Care Home: Summon Bonum

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What the care home does well Summon Bonum is a friendly and comfortable place, and residents feel at home there.Staff help residents to look after their health.Residents can make choices about how they want to live.Residents can choose activities they want to do.They go on outings and holidays.Summon BonumDS0000018436.V356839.R01.S.docVersion 5.2Page 8The home is well managed. Service users, staff and relatives are asked how it can be improved. What has improved since the last inspection? Each resident has talked about their care plan with their keyworker, to make sure it includes all the things they want to do.A new decking area has been built in the garden. What the care home could do better: Some changes are needed to the building. This would help residents who find it difficult to walk or climb stairs. There should be a better laundry, so that residents can help wash their clothes if they want to. CARE HOME ADULTS 18-65 Summon Bonum Summon Bonum 56a St Marychurch Road Torquay Devon TQ1 3JE Lead Inspector Stella Lindsay Key Inspection (unannounced) 31st January 2008 9:45 Summon Bonum DS0000018436.V356839.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 Summon Bonum DS0000018436.V356839.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. Summon Bonum DS0000018436.V356839.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Summon Bonum Address Summon Bonum 56a St Marychurch Road Torquay Devon TQ1 3JE 01803 293512 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) summonbonum@hotmail.com Mrs Jenny Whitney Mrs Jenny Whitney Care Home 9 Category(ies) of Learning disability (9), Learning disability over registration, with number 65 years of age (9) of places Summon Bonum DS0000018436.V356839.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons with a Learning Disability and an additional Mental Disorder up to and over 65 years can reside at the Home. 7th March 2008 Date of last inspection Brief Description of the Service: Summon Bonum provides residential care for up to nine adults with learning disabilities up to and over the age of 65, who may have additional mental health problems. The current residents include men and women aged between 45 and 80 years. The house is a Victorian villa set in its own gardens close to local shops, and half a mile from Torquay town centre. Seven bedrooms are single, one double. Residents are supported to use public transport, and the home uses its people carrier for outings of all sorts. The homes emphasis is on promoting independence, encouraging residents to develop their skills, follow their own interests, and value and encourage each other. At the time of this inspection, fees for a place in the home ranged between £315 and £819 per week. Summon Bonum DS0000018436.V356839.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 3 star. This means the people who use this service experience excellent quality outcomes. We spent 10.5 hours spent in the home over two days. An Expert by Experience (EbyE) joined us, who met with residents to hear their views. This is what we did for this inspection. • Before the inspection Mrs Whitney and her daughter sent us some information. • Staff and relatives answered questions about the home. We looked around the home. Summon Bonum DS0000018436.V356839.R01.S.doc Version 5.2 Page 6 Residents and staff spoke with us. We looked at Care plans. Mrs Whitney and her daughter showed us other records about the home. What the service does well: Summon Bonum is a friendly and comfortable place, and residents feel at home there. Summon Bonum DS0000018436.V356839.R01.S.doc Version 5.2 Page 7 Staff help residents to look after their health. Residents can make choices about how they want to live. Residents can choose activities they want to do. They go on outings and holidays. Summon Bonum DS0000018436.V356839.R01.S.doc Version 5.2 Page 8 The home is well managed. Service users, staff and relatives are asked how it can be improved. What has improved since the last inspection? Each resident has talked about their care plan with their keyworker, to make sure it includes all the things they want to do. A new decking area has been built in the garden. Summon Bonum DS0000018436.V356839.R01.S.doc Version 5.2 Page 9 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. Summon Bonum DS0000018436.V356839.R01.S.doc Version 5.2 Page 10 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 Summon Bonum DS0000018436.V356839.R01.S.doc Version 5.2 Page 11 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 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Great care was taken to ensure that the service was described to a person before they moved in, and that the admission would be acceptable to the people already living in the home. EVIDENCE: Summon Bonum has a Statement of Purpose that had been kept up to date. It has a plainly written Service Users’ Guide, with symbols to help some people understand it, and it includes photos of the house, the rooms and the staff. Some residents have included photos of themselves with their comments, including, ‘I have a nice keyworker. It’s alright’, and ‘I can be independent here, it’s nice’. One resident was pleased to show us their copy of this booklet in their own room. Following several years with no change in the group of residents, there had been one admission since the last inspection. The Manager visited them in hospital, a Social Worker and Community Nurse were involved in the decision about their admission, and the pre-admission form was completed with information from all these sources. Other residents in the home were consulted, and were pleased because they were already well acquainted. In hospital, they were shown pictures of the home they were coming to, and they initially agreed to come for a trial stay. Summon Bonum DS0000018436.V356839.R01.S.doc Version 5.2 Page 12 When they arrived, the Senior Support worker on duty arranged to stay overnight to provide a familiar face in the morning. The Manager said that she was pleased with the welcome that the residents gave to the new person. They had been encouraged to be available to answer any queries. The Social Worker who had been involved during this admission confirmed that the home had been very helpful, caring and supportive, and the person had settled in remarkably quickly. The home had provided a ‘Contract of Residence’ for each resident, to be clear about what is included in the service. We saw that residents had signed new ones annually to acknowledge the increase in fees. Summon Bonum DS0000018436.V356839.R01.S.doc Version 5.2 Page 13 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff had successfully included the residents in developing their care plans to consider how their needs and aspirations are to be achieved, and to manage risks positively so they can live the lives they want. EVIDENCE: New care plans had been drawn up for each resident. These were kept in the office, but residents could see them whenever they wish. These specify their preferences on routines and activities, and include an assessment of their abilities. Goals were recorded for each area of a person’s life, and how the person could work towards them. One resident with a diagnosis of dementia was receiving individual attention from a staff member (for which additional funding had been secured). A booklet entitled ‘All about me’ had been compiled on their behalf, with photos and information about their life. Summon Bonum DS0000018436.V356839.R01.S.doc Version 5.2 Page 14 Risk assessments were seen, which had useful directions for staff and showed how residents could be supported to take reasonable risks to increase their independence and enhance their lifestyles. Staff members know the residents well, and are alert to any changes in mood and behaviour. Some residents have ‘traffic light’ behaviour scales worked out with professional help, to alert staff to triggers and the right action to take to avoid disturbance and promote well being for all. The newly admitted resident had a review of their care one month after they moved in. Care plans had been reviewed six monthly, or more when anything had altered, and we saw that staff had written observations and alterations. This showed that the plans are properly used in daily life to make sure the residents get the support they need. Residents had been asked if they were happy with their key worker. They are offered two, for greater availability, though two residents said prefer to have just one. Time for key workers to spend with their residents is written into the rota, to make sure this attention is given. Staff meetings were held monthly, to enable the team to keep up to date with residents’ changing needs. Meetings were held on different days, so that all staff could attend some, and all were required to sign the minutes, to ensure that all information was shared. Residents meetings are held every month, before the staff meeting. We saw the notes taken at the January meeting. People had discussed their keyworkers, and whether they wanted a different one. They talked about which jobs they like to do around the house, and where they would like to go on holiday. The Manager told them about the extension that they are planning to build. They took a vote on the colour for new lounge curtains. The Manager asked for their views about recently recruited staff. Favourite meals were recorded for the menu, and it was agreed that they would like a take-away at the weekends. Two residents are helped to understand these records by the use of widgets. One resident helps to choose the symbols that will be useful. The Registered Manager is appointee for all residents. All residents have a bank account in their own name. Most keep some cash in the home’s safe. We checked this for accuracy. An accountant audits the system. Residents can access this money any day except Sunday, when staff may help them get cash from the secure boxes in their own rooms. Summon Bonum DS0000018436.V356839.R01.S.doc Version 5.2 Page 15 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are involved in meaningful activities of their own choice and according to their individual interests and capabilities. Good food is provided, with encouragement towards healthy eating. EVIDENCE: Evidence around the home and in residents’ rooms demonstrated their achievements in activities supported by the home. Certificates from college courses were on display in some rooms. Some residents were finding that they do not want to go out as much as they used to. One resident said they liked sewing and going to the pub. They said they did not go out at weekends, but did not want to. Another resident said they enjoyed cooking and going shopping. They helped prepare the meals for the house. Residents can go into the kitchen whenever they want, and this resident was seen working in the kitchen, alone and with a support worker. Summon Bonum DS0000018436.V356839.R01.S.doc Version 5.2 Page 16 Residents had discussed doing jobs around the house at their latest meeting. One had said they like to hoover, another to clean tables and peel vegetables. One liked to feed the fish and another to take the bins out. Another resident said, “It’s nice living here. I don’t do much in the day but I don’t want to do more.” There is a rabbit in the garden called Smudge who they like to look after. They buy his food and change his water. Another resident likes to read and gets the paper everyday. They said, “I like the food here”. One resident still attends the Community Resource Centre. Another had a weekly timetable showing activities that were arranged or available throughout the week. These included music and film sessions in the home, as well as family visits. During the inspection one person was supported to go swimming. Four were accompanied to a Tea Dance. All were excited on their return and had clearly enjoyed it. A visiting Reflexologist was seen providing foot massage in the lounge. This was seen to be a pleasant occasion for all, with soft music playing, and residents choosing when to take part. One person had wanted to improve their fitness, but had not been willing to go to a gym, and arrangements had been made for a personal trainer to come to the house. The resident was assessed as safe to undergo a constructive exercise programme, and has exercised regularly, and benefited by increased mobility and confidence. One resident said they had a timetable and went out every Tuesday. They said, “I love living here”. Last year they chose a holiday to London to see Grease the show. Another said they had been on holiday last year to London to see Dirty Dancing and stayed in a hotel. A minibus is provided, and some staff were able to use their cars to provide transport for residents. Holidays are provided to the level of a caravan holiday within the residents’ contract. If they choose a more expensive location, they may top up the finance. Some staff had received training in healthy eating, and encouraged residents to choose a well balanced diet. We saw a staff member speak to everyone individually about what they wanted for lunch. Residents were given a choice of soup or a sandwich on the first day, pork pie or omelettes on the second day. The staff member did not rush anyone. Residents said the food is good and they can have more if they want. In the staff meeting staff were instructed to offer and encourage residents to accept an alternative, if they do not like the main hot dish of the day. Favourite meals were discussed in the residents’ meeting, and staff were kept up to date with residents’ particular nutritional needs. Records are kept each day of residents’ menu choices. Summon Bonum DS0000018436.V356839.R01.S.doc Version 5.2 Page 17 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 and 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal support was given according to varied and individual needs and preferences. Staff were meeting particular health care needs, as they had been provided with training. There were safe and efficient procedures and guidance for dealing with medication, which staff understood and complied with. EVIDENCE: Each resident had a care plan which detailed their routines and the support that they need for personal care as well as a health action plan. Discussion with the Registered Provider and Assistant Manager demonstrated that service users changing personal healthcare needs were monitored and responded to appropriately. This was confirmed in individual plans. Staff had received training with respect to health conditions of individual residents, including dementia, epilepsy and diabetes. Autism training had begun, starting with two Support workers who particularly needed this training because of their keyworker role. The Assistant Manager and four staff had Summon Bonum DS0000018436.V356839.R01.S.doc Version 5.2 Page 18 attended training on ‘Healthier Food and Special Diets’, which had given good ideas for promoting good health. Fitness and exercise were actively promoted. Residents were encouraged to go swimming and taken to a gym. One had a personal trainer come to the house, as described in the previous section, and their general health, mobility and confidence had improved markedly. The medication policy was seen to be clearly written, with clear and useful guidance for staff. It included instructions on what to do in a variety of situations including if someone refuses to take their medication. Advice had been received from the home’s pharmacy with respect to the policy, and also with advice about assessment with regard to self administration. Staff were observed administering medication to individuals, individually in the office, as required by the policy. Records were checked and found to be accurate. Training had recently been provided for all staff on the administration of medication. An external trainer came to Summon Bonum. This gave staff the opportunity to ask the trainer about particular aspects of medication that they administer. Newly recruited staff had completed a Medication Induction programme. They are observed by the Assistant Manager six times, and comments were recorded about their competence, which must be assured before they may take responsibility for giving medication. Specific guidance is included in a resident’s care plan with regards to the proper use of PRN (as required) medication, and how the decision is to be taken about when it is needed, to make sure the resident is given the right amount of medication, at the right time. This group of residents have lived together for many years, and some are losing some abilities with the ageing process. Staff had helped people to understand each other’s changing problems. The death of a resident caused great sadness for all. Residents helped plan the funeral. Plenty of time was allowed to elapse before their room was rearranged for the next occupant. Summon Bonum DS0000018436.V356839.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by the home’s open culture that encourages people to express their views and concerns in a safe and understanding environment. EVIDENCE: A complaints record was available for inspection. A clear complaints procedure was available which has been produced for residents in a user-friendly format. There was a very evident openness in the relationships between staff, service users and their relatives, which enables concerns to be aired with confidence. One complaint had been received, and been properly investigated. It was found not to be upheld. One service user had a separate complaints record as part of an agreed plan of care, which is overseen by relevant professionals. A very clear abuse policy had been produced, giving guidance to staff. This had been discussed at staff meetings, to raise staff awareness. Staff said they would tell their Manager of any concern they might have, or any unsuitable behaviour (such as a staff member shouting) if they were to see anything untoward. Training in the Protection of Vulnerable Adults is included in NVQ training. It would be good practice to obtain specific POVA training for all staff. Training in the Mental Capacity Act had been arranged. Summon Bonum DS0000018436.V356839.R01.S.doc Version 5.2 Page 20 Training was being provided for staff in dealing with challenging behaviour, to promote their skills in protecting residents. One resident was provided with 1:1 support in order to avoid difficult situations. Residents are assisted to manage their money, to protect them from exploitation and putting themselves at risk. Summon Bonum DS0000018436.V356839.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. This elegant and comfortable house will need to be adapted if it is to remain suitable for the residents as their mobility decreases. EVIDENCE: Accommodation is provided in a large, comfortably furnished Victorian villa within easy walking distance of local shops and not far from Torquay town centre. There is a pleasant garden, and a decking area had been provided. Residents feel the home is their own, and are fully involved in the choice of colour schemes, and in discussion of alterations inside and out. The home owners are planning to up-date the building in order to meet the changing needs of the residents. Some of the residents at Summon Bonum have lived there for many years. Though they were fit and active, some are finding it more difficult to get about as they grow older, and become more aware of little steps around the ground floor, narrow corridors, and steep flights of stairs to the bathroom and the upper floors. The home owners are looking into the possibility of installing a shaft lift. They are also planning to Summon Bonum DS0000018436.V356839.R01.S.doc Version 5.2 Page 22 build an extension that will provide an accessible building, to promote independence. This will include an increase in the size of the kitchen and dining room. There is a shower on the ground floor. The bathroom is up a flight of stairs. It would be good practice to obtain an Occupational Therapist’s advice on accessibility around the home. The dining room is also used as a craft and activity room. It has a laminated floor and florescent lighting. This is good to help people see what they are doing. It would be good to have alternative lighting to give a more relaxed atmosphere. Residents said that in the evening they like to sit in the lounge and have their dinner. The kitchen is open all the time so residents can get things they want. Some residents were pleased to have a TV in their room. Residents’ bedrooms are decorated and furnished according to their choice. Residents do not have private telephone lines, but may take private phone calls in the office. The residents said the house was warm. The laundry is down steep stairs in the basement, and not suitable for residents. One resident did their own washing, but that was in their hand basin. It is planned to include a laundry in the new extension, so that residents can be involved in washing their own clothes. Summon Bonum DS0000018436.V356839.R01.S.doc Version 5.2 Page 23 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): 32,34,35 and 36 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff are available to meet the many and varied needs of the residents, and the residents consistently report that they are happy with the staff. There are well thought out programmes for induction and training, to enable staff to meet specific client needs. The recruitment process is robust to ensure the protection of residents from potential harm, and involves residents in meeting the candidates. EVIDENCE: A written rota was kept which showed that three Support staff were on duty throughout the day, and two from 9pm to 8am. They were on sleeping-in duty after residents have gone to bed. The Manager and Assistant Manager were also in the house most days. Staff returning surveys considered that there were usually enough staff for meeting the many and varied needs of the residents. One resident had 1:1 care allocated and paid for, because of increased care needs. This was not specified on the rota, but they were seen at most times to have individual attention. Summon Bonum DS0000018436.V356839.R01.S.doc Version 5.2 Page 24 The staff team was seen to be varied in personal attributes and experience. A resident said, ‘the staff have been good to me’. One of the staff said that they build a good emotional connection with the residents at Summon Bonum. Staff appreciated having staff meetings every month and confirmed that they are able to contribute. Those who found it difficult to speak up in a group said they could speak to the Manager beforehand to get something put on the agenda. There is a robust recruitment procedure, which considers the response of the residents to the candidates. Residents had met candidates informally and had the opportunity to ask questions. The managers said they plan to involve them in a more structured way. The files of two recently recruited staff were examined. Application forms had been completed, written references obtained, and Criminal Records Bureau clearances received, to protect residents from potential harm. A three-month trial period follows appointment, during which the person’s suitability and progress are discussed with residents and the staff team. A new induction programme had been obtained and used with a recently recruited member of staff. The Skills for Care Induction programme had been available and partially accomplished by two recently recruited staff. The Assistant Manager said that she intended to combine it with Summon Bonum’s own programme, to make training for newly recruited staff both thorough and tailored to meet the home’s particular requirements. Of the eleven Support workers currently working in the home, six had either achieved NVQ 2 in care, or above, or were engaged in working towards this. Of the others, four were booked to start this training in the weeks following this inspection. This is excellent progress towards a qualified workforce. Other training was obtained with regard to meeting the needs of residents. All staff had received or were booked to attend training in Learning Disability and Mental Health, Challenging Needs, epilepsy, dementia, food hygiene and Moving and Handling. Training for all staff on the Mental Capacity Act had been booked. Further training needed to be obtained with respect to Total Communication and Autism. Staff in surveys said that, ‘I learn new things all the time’, ‘I find the job very rewarding’, and that they get options to do any relevant training. One told us that their confidence had been boosted since working at Summon Bonum. Staff had received individual supervision sessions, for their support and guidance. We saw the diary dates, and staff confirmed that they have ‘regular reviews, yearly appraisals, and staff meetings every month.’ We were told that staff felt they received good support from management, and in a survey, one said ‘I can speak to my manager whenever I need to. I am given support and useful ways to help me work and solve problems.’ Summon Bonum DS0000018436.V356839.R01.S.doc Version 5.2 Page 25 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 excellent. This judgement has been made using available evidence including a visit to this service. The Managers communicate a clear sense of direction, and provide an excellent lead in communicating well with residents. They provide clear guidance for safe working practices, and promote continuous improvement in the service to the residents. EVIDENCE: Summon Bonum is managed jointly by the Registered Provider and her daughter who is the Assistant Manager. Both have now completed the Registered Manager’s Award and have undertaken a wide range of additional training. Both show a commendable attitude to the development of the staff as well as their own development. The home is run in the best interests of the residents. Staff said in surveys, ‘A big emphasis placed on individuality of clients.’ ‘The managers always make Summon Bonum DS0000018436.V356839.R01.S.doc Version 5.2 Page 26 sure the service users are happy and have got everything they need.’ ‘Staff & clients feel they can talk to management at any time.’ The policies and procedures are clear and provide guidance and advice to maintain good practice and safe systems of work. The managers employ a health and safety agency and an employment law agency to ensure that they adhere to good practice in these areas. A strong commitment to the continuous improvement and development of the service was evident in the training programme and in records of the residents’ and staff meetings. Residents, staff and relatives had been asked for their views about the service, and views are where possible taken into account and used to improve the service. We examined the fire log book. Records showed that professional fire safety training had been provided on 07/03/07, and in-house training had been provided for all staff, at three monthly intervals for staff who had been on duty overnight, which was the majority of the team. The Assistant Manager had reviewed the fire risk assessments at six monthly intervals. The fire precaution system was checked professionally on 19/04/07. A professional audit of health and safety in the home is commissioned annually, which was due at the time of this inspection. The heating system had been checked professionally, on 26/01/08. Summon Bonum DS0000018436.V356839.R01.S.doc Version 5.2 Page 27 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 4 4 X 5 3 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 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 4 33 3 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 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 3 4 4 4 X X 3 X Summon Bonum DS0000018436.V356839.R01.S.doc Version 5.2 Page 28 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. Standard Regulation Requirement Timescale for action 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 YA23 YA24 Good Practice Recommendations It would be good practice to provide professional training for staff in the Protection of Vulnerable Adults from Abuse, to ensure they have full knowledge and awareness. The Registered Provider should obtain a professional assessment of adaptations that would improve accessibility around the home, and prioritise modifications to the home’s environment to meet the needs of residents. Laundry arrangements should be reviewed and modified to ensure that they meet the needs of service users with increasing continence needs in a safe and hygienic way. 3. YA30 Summon Bonum DS0000018436.V356839.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Summon Bonum DS0000018436.V356839.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. Re-publishing this information is in breach of the terms of use of that website. 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