Care Home: Sylvan Road (16)

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What the care home does well Service users are receiving as good service that continues to develop under the guidance of the new manager. Service Users said: "I am `comfortable` and feel `involved` in this home". "I can go to a club and visit my relatives and sometimes have lunch out, which I`m happy with". "If I was not happy I could speak to my key worker". Relatives said: "Each time I go to Sylvan road, I have found staff to be very helpful and my sister seems quite happy when we visit." "Sylvan Road is a spotless house for people and the staff are always very kind and helpful". The GP said: "The carers seem to always know all about the service users when I`m dealing with them". The Expert by Experience said: "The long term Service Users are comfortable, not surroundings, but with each other and especially, staff". only with their"The complaints procedure was well detailed and promoted. All service users were positive about its use and the responses achieved by staff". "A glowing example of how Service Users should be treated and cared for". What has improved since the last inspection? A new manager is in post and has been registered by the Commission. New staff have been recruited and there is now a full staff team. Service users are being supported by a consistent staff team that they know. New furniture has been purchased for the lounge and service users helped to choose this. The lounge is comfortable and homely and one service user said that they were `proud` of their home. The longstanding problems with the heating have been resolved and this means that the whole house is warm now. It is therefore more comfortable for service users to spend time in their own rooms if they wish. What the care home could do better: This service continues to develop and improve and there are not any requirements from this inspection. There are ongoing structural problems in the conservatory that are proving difficult to resolve but these are being followed up so that they can be remedied and the area decorated. This will then mean that the conservatory will be a more welcoming and comfortable area for service users.It is suggested that the manager uses the Key Lines of Regulatory Assessment (KLORA) to assist the service to identify areas for further development of the service. CARE HOME ADULTS 18-65 Sylvan Road (16) 16 Sylvan Road Wanstead London E11 1QN Lead Inspector Jackie Date Unannounced Inspection 8 January 2008 11:45 th Sylvan Road (16) DS0000025929.V355343.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 Sylvan Road (16) DS0000025929.V355343.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. Sylvan Road (16) DS0000025929.V355343.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sylvan Road (16) Address 16 Sylvan Road Wanstead London E11 1QN 020 8518 8004 020 8518 8004 sylvan.road@rchl.org.uk www.rchl.org.uk Redbridge Community Housing Limited [RCHL] 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) Beatrice Mwewa Mwitwa Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Sylvan Road (16) DS0000025929.V355343.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 3 named people over 65 years. Date of last inspection 28th February 2007 Brief Description of the Service: Sylvan Road is a home registered for six people with mental health problems. It is one of a number of homes run by RCHL, Redbridge Community Housing Ltd. The house is in Wanstead in the London Borough of Redbridge. The ground floor has a bedroom with a shower, a lounge, dining area, kitchen and conservatory. The conservatory has a smoking and non-smoking sitting area and there is also a garden. Upstairs there are four single bedrooms and a bathroom. The home is near to bus stops and the train station. There are shops close by. Most of the service users have lived together for a long time. None of the service users go to regular day services but they do go to clubs and can go out on their own and go where they want to go. The staff also organise some trips. The previously double room is now being used as a single room and therefore there are now five service users living at the home. The basic charge per week for each service user is £1226.47. The manager provided this information in November 2007. Information about the service provided is contained in the service users guide. Sylvan Road (16) DS0000025929.V355343.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 11.45 am. It took place over four and a half hours hours. This was a key inspection and all of the key inspection standards were tested. Staff were asked about the care that service users receive, and were also observed carrying out their duties. Where possible, service users were asked to give their views on the service and their experience of living in the home. All of the shared areas and one of the bedrooms were seen. Care and other records were checked. The inspector was joined for part of the visit by an ‘Expert by Experience’. The Expert by Experience had a look around the home and spent time talking to staff and service users. He then gave feedback to the shift leader. Comments from his report have been included in this report. Relatives, social workers and healthcare professionals were contacted and asked for their opinions of the service. At the time of writing this report feedback had been received from 2 relatives and the GP. Staff supported some of the service users to complete feedback forms and feedback forms were received from all 5 service users. Feedback forms were also received from 4 staff. Any feedback subsequently received will be taken into account for future inspections. Services are now required to complete an AQAA (Annual Quality Assurance Assessment) and the completed form was received in October 2007. Information provided in this document also formed part of the overall inspection The inspector would like to thank the service users and staff and also the Expert by Experience for their input during the inspection. What the service does well: Service users are receiving as good service that continues to develop under the guidance of the new manager. Service Users said: “I am ‘comfortable’ and feel ‘involved’ in this home”. “I can go to a club and visit my relatives and sometimes have lunch out, which Im happy with”. “If I was not happy I could speak to my key worker”. Sylvan Road (16) DS0000025929.V355343.R01.S.doc Version 5.2 Page 6 Relatives said: “Each time I go to Sylvan road, I have found staff to be very helpful and my sister seems quite happy when we visit.” “Sylvan Road is a spotless house for people and the staff are always very kind and helpful”. The GP said: “The carers seem to always know all about the service users when Im dealing with them”. The Expert by Experience said: “The long term Service Users are comfortable, not surroundings, but with each other and especially, staff”. only with their “The complaints procedure was well detailed and promoted. All service users were positive about its use and the responses achieved by staff”. “A glowing example of how Service Users should be treated and cared for”. What has improved since the last inspection? What they could do better: This service continues to develop and improve and there are not any requirements from this inspection. There are ongoing structural problems in the conservatory that are proving difficult to resolve but these are being followed up so that they can be remedied and the area decorated. This will then mean that the conservatory will be a more welcoming and comfortable area for service users. Sylvan Road (16) DS0000025929.V355343.R01.S.doc Version 5.2 Page 7 It is suggested that the manager uses the Key Lines of Regulatory Assessment (KLORA) to assist the service to identify areas for further development of the service. 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. Sylvan Road (16) DS0000025929.V355343.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 Sylvan Road (16) DS0000025929.V355343.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4 & 5. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. Information is available to enable the staff team to meet service users’ needs. If a vacancy arose the required information would be gathered on a prospective service user and they and their relatives could spend time in the home to find out what it would be like to live there and to enable the service user to make a choice about living in the home, within their capacity to do so. EVIDENCE: The service users have all lived together for some time and there have not been any new admissions for several years. The organisation has an admissions procedure that includes gathering of information and assessments. It also contains details of how a prospective service user would be introduced to the home. The staff would be able to assess and introduce a new service user to the home if needed. Each service user has a care plan that contains information about what they can do, their likes and dislikes and what help and support they need. The staff team know service users well and know what they can do, their likes and dislikes and what help and support they need to meet these needs. Sylvan Road (16) DS0000025929.V355343.R01.S.doc Version 5.2 Page 10 The service users have a contract between themselves and provider. These include information about individual financial arrangements. The contracts were available at the home. This means that there is clear information available about the service that will be provided to individual service users. Sylvan Road (16) DS0000025929.V355343.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, 9 & 10. People using the service experience excellent quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. Service users’ plans focus on their individual needs and abilities and contain detailed information so that staff can meet their needs safely. Service users’ needs are reviewed regularly and care plans and risk assessments updated when needed. The care plans of the older service users are reviewed more regularly as a matter of good practice and this exceeds minimum standards. Service users are encouraged and supported to be involved in decisions about what they do and what happens in the home. This includes staff recruitment and the development of the organisations business plan and this exceeds minimum standards. Service users’ personal information is safely stored to maintain confidentiality. Sylvan Road (16) DS0000025929.V355343.R01.S.doc Version 5.2 Page 12 EVIDENCE: Each service user has an up to date Mental Health needs assessment. Areas covered included health, self-care, communication, psychological needs, relationships and sexual needs, finance and cultural needs. Where service users are known to have certain specific needs support plans are developed to address these. Daily reports are made and these are linked to the care plans. Therefore there is a record of service users’ care and well-being. A random sample of care plans were checked at the time of the visit and these were all relevant and up to date. There was evidence that they had been reviewed regularly. Appropriate risk assessments were in place and again those seen had been reviewed and updated when needed. Service users also have six monthly reviews with other professionals as part of the Care Programme Approach (CPA). Copies of notes of the most recent CPA meetings were seen on service users’ files. Service users spoken to confirmed that they were involved in developing their care plan and in reviewing these. The care plan of service user over the age of 65 is reviewed monthly and this ensures that the staff team always have current information to work to. This good practice is to be commended and exceeds minimum standards. Risk assessments relevant to each individual are made. The risk assessments seen had been reviewed regularly and updated when needed. Overall sufficient detailed information is available so that staff can meet service users’ needs. Each service user also has a risk assessment in relation to his or her finances. Bankbooks are kept in the safe but all of the service users go to the bank independently to draw out money. When they return the amount that they have withdrawn is checked and recorded. Service users have lockable tins in their rooms to store cash if they wish. Service users are assisted to budget their money and are supported to be as independent as possible in this area and therefore differing levels of support are given to each person. One person manages his own money. Service users’ meetings are held each week and a variety of topics are discussed. This includes everyday things like the menu and shopping and also changes in the home and plans for the future. Staff are present at the service users meetings to provide support but service users “do their own meetings” and this includes taking the minutes. Three of the service users have in the past attended training to enable them to participate in staff recruitment and have since been involved in interviewing staff. Two of the service users also participated in the development of the organisations business plan. Another service user has recently become a member of the diversity action group. These service users said that they enjoyed taking part. Staff spoken to said that the involvement of service users in decision-making continues to increase. A service user told the Expert by Experience that “he is “comfortable” and feels “involved” in his home. The Sylvan Road (16) DS0000025929.V355343.R01.S.doc Version 5.2 Page 13 Expert by Experience stated in his report “I believe that service users are “encouraged” in the running of the home including consensus about the weekly menu and even the style and colour of the new furniture.” Service users can and do make their wishes known and make decisions about their lives. They are consulted about all aspects of life in the home. . Service users’ records and other information are stored in a lockable cabinet in the office and staff are aware of issues of confidentiality. Sylvan Road (16) DS0000025929.V355343.R01.S.doc Version 5.2 Page 14 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 & 17. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. Service users are encouraged and supported to do as much as possible for themselves and to be independent. Service users go out when they want to and can keep in contact with their friends and families. The service users take part in a variety of activities and are part of the local community. Service users are given meals that they have chosen, like, and that meet their needs and individual preferences. EVIDENCE: Service users participate in household tasks on a rota basis. This includes the cooking as well as domestic chores. During the course of the visit service users were observed to make drinks when they wanted to. All of the service users are able to go out independently and can choose where they want to go. Sylvan Road (16) DS0000025929.V355343.R01.S.doc Version 5.2 Page 15 They are encouraged to do as much as they are able. For example service users go to the bank to collect their money. Service users said that they go to the cinema, the pub, out for meals and to church. Most go to clubs on Mondays and Saturdays and some of them go to church on Sunday. Staff support service users to be independent and to access activities. All of the service users were given the opportunity of paying for specific one to one support from an outreach worker if they wished. Two of the service users decided to do this. On the day of the visit one service user went out for a drink and to play snooker. Later another was going out for ‘pie and mash’. One of the service users said how much he enjoyed playing golf and that he still goes swimming on occasions. The service users went on holiday to Norfolk. Service users had said that they wanted to go somewhere different so at their request the venue was changed from Bognor to Norfolk. Service users said that they had a really good time there. One of the service users is now doing voluntary work on a farm for two days each week. He has been supported and encouraged by the staff and by his family. Therefore the service users have the opportunity to do what they wish, to participate in activities and to be part of the local community. Service users’ families are welcome to visit and four of them have contact with their families. One service user goes home twice a week and his sister visits weekly, another service user’s brother visits fortnightly. At the time of the visit one service user was visiting his mother. A relative said “I know I would get a phone call if my sister was ill or had an accident”. Therefore service users are encouraged and if needed supported to keep in contact with their friends and relatives. As previously stated service users are able to come and go as they choose and are therefore able to meet friends or relations when they wish. The service users discuss the menu at the weekly service users meeting. They then take turns to help with the cooking. Service users also help to get the main weekly shopping and during the week go out to get any extras. For example milk and bread. Service users also said that they like the food. Two of the service users have diabetes and they are supported to have an appropriate diet. Service users also help to clean the house and chores are shared out. In discussion with service users two days have been introduced when the service users are being encouraged to take more responsibility for managing and planning their own day. For example in organising what they do and what and when they eat. One service user expressed a particular interest in developing computer skills and a computer has been purchased. It has been set up in the lounge so that service users can have easy access to this. Service users are encouraged to develop their skills and independence and this is an ongoing process. Sylvan Road (16) DS0000025929.V355343.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, 20 & 21. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. When required, service users receive personal care that meets their individual needs and preferences. Service users are given regular prescribed medication safely. Service users receive good support to ensure that they get the medical and health care that they need. Information is available to enable staff to identify the needs of service users, as they get older, and also to meet their wishes in the event of their death. EVIDENCE: The service users are quite independent and require little support in terms of their personal care. The care plans contain details of the support needed, which can be in terms of prompts and reminders. They also confirm that service users are encouraged to be as independent as possible. For example Sylvan Road (16) DS0000025929.V355343.R01.S.doc Version 5.2 Page 17 key workers will remind service users to shop for toiletries when they are about to run out. Some of the service users go to the doctor unaccompanied and others are accompanied by the staff. One service user refuses to go to the dentist but the others visit a dentist in the community. Some of the service users go to a private chiropodist; others go to the NHS chiropodist. The service users visit an optician in the community. Records are kept of medical appointments and outcomes and evidence of this was seen in service users’ files. One of the service users has a serious illness and the staff team monitors this person’s condition. He is supported by his mother and by his key worker to attend appointments and discuss and decide on treatment. Service users also receive input from Community Psychiatric Nurses and from the Consultant Psychiatrist as and when required. The Consultant Psychiatrist now visits the home every 3 months to meet staff and service users and discuss any issues or concerns. Service users’ files contained information on their, or their families, wishes in the event of death. The Expert by Experience, in his report, says of a service user: “When asked if she felt she was treated with dignity and respect she held strong eye contact, smiled and replied simply, yes”. None of the service users self medicates and medication is administered by staff that have been trained to do this. Medication is securely stored in a locked cabinet in the office and most medication is in a monitored dosage system. In line with good practice the medication file has photographs of each service user and information about the medication that they take, how it is taken and possible side effects. The file also contained a list of staff that are able to administer medication and a sample of their initials. Medication administration records are kept and are up-to-date. Service users have regular medication reviews and a pharmacist visits monthly to check medication and any issues identified are addressed. The manager also carries out monthly medication audits to ensure that medication is being appropriately administered and records accurately kept. As part of the development of the service and of service users it is hoped that some service users will be supported to self medicate in the future. Sylvan Road (16) DS0000025929.V355343.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. There is a complaints procedure, available in a user-friendly format that would be followed in the event of any complaints being made. Concerns and issues are listened to and addressed. Staff have received safeguarding adults training to ensure that they are clear about what constitutes abuse and what to do if abuse is seen or suspected. This gives service users a greater protection from abuse. Service users’ finances are appropriately managed and monitored and this lessens the risk of financial abuse. EVIDENCE: The organisation has an appropriate complaints procedure and is available in a user-friendly format. This is displayed clearly on the wall outside the office. Service users are reminded of their right to raise any issues that they are not happy with. The Expert by Experience stated in his report: “the complaints procedure is well detailed and promoted. All service users were positive about its use and the responses achieved by staff. A refreshing attitude toward complaints is enjoyed by service users and all staff should be congratulated for the active promotion of said procedure.” Sylvan Road (16) DS0000025929.V355343.R01.S.doc Version 5.2 Page 19 Staff are aware of what to do and how to facilitate a complaint and any complaints or concerns raised by service users will be listened to and addressed. The Commission has not received any complaints or concerns about the service since the last inspection. The organisation has produced a detailed adult protection policy that tells staff the actions to take in the event of abuse/suspected abuse being discovered. Staff spoken to were aware of the issues of abuse and aware of their responsibility to service users All of the service users go to the bank or building society to sign for and withdraw their own cash. Some of the service users keep their own cash but bankbooks are kept in the safe. Records are kept of financial transactions and as part of this inspection the record, cash held and bankbooks were checked for two service users. In both cases the amount recorded in the book tallied with the records kept, as did the cash held. The organisation carries out annual financial audits. Therefore systems are in place to ensure that service users are protected from financial abuse. Sylvan Road (16) DS0000025929.V355343.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, 25, 26, 27, 28, 29 & 30. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. Service users live in a clean, comfortable home that is suitable for their needs but ongoing problems with the conservatory mean that this area is not in the same good repair or decoration as other communal areas. EVIDENCE: The house is near to the local shops, bus routes and the tube station. The communal space consists of a lounge/diner, kitchen, conservatory, laundry room and a garden. The lounge diner is comfortable and has sky TV, video and a DVD player for the service users use. The conservatory has both smoking and no smoking areas and provides additional communal space and an area where service users can meet visitors in private if they want to. There are now five single bedrooms. The ground floor bedroom has an ensuite shower. The inspector visited all of the communal areas and one of the upstairs bedrooms. Bedrooms reflect individual likes and preferences and service users have previously confirmed that they chose the colours for their Sylvan Road (16) DS0000025929.V355343.R01.S.doc Version 5.2 Page 21 rooms. Since the last inspection a new three-piece suite, dining table and chairs and a coffee table have been purchased. The lounge, kitchen, hall, laundry and upstairs toilet were decorated just over a year ago. Unfortunately there are still some on going problems with the conservatory. Cracks in the wall in the smoking room were plastered but have appeared again. This was discussed with the housing officer who confirmed that she is still trying to get the problem resolved but that it could be linked to previous subsidence. She also said that once repairs have been carried out this area would be redecorated. Problems with the heating had also proved difficult to resolve however it had recently been discovered that the thermostat was too near to the boiler and this has been moved. On the day of the visit both the ground floor and upstairs heating was working and the home was warm. With the exception of the conservatory the home is appropriately decorated and furnished and now that the heating is fully functioning service users have more flexibility about where they spend there time as previously bedrooms could be cold during the day. In addition to the ensuite facility there is a bathroom on the first floor and three toilets around the home. None of the service users need any special aids and bathing and toilet facilities meet their needs. Service users do the day-to-day cleaning with support from the staff team and at the time of this visit the home appeared to be clean and hygienic Sylvan Road (16) DS0000025929.V355343.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): 31, 32, 33, 34, 35 & 36. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. Service users are supported and protected by the organisations recruitment practice, including the recruitment of bank and agency staff. Staffing levels are sufficient, and staff receive the necessary training, supervision and support, in order to meet service users’ current needs and provide a good service for them. EVIDENCE: From Monday to Friday two staff are on duty from 8am to 8pm, on Saturdays there is only one member of staff on duty from 2.30pm and on Sundays from 3.30pm. At night there is one waking night staff. The times when one staff is on duty are when service users usually all go out. For example on Saturdays they go to a club between 1 p.m. and 7 p.m. This arrangement is flexible and staffing levels are sufficient to meet the assessed needs of the service users. Sylvan Road (16) DS0000025929.V355343.R01.S.doc Version 5.2 Page 23 Staff have job descriptions and in discussion were clear as to their individual role in the home. The organisation operates an appropriate recruitment procedure. Jobs are advertised, application forms completed and interviews held. Staff records are held centrally at the organisations head office in line with an agreement made with the Commission. However copies of the necessary information are available at the home. It was not possible to access staff records on this occasion but during previous visits files have contained copies of the application form, references and identification documents. Also evidence that the necessary checks had been carried out. In addition there was evidence in the monthly monitoring report for November that staff records had been checked and that the necessary information was on the premises. Therefore the recruitment procedure offers safeguards to service users. Since the last inspection new staff have been recruited and there is now a full staff team. Service users were involved in the recruitment of the staff. There is a member of staff on long term sickness leave and permanent staff and relief staff cover this post. From examining the rota and from speaking to staff it was evident that regular relief staff are usually being used. It was also evident that they knew the service users and were very much part of the staff team. Relief staff attend staff meetings and also receive supervision from the senior support worker. Staff on duty confirmed that they receive regular supervision and good support from the manager. They also said that the staff and service users are involved in what is happening in the home and looking at ways of improving the service. All staff have personal development folders and have had appraisals. Therefore staff training needs have been identified and appropriate training is being arranged to give the staff team the skills they need to work with the service users. Records show that this includes support plans, good practice, equal opportunities, adult protection awareness, fire safety, moving and handling and food hygiene. Information provided in the AQAA (Annual Quality Assurance Assessment) states that 4 of the 5 permanent staff have NVQ level 2 or above and the other person is working towards this. It also states that all 3 of the regular relief staff are working towards this. Staff were clear about their duties and responsibilities towards the service users and get the support and training that they need to provide an appropriate service to the service users. The Expert by Experience said in his report “I was also struck by the dignity and respect with which all service users are treated by each and every member of both permanent and temporary staff”. Sylvan Road (16) DS0000025929.V355343.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 & 42. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. The home is well managed and provides a safe environment for the service users. The registered provider monitors the service appropriately to check the quality of the service provided to service users. The service users are benefiting from the management and development of the home. EVIDENCE: Since the last inspection a new manager has been appointed and has been registered by the Commission. She was therefore deemed a fit person to Sylvan Road (16) DS0000025929.V355343.R01.S.doc Version 5.2 Page 25 manage the home and to have the necessary experience and qualifications to do this. The manager is studying for RMA (Registered Managers Award). Feedback from staff was that the manager is supportive and approachable and that they are clear as to what is expected of them. Additionally they are being given more responsibility. For example for care plans and reviews and presenting information at staff meetings. They felt that the changes made were for the better. The result is that the service is developing and that service users are benefiting from the management of the home. The quality of the service provided to the service users is monitored by the manager and by the organisation. The service manager carries out monthly monitoring visits to assess how effectively the home is operating to meet its stated aims and objectives, and reports are written. These indicate the action to be taken when deficiencies are identified. Copies of these reports were available in the home and copies are sent to the Commission. In addition to this the organisation carries out a quality audit each year. All of the necessary health and safety checks are carried out and records are kept of these checks. The home has a comprehensive range of policies and procedures to promote and protect service users’ and staff safety. Staff receive the training that they need to understand and use these. Staff carry out monthly health and safety audits and every three months a ‘housing officer’ from the head office carries out a more in depth audit. Therefore the organisation also monitors health & safety. A safe environment is provided for the service users. Sylvan Road (16) DS0000025929.V355343.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 3 4 3 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 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 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 4 3 4 3 3 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 3 3 3 3 3 X X 3 X Sylvan Road (16) DS0000025929.V355343.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. 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. Refer to Standard Good Practice Recommendations Sylvan Road (16) DS0000025929.V355343.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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. 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