a person who is fit to be in charge of good character and able to discharge his or her responsibilities fully. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) 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 homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 and 42 Quality in this outcome area is good.This judgement has been made using available evidence including a visit to this service. Management in the home could be more effective if the staff received training on communication skills, and if the manager observed the staff more on a day to day basis. Station Road DS0000068469.V357322.R01.S.doc Version 5.2 Page 23 EVIDENCE: The manager is an experienced first level registered nurse who keeps himself professionally updated by attending any relevant courses. A spot check of certain policies and procedures identified they were up to date and in line with any changes in legislation. Health and Safety in the home is good, and all staff are aware of their responsibilities. Formal supervision is taking place, and there was evidence of this in staff files inspected. However, as a result of the SOFI observation it was evident he needs to spend more time on the shop floor. This would result in making sure the staff have more interaction with the clients. Arranging for the staff to have instruction in communication skills would also help to achieve this. Station Road DS0000068469.V357322.R01.S.doc Version 5.2 Page 24 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. Where there is no score against a standard it has not been looked at during this inspection. 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 4 3 X 4 4 5 4 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 4 25 4 26 4 27 4 28 4 29 4 30 4 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 2 CONDUCT AND MANAGEMENT Standard No Score 37 3 38 X 39 3 40 X 41 2 42 2 43 X 4 3 X 3 4 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Station Road Score 2 3 3 X DS0000068469.V357322.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No 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 YA18 Regulation 12 Requirement The Registered provider must ensure by adequate day to day supervision, staff provide sensitive flexible personal care and support to maximise service user independence. The registered provider must ensure that staff are provided with up to date training in manual handling and safeguarding adults, and that records are kept Timescale for action 31/03/08 2. YA42 18(1)(a) 31/03/08 Station Road DS0000068469.V357322.R01.S.doc Version 5.2 Page 26 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 YA36 Good Practice Recommendations Formal supervision is taking place and records are kept, however during the SOFI observation it was clear the manager and senior nursing staff at the home are not supervising staff enough on a day-to-day basis. A higher profile needs to be kept. Records of safe thorough recruitment procedures should be kept at the home. 2 YA41 Station Road DS0000068469.V357322.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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. 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