Care Home: Summerfield Court

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What the care home does well There is a warm friendly and welcoming atmosphere in the home. Staff interact well with people who use the service. In a returned survey, a relative said, "Summerfield Court has a lovely family atmosphere". In the home`s compliments book, a relative said, "What a great place Summerfield Court is, I would recommend it to anyone" and "You feel welcome as soon as you arrive". The manager makes sure that a thorough assessment of the needs of the people who use the service is carried out. This means that people can be sure that the home will be able to meet their needs properly. Staff have good knowledge and understanding of the care and support needs of people who use the service. In a returned survey, a relative said, in answer to `what does the home do well`, "Meet the needs of everyone there and they look after them very well". The home is well designed, equipped and furnished. This means that people who live at the home can practice their independence skills. Staff are good at encouraging people to be more independent. One person who uses the service said, "Staff are here to help us become independent, they are really good at that". Staff said they felt their role was to encourage and support people. One said, "We are here to support them, it`s all about their choices, their home, all part of getting on". The manager has good leadership skills and is supportive to the people who use the service and the staff team. Comments from staff included, "She is a good manager", "She is approachable" and "She is very hard working". People who use the service said, "She`s alright, if you need `owt you only have to ask", "She`s there for you" and "If you are struggling with something she will always be there for you". What has improved since the last inspection? A requirement and some recommendations were made at the last inspection of the home. Some of these have been dealt with. Work has been done to improve care and support plans. They are now clearer and give staff good instructions to follow so that they can meet people`s needs properly. The service user guide has now been produced in an audio format. This is now more accessible and understandable information. Records of medication ordered by the home are now improved. This is safer and means errors can be avoided. The manager now keeps better records of duty rotas, health and safety and recruitment. This means they can be checked more easily. What the care home could do better: Where risk management plans place any limitation on the freedom of people who use the service, the person using the service or their representative must have agreed to this. This will make sure their rights are respected. The contract between people who use the service and the organisation should have all costs and additional costs included. All parties should also sign thecontracts. This will make clear, what has been agreed. This was also recommended at the last inspection of the service. The manager should make sure that health actions, such as physiotherapy exercises are carried out at the frequency requested by any health practitioners for people who use the service. This will make sure health needs are properly met. Medication administration needs to be safer to avoid the risk of errors occurring. All handwritten entries on Medication Administration Records should be checked and countersigned by a second person to reduce the risk of errors. The manager should also make sure that staff follow the medication administration procedure when administering medications so that errors can be prevented or minimised. Staff should receive regular refresher training in medication administration to make sure their skills are up to date. All relatives of people who use the service should be made aware of the complaints procedure to make sure they can express their views fully. The manager should make sure that staff have access to NVQ training or something equivalent in order to develop their skills. CARE HOME ADULTS 18-65 Summerfield Court Summerfield Drive Bramley Leeds LS13 1AJ Lead Inspector Dawn Navesey Key Unannounced Inspection 8th January 2008 10:30 Summerfield Court DS0000067957.V357451.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 Summerfield Court DS0000067957.V357451.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. Summerfield Court DS0000067957.V357451.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Summerfield Court Address Summerfield Drive Bramley Leeds LS13 1AJ 0113 2362229 0113 2909988 summerfielddrive@tisacali.co.uk 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) Voyage Ltd Joanne Morris Care Home 14 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (14), Physical disability (14), Sensory of places impairment (14) Summerfield Court DS0000067957.V357451.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th February 2007 Brief Description of the Service: Summerfield Court is a purpose built home providing accommodation over two floors for 14 people of both sexes with an acquired brain injury. The home is situated in Bramley, a suburb of Leeds, near to shops, pubs, and other local amenities. Accommodation is spacious, with communal lounges, a small gym, snooker area, sensory room and a spacious kitchen and adjoining dining area. Private accommodation for people who use the service consists of 5 flats with en-suite and kitchenettes, which includes a hob, microwave and fridge; 4 transitional living apartments with en-suite, lounge, dining area and full kitchens and 5 flats with en-suite facilities. All rooms have a wet room with shower. There is an adjoining resource centre, for people with acquired brain injuries. This is independent of the home and is not regulated, therefore is not included in the inspection process. However, when fully operational service users from the home will be able to take full advantage of the facilities provided by the centre. The manager confirmed the fees that applied at the time of this inspection ranged from £1300 - £1828 per week. This information was gained from the manager of the home on 10 January 2008. More up to date information may be obtained from the home. Inspection reports are usually available in the front entrance of the home. Summerfield Court DS0000067957.V357451.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission for Social Care Inspection (CSCI) inspects homes at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. More information about the inspection process can be found on our website www.csci.org.uk This visit was unannounced and was carried out by one inspector who was at the home from 10-30am to 5-30pm on the 8 January 2008. The purpose of the inspection was to make sure the home was operating and being managed for the benefit and well being of the people living there. And also to monitor progress on the requirement and recommendations made at the last inspection. Before the inspection evidence about the home was reviewed. This included looking at any reported incidents, accidents and complaints. This information was used to plan the visit. An AQAA (Annual Quality Assurance Assessment) was completed by the home manager before the visit to provide additional information. Survey forms were sent out to people living at the home, their relatives and health and social care professionals. Five of these have been returned and this information has also been used in the preparation of this report. During the visit a number of documents and records were looked at and some areas of the home used by the people living there were visited. Some time was spent with the people who live at the home, talking to them and interacting with them. Time was also spent talking to staff and the senior support workers. Feedback at the end of the visit was given to the senior support worker. The quality rating for this service is 2 star. This means the people who use this service experience goo quality outcomes. What the service does well: There is a warm friendly and welcoming atmosphere in the home. Staff interact well with people who use the service. In a returned survey, a relative said, “Summerfield Court has a lovely family atmosphere”. In the home’s compliments book, a relative said, “What a great place Summerfield Court is, I would recommend it to anyone” and “You feel welcome as soon as you arrive”. The manager makes sure that a thorough assessment of the needs of the people who use the service is carried out. This means that people can be sure that the home will be able to meet their needs properly. Summerfield Court DS0000067957.V357451.R01.S.doc Version 5.2 Page 6 Staff have good knowledge and understanding of the care and support needs of people who use the service. In a returned survey, a relative said, in answer to ‘what does the home do well’, “Meet the needs of everyone there and they look after them very well”. The home is well designed, equipped and furnished. This means that people who live at the home can practice their independence skills. Staff are good at encouraging people to be more independent. One person who uses the service said, “Staff are here to help us become independent, they are really good at that”. Staff said they felt their role was to encourage and support people. One said, “We are here to support them, it’s all about their choices, their home, all part of getting on”. The manager has good leadership skills and is supportive to the people who use the service and the staff team. Comments from staff included, “She is a good manager”, “She is approachable” and “She is very hard working”. People who use the service said, “She’s alright, if you need ‘owt you only have to ask”, “She’s there for you” and “If you are struggling with something she will always be there for you”. What has improved since the last inspection? What they could do better: Where risk management plans place any limitation on the freedom of people who use the service, the person using the service or their representative must have agreed to this. This will make sure their rights are respected. The contract between people who use the service and the organisation should have all costs and additional costs included. All parties should also sign the Summerfield Court DS0000067957.V357451.R01.S.doc Version 5.2 Page 7 contracts. This will make clear, what has been agreed. This was also recommended at the last inspection of the service. The manager should make sure that health actions, such as physiotherapy exercises are carried out at the frequency requested by any health practitioners for people who use the service. This will make sure health needs are properly met. Medication administration needs to be safer to avoid the risk of errors occurring. All handwritten entries on Medication Administration Records should be checked and countersigned by a second person to reduce the risk of errors. The manager should also make sure that staff follow the medication administration procedure when administering medications so that errors can be prevented or minimised. Staff should receive regular refresher training in medication administration to make sure their skills are up to date. All relatives of people who use the service should be made aware of the complaints procedure to make sure they can express their views fully. The manager should make sure that staff have access to NVQ training or something equivalent in order to develop their skills. 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. Summerfield Court DS0000067957.V357451.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 Summerfield Court DS0000067957.V357451.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): 1, 2 and 5 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service can be sure that the home will meet their needs following assessment. Also, in the main, written and verbal information that is available provides enough information for them to decide whether the home will meet their needs. EVIDENCE: The Statement Of Purpose and Service User Guide, which provide information on the services provided by the home, have been produced in an audio format. This makes them more accessible to people who have difficulties with reading. People who use the service are given their own copy of the Service User Guide and a brochure about the home before they move in. The needs of people who use the service have been assessed before they move into the home, to make sure the home can meet their needs. The manager completes detailed pre-admission assessments with people and then uses this information as a basis for care and support plans. The records showed that people who use the service and their families are involved in the assessment. Most information is written in the person’s own words, saying what sort of service they need. Information is also gained from previous Summerfield Court DS0000067957.V357451.R01.S.doc Version 5.2 Page 10 placements and from care managers or health professionals. Staff said they always have enough information to help them to care for or support people when they move into the home. People who use the service can visit the home before they move in and have overnight stays if they want. Staff said that most people who have visited the home have chosen to move in from just the one visit. Staff can also go to work with people at their previous placement so that they can get to know their needs better. This is good practice and makes sure people get continuity with their care and support. It was clear from talking to people who use the service that they had made the choice to move into the home. One person said, “This is a very nice service”. Another said, “It’s great here” and “I have never been happier in my whole life”. In a returned survey, someone who uses the service said, “This is the best place I can be at the moment”. People who use the service have a contract with the organisation. At the last inspection of the home, it was recommended that contracts were improved to include all costs and any extra costs. Also to be signed by all parties concerned and to be produced in a format all people who use the service could understand. The contracts are still in a standard written format. Some people had signed to say they had read and understood the contracts. Staff said that all people who currently live at the home could read and therefore understand the contractual information. The senior support worker said that if anyone needed alternative formats, this would be looked into. In the AQAA, the manager said that they needed to improve the service by producing contracts in alternative formats. Contracts have still not been signed by representatives of the organisation or had extra costs included. This means that it is not clear what the organisation have agreed to provide. In the AQAA, the manager said she wants to improve the service by getting this done. Summerfield Court DS0000067957.V357451.R01.S.doc Version 5.2 Page 11 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, 8 and 9 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service are involved in decisions about their lives, and play an active role in planning the care and support they receive. EVIDENCE: The organisation has recently introduced a new system of care planning. This is person centred and involves people who use the service. The plans are written in the first person, using the language and words of people who use the service. People who use the service have signed the plans and are aware of what is in them. Staff said that the manager was introducing them for all people who use the service. They said they were to receive training from the manager in how to complete them. In the AQAA, the manager said she was aware the new support plans need to be completed in order to provide ‘in depth detail of support needs and activity’. Summerfield Court DS0000067957.V357451.R01.S.doc Version 5.2 Page 12 The new support plans looked at were clear and gave good instruction for staff on care and support needs. Some of the older style plans were not as clear and needs were not accurately described which, could lead to them being overlooked. For example, a person who needs support with some behaviours that challenge others, had their behaviour described as ‘violence’. This is not detailed enough and does not describe the actual behaviour. However, staff have very good knowledge of the support needs of people who use the service. They were able to accurately and confidently describe the care and support they give. They showed they had a good understanding of what being person centred means. In a returned survey, a relative said, in answer to ‘what does the home do well’, “Meet the needs of everyone there and they look after them very well”. Care plans have been evaluated and reviewed, with changes being made as needed. Key-workers have a monthly meeting with people who use the service to do this. This makes sure that people are supported with their changing needs. One person is moving on from the service in response to their increased independence. Staff said other people had been supported in this way in the last year too. The care plans link well to risk assessments. There is a good attitude to responsible risk taking and how this can help people who use the service to greater independence. One person who uses the service said, “Staff are here to help us become independent, they are really good at that”. Risk assessments are up to date and reviewed. There were some risk management plans that placed limitations on the freedom of people who use the service. It was not clear how this had been agreed. The senior support worker said she would make sure that people who use the service or their families signed the plans to show they are in agreement with them. Throughout the day of the visit, people who use the service were involved in choice and decision-making. This included, the choice to go out, get involved in an activity and what to eat. Staff responded well to any choices or decisions made and respected them. People who use the service have a regular meeting. Topics at the meeting include any forthcoming events, food choices, likes and dislikes, shopping, activities and holidays. In the AQAA, the manager gave a number of examples of how people who use the service can influence what happens in the home. These included, involvement in interviewing staff, showing visitors round, monthly service reviews and annual service reviews. Summerfield Court DS0000067957.V357451.R01.S.doc Version 5.2 Page 13 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): 11, 12, 13, 14, 15, 16 and 17 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service are able to make choices about their lifestyle and supported to develop their life skills. Social, educational, cultural and recreational activities meet their individual expectations. EVIDENCE: People who use the service enjoy a wide variety of activity. This includes, college courses, shopping, meals out, bowling, cinema and going to the pub. On the day of the visit, people who use the service went out shopping, went out for lunch and were planning to go out for dinner to celebrate a birthday. Some people are being given support to look for paid employment. In a returned survey, a relative said, “My son is always given a choice in everything he does”. A person who uses the service said, “I choose what I want to do, I won’t do things I find boring”. Summerfield Court DS0000067957.V357451.R01.S.doc Version 5.2 Page 14 There are also plenty of activity opportunities within the service. There is a small gym, a snooker table and a sensory room. Staff and people who use the service said these are well used. The upstairs sitting room is currently being changed into an activities room. This will be used for arts and crafts, games and computer games. People who use the service said they always had plenty to do. Staff are supportive to the determination of people who use the service to gain their independence. College courses have been found to enable people to relearn skills that will prepare them for the future and moving on to more independent living. Some people have one to one support to carry out activities. One person said this was useful, especially in helping to get to know the local area. People who use the service are given good support to keep in contact with family and friends. Staff give assistance in reminding people of important dates such as family birthdays. People who use the service said their visitors are always made welcome and given refreshments when they visit. Staff are good at making sure a wide diversity of people’s needs are met. People are supported with any needs relating to their age, culture, sexuality, gender, disability or beliefs. There is a vegetarian option available at meal times. Care plans clearly state if care is to be given by someone of the same gender as the person receiving the care. Activity is organised and offered around people’s needs and lifestyle choices. The home has its own transport; a minibus, with adaptations for people who use a wheelchair and also a car. People also make use of public transport. Staff gave good examples of how they support people to be more independent. They said they are encouraged to get involved in household tasks, budgeting and food preparation. Staff said they felt their role was to encourage and support people. One said, “We are here to support them, it’s all about their choices, their home, all part of getting on”. People who use the service said they enjoyed their independence. One said, “I clean my own room, prepare the food and go out to do the shopping”. There was plenty of social interaction between the staff and people who use the service. The atmosphere is relaxed and there was lots of laughter and fun throughout the day. It was clear that staff and people who use the service get on well. Menus look to be well balanced and nutritious. Menus are put together based on the likes and dislikes of people who use the service. This is done through the meetings they have. If someone wants something different to what is on the menu, this can be done. A good variety of food is available and staff make sure there is a good selection of fresh produce and home cooked food available. People who use the service spoke highly of the food. One person Summerfield Court DS0000067957.V357451.R01.S.doc Version 5.2 Page 15 said, “It’s lovely food, plenty of choice” another said, “Staff are terrific cooks”. People who use the service get involved in doing the weekly shop. Some people receive regular one to one support to cook their own meals. Some foods stored in the fridge had been opened and not labelled with the date of opening. This could lead to foods being eaten past their use by date and therefore putting people at risk of food poisoning. The senior support worker agreed to remind staff of their responsibilities in this area. Summerfield Court DS0000067957.V357451.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Staff gave good support with any personal care needs and made sure they were carried out in private to respect people’s dignity. The support people need is well documented in the care plans and makes sure the needs of the people who use the service are properly met. A moving and handling plan has been developed using photographs, this is good practice and shows very clearly how to position and seat the person using the service. The care plans and health action plans also have details of any health professionals that people see. These include, GP (General Practitioner), dentist, physiotherapist, psychologist and speech and language therapist. Good, detailed records are kept of any health appointments and their outcome. In a returned survey, a GP was very positive about contact with the service. In a returned survey, a person using the service said, “If I have any problems Summerfield Court DS0000067957.V357451.R01.S.doc Version 5.2 Page 17 I go to the doctors, the staff or some staff help me with that”. One person using the service said they would like more physiotherapy help from the staff. The care plan from the physiotherapist recommended daily support from staff. The daily notes showed that this was not always carried out daily. Some staff have received training in the health needs of the people who use the service. They gave examples such as epilepsy and acquired brain injury. Staff were able to describe the health and personal care needs of people who use the service well. They were clear on any risks associated with health needs for people and what they do to prevent or minimise them. The home uses a monitored dosage pre-packed system for medicines. All staff have been trained to administer medication. In the main though, it is the senior members of staff who take responsibility for the administration of medication. We recommend that all staff have regular refresher training so they don’t lose their skills if they don’t administer medication on a regular basis. There are now good ordering and checking systems in place, with a clear audit trail for any unused medication returned to the pharmacy. The medication administration record (MAR) sheets were checked and showed a number of errors in that medication appeared to have been given but staff had not signed the MAR sheet. This means that it is not clear if medication has been given. The senior support worker said she would investigate the errors. Also, a handwritten entry had been made on the MAR sheet without it having been countersigned. The senior support worker was aware that this should be done to minimise the risk of errors and apologised for the oversight. People who wish to take responsibility for their own medication are enabled to do this. A risk assessment is completed first to make sure it is safe for them. Summerfield Court DS0000067957.V357451.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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service and their relatives have their views listened to, taken seriously and acted upon. There are good systems in place to protect people who use the service from abuse. EVIDENCE: In the AQAA the manager said, ‘All service users are provided with an accessable version of letting us know what you think policy and service users are each provided with help cards.’ People who use the service said they were aware of these things to assist them if they needed to complain. Most people said they would talk to the manager or their keyworker if unhappy about anything. In a returned survey, one relative said they didn’t know how to complain. The complaints procedure is part of the Statement of Purpose and left on display in the entrance hall. We recommend that relatives are made aware of the complaints procedure to make sure they can express their views fully. The senior support worker said that the home has not received any complaints since the last inspection. We could not check this as the complaints book could not be located. Staff have received training on the protection of vulnerable adults. They were able to say what action they would take if they suspected abuse or had an allegation of abuse made to them. They were also able to describe the different types of abuse. Some people who use the service have good support plans in place which describe how they may be vulnerable when out in the Summerfield Court DS0000067957.V357451.R01.S.doc Version 5.2 Page 19 community and how this can be avoided. The organisation has a detailed policy on the protection of vulnerable adults and whistle blowing. Good records are kept of the finances and monies of the people who use the service. There are good systems in place to make sure money held on behalf of people who use the service is kept safe. Summerfield Court DS0000067957.V357451.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 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The design and layout of the home enables people who use the service to live in a safe, well-maintained and comfortable environment, which encourages independence. EVIDENCE: The home is very spacious, homely, clean and well laid out, providing plenty of room and access for all people who live there. Décor in the home is modern and tasteful. The bedrooms of the people who use the service have been decorated and furnished to suit them as individuals and their interests and personality. They are all en-suite, with a shower and toilet. Some of the rooms are actually flats where people can practice their independence skills. The flats have their own kitchen, lounge area, bathroom and bedroom. In the AQAA, the manager said she is planning to improve the Summerfield Court DS0000067957.V357451.R01.S.doc Version 5.2 Page 21 flats by having doorbells and letterboxes put on them to increase people’s privacy and independence. The communal areas of the home include, a large dining and kitchen area and plenty of lounge space. Bathrooms have assisted baths and moving and handling equipment. There are offices and storage space. There is also a small gym room and a well- equipped sensory room. People who use the service spoke highly of facilities in the home. One person said, “It has everything we need” another said, “It’s beautiful here”. In a returned survey, a relative said, “Summerfield Court has a lovely family atmosphere”. Staff wear protective clothing when attending to any personal care needs of people who use the service. They also make sure they do this when cleaning or when cooking. Most staff have received training in infection control and were able to say what infection control measures are in place. Summerfield Court DS0000067957.V357451.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 and 36 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff are, in the main, trained, skilled and in sufficient numbers to support people who use the service, and to support the smooth running of the home. EVIDENCE: There are enough staff on duty to meet the needs of the people who use the service. There are usually six staff on through the day and two staff on waking night duty. They also have the support of an on-call manager. The manager works daytime hours through the week to support the staff. In returned surveys, relatives spoke highly of the staff. Comments included, “The staff are so friendly”, “They are doing a very good job and it is a lovely place” and “Very good at their job, very caring people”. People who use the service said there were enough staff at all times and that staff are helpful and supportive. One person said, “They help you out, if you need something they are there for you”. Another person said that staff are “Always friendly and cheerful”. Summerfield Court DS0000067957.V357451.R01.S.doc Version 5.2 Page 23 Recruitment is properly managed by the home; interviews are held, references and CRB (Criminal Record Bureau) checks are obtained before staff start work and checks are made to make sure staff are eligible for work. The manager now keeps records of interviews held, as recommended at the last inspection. Staff’s training is mainly up to date. Some staff are waiting to do some training to complete their induction. Fairly good records are kept of staff’s training and when their updates are due. Induction training is based on the Skills for Care, Common Induction Standards. Staff spoke well of their training. They said they found it useful and it had helped them to provide better care and support. National Vocational Qualification (NVQ) training has not yet started for staff. The training manager has had difficulties in accessing this training and finding assessors for it. Some staff have been registered to start this training for the last two years. Staff said it was disheartening, as they felt ready to do the training but had not been able to. The manager should make sure that staff have access to this training or something equivalent in order to develop their skills. All staff said they felt they had a very good team and the manager is very supportive and gives excellent direction. Staff said they felt communication and teamwork within the home is good. Staff receive regular supervision from the manager and monthly team meetings take place. Summerfield Court DS0000067957.V357451.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, 38, 39 and 42 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is well managed, the interests of the people who use the service are seen as important to the manager and staff and are safeguarded at all times. EVIDENCE: The home has an experienced manager who has almost completed her NVQ level 4 in care and the Registered Managers Award. The provider of this training course has gone into liquidation so the manager is currently seeking another training provider who will assess her work. She offers good leadership to the staff and has good systems in place to make sure people who use the service are supported and cared for properly. Comments from staff included, “She is a good manager”, “She is approachable” and “She is very hard working”. People who use the service said, “She’s alright, if you need ‘owt you Summerfield Court DS0000067957.V357451.R01.S.doc Version 5.2 Page 25 only have to ask”, “She’s there for you” and “If you are struggling with something she will always be there for you”. The operations manager visits the home on a monthly basis to carry out visits. This involves talking to people who use the service and staff about the home. A report of these visits is made showing details of any action to be taken to improve the service. In addition to this, the organisation carries out an annual service review, as part of its quality assurance programme. This also includes people who use the service, relatives and staff. The results of the most recent review were not yet available in the home. Staff said that people who use the service had recently completed questionnaires. The home also has a compliments book in the entrance hall of the home. Comments on the service included, “What a great place Summerfield Court is, I would recommend it to anyone” and “You feel welcome as soon as you arrive”. Staff carry out weekly or monthly health and safety checks around the home such as fire alarms, emergency lighting and water temperatures. Maintenance records are well kept. Environmental risk assessments are completed and reviewed. Health and safety training is well maintained. Accident or incident reports are completed well. In the AQAA, the manager said that all equipment and appliances had been serviced as recommended by the manufacturers or regulatory bodies. The home has a comprehensive range of policies and procedures in place to ensure health and safety. The manager makes sure staff are familiar with these and asks them to sign them when read. Summerfield Court DS0000067957.V357451.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 3 2 3 3 X 4 X 5 2 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 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 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X 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 Score 3 3 2 X 3 3 3 X X 3 X Summerfield Court DS0000067957.V357451.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 YA9 Regulation 12 (2) (3) Requirement The manager must make sure that where risk management plans place any limitation on the freedom of people who use the service, the person using the service or their representative has agreed to this. This will make sure people’s rights are respected. Timescale for action 28/02/08 Summerfield Court DS0000067957.V357451.R01.S.doc Version 5.2 Page 28 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 YA5 Good Practice Recommendations The manager should make sure contracts for people who use the service are signed by a representative from the organisation and contain all the costs to people who use the service. This will make the contractual agreement clearer. The manager should make sure that health actions, such as physiotherapy exercises are carried out at the frequency requested by any health practitioners for people who use the service. This will make sure health needs are properly met. Staff should receive regular refresher training in medication administration to make sure their skills are up to date. All handwritten entries on Medication Administration Records should be checked and countersigned by a second person to reduce the risk of errors. The manager should make sure that staff follow the medication administration procedure when administering medications so that errors can be prevented or minimised. All relatives of people who use the service should be made aware of the complaints procedure to make sure they can express their views fully. The manager should make sure that staff have access to NVQ training or something equivalent in order to develop their skills. 2. YA18 3. YA20 4. 5. YA22 YA32 Summerfield Court DS0000067957.V357451.R01.S.doc Version 5.2 Page 29 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 Summerfield Court DS0000067957.V357451.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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