Care Home: The Bungalow

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What the care home does well The Bungalow provides a service that values the individuality of people who live there. Interactions between staff and people in the home are good. Staff are able to provide support for people in a way that meets their complex needs. The personal and healthcare needs of people living in the home are met and relevant healthcare professionals are consulted where appropriate. One member of staff who completed a survey said, "All the staff do genuinely care for the service users and the home is very homely". The Bungalow provides a comfortable, homely environment for people; it provides a good standard of furnishings and bedrooms that are decorated to reflect individual tastes. Visitors are made welcome and people are encouraged to maintain contact with families and friends. A relative spoken with said they visit a number of times a week and they have "absolutely no concerns about the way [their relative] is treated, staff always give a good standard of care". What has improved since the last inspection? There have been improvements to the environment as part of the home`s ongoing programme of maintenance, repairs and renewals. There has been new flooring in the kitchen and some of the cupboards and worktops have been repaired and replaced. There is a new carpet in the communal lounge and other carpets in individual rooms have been cleaned. The main bathroom has had a new shower cubicle installed and changing mats and the electric bath chair have been replaced. Staff supervisions are now carried out more regularly and staff made positive comments about the way they are supported, including "Anything I need to talk about with my manager she gives good advice and listens. She also takes us for supervision to see how we feel about everything in the work place". What the care home could do better: The home could continue to develop and build on the work that has been started around improving communication for people living in the home. This includes things like producing the activity planner in a format that people can more easily understand. The storage of medication could be improved, including the provision of a controlled drugs cabinet in line with recent changes to legislation around the storage of controlled drugs. CARE HOME ADULTS 18-65 The Bungalow Plains Farm Close Ardleigh Colchester Essex CO7 7QX Lead Inspector Ray Finney Unannounced Inspection 25th June 2008 09:30 The Bungalow DS0000017956.V367195.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 The Bungalow DS0000017956.V367195.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. The Bungalow DS0000017956.V367195.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Bungalow Address Plains Farm Close Ardleigh Colchester Essex CO7 7QX 01206 852010 01206 843661 coass@tiscali.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) Mr Rohan Vasantha Kumara Dias Mrs Velamba Dias Manager post vacant Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places The Bungalow DS0000017956.V367195.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home accommodates six people with learning disabilities who may also have physical disabilities Date of last inspection Brief Description of the Service: The Bungalow is a large detached property situated a few miles from the centre of Colchester. The property has been adapted to accommodate six adults with learning disabilities, who may also have physical disabilities. There are six single bedrooms in the home and communal areas include a dining room and lounge with patio doors leading on to a pleasant patio area. The grounds and garden are well maintained and accessible to people living in the home. There are parking facilities to the front of the Bungalow. The service supports people to live in an ordinary home environment that meets their individual needs. The home charges between £878.92 and £1,769.44 a week for the service they provide. This information was given to us in June 2008. Information about the home can be obtained by contacting the manager. Inspection reports are available from the home and from the CSCI website www.csci.org.uk The Bungalow DS0000017956.V367195.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. A range of evidence was looked at when compiling this report. Documentary evidence was examined, such as food records, staff rotas, care plans and personnel files. An Annual Quality Assurance Assessment with information about the home was completed by the manager and sent to us before the inspection. Throughout the report this document will be referred to as the AQAA. A visit to the home took place on 25th June 2008 and included a tour of the premises, discussions with some of the people living in the home, the manager, members of staff and a visiting relative. Some of the people living there have complex needs and are unable to communicate verbally, although the inspector was able to have some communication based around facial expressions and gestures. Observations of how members of staff interact and communicate with people living there have also been taken into account. On the day of the inspection the atmosphere in the home was calm and relaxed and the inspector was given every assistance from the manager, the proprietors and the staff team. What the service does well: What has improved since the last inspection? The Bungalow DS0000017956.V367195.R01.S.doc Version 5.2 Page 6 There have been improvements to the environment as part of the home’s ongoing programme of maintenance, repairs and renewals. There has been new flooring in the kitchen and some of the cupboards and worktops have been repaired and replaced. There is a new carpet in the communal lounge and other carpets in individual rooms have been cleaned. The main bathroom has had a new shower cubicle installed and changing mats and the electric bath chair have been replaced. Staff supervisions are now carried out more regularly and staff made positive comments about the way they are supported, including “Anything I need to talk about with my manager she gives good advice and listens. She also takes us for supervision to see how we feel about everything in the work place”. 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. The Bungalow DS0000017956.V367195.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Bungalow DS0000017956.V367195.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People choosing to live at The Bungalow receive sufficient information about the home and can be confident their needs will be assessed before admission. EVIDENCE: The manager said in the AQAA that “prospective service users are invited for trial periods. However, there have been no admissions since the last inspection”. As previously reported, there is a Statement of Purpose and Service User Guide in place that contain appropriate information for people who may wish to move into The Bungalow. The manager said they have plans in the coming year to develop a website to give people who may wish to use the service in the future the opportunity to find out more about the home. They are also planning to produce the brochure in a pictorial format using signs and symbols to make it “user friendly” for people who cannot read. Information provided in the AQAA states that the home has “an assessment programme” in place and “following the assessment an individual programme is put into place to meet the person’s needs”. There have been no new admissions in the past year, but the manager was able to demonstrate a good awareness of the importance of a detailed assessment. A sample of records examined confirm that the home has an appropriate assessment process in place and the people currently living in the home had their needs assessed The Bungalow DS0000017956.V367195.R01.S.doc Version 5.2 Page 9 before moving in. Staff spoken with were able to demonstrate a good knowledge of people’s assessed needs. The Bungalow DS0000017956.V367195.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in The Bungalow receive good quality care based on their identified needs. EVIDENCE: A sample of three care plans examined all contained good, detailed information. The care plans identify the person’s need or difficulty, what the objective is for the person and what interventions or actions need to be taken to meet the need. Records examined show that care plans are evaluated and reviewed. There was a good response from staff to surveys sent to the home and many of them made positive comments about the care plans. One person said, “All staff follow the care plans on a day-to-day basis. All information is put on the care plans as it happens or changes. This is also put in the communication book for staff to read as well” and another said, “Care plans are kept up to date and are very good”. The manager stated in the AQAA that they hold The Bungalow DS0000017956.V367195.R01.S.doc Version 5.2 Page 11 “care plan meetings to do with the ongoing reviewing of care plans” and one person stated in a completed survey, “We hold care plan meetings”. Records examined confirm that staff discuss care plans at meetings. Communication between members of staff and the management team was observed to be good. There were also positive comments in completed surveys from members of staff around good communication. One person said, “All information is passed on to seniors and carers. We always use the communication book” and another, “We have a very good staff team and anything that changes with our service users is always told to care staff and seniors”. Records examined confirm there are risk assessments in place, including manual handling assessments. The assessments identify the risk and record what measures are in place to reduce the risk. Care plans contain evidence of good practices and guidelines for staff to follow to ensure people are treated with respect. Staff spoken with on the day of the inspection were able to demonstrate a wide knowledge of people’s needs, preferences and dislikes. Staff were observed treating people living in the home with courtesy and respect.. The manager stated in the AQAA that there is “staff training on the Mental Capacity Act to give insight to staff in how to support service users in making decisions and what to do if a service user has not got the capacity to make a decision”. The manager explained that they have a member of staff who has received specific training developed by speech and language therapists called ICE (Inclusive Communication Essex) and this has “assisted staff in more effective ways of understanding our service users needs and choice”. This person is ‘rolling out’ the training to other members of the staff team. It was clear that people living in The Bungalow benefit from a staff team who have all developed good communication skills that they can use to support people with complex needs and communication difficulties. The Bungalow DS0000017956.V367195.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in The Bungalow can expect to have opportunities to participate in activities that are appropriate to their needs and to be supported to build and maintain relationships. People can expect to be offered a varied diet that provides them with choice. EVIDENCE: The manager states in the AQAA that, “Each service user has a weekly individual activity plan relating to a diverse range of activities inside and outside the home’s environment”. A relative said there is “a good range of structured activities outside the home”, although more varied activities could take place in the home. On the day of the inspection staff were playing ‘swing ball’ out in the garden with someone living in the home and another member of staff was planning a swimming trip with someone else. This person goes swimming regularly and The Bungalow DS0000017956.V367195.R01.S.doc Version 5.2 Page 13 was enthusiastic about using the local leisure centre. The atmosphere was relaxed and people were enjoying socialising with each other and with members of staff. There is an activity board on the wall in the dining area, although this could be more ‘user friendly’ for people who cannot read. The manager said that they are looking at ways of improving information using the principles of their ‘Inclusive Communication in Essex’ training. They are working on ‘total communication and communication passports’ and are going to use the ideas in practical ways to improve information for people in the home. One of the things they are developing is a board for staff photos to show people who will be on shift and they plan to look at improving information around activities. The manager said that people living in The Bungalow are encouraged to make choices about college courses. They are supported by staff to go to the interview when they are enrolling on the course. People’s records confirm that they attend a variety of courses at the local college, although at the time of the inspection most of these had finished for the summer. The manager said they are looking at doing other things like trips out during the college holidays. Staff have actively involved people living in the home in gardening and developing a small vegetable garden where they are learning about growing, preparing and cooking their own produce including tomatoes and strawberries. As a result, one person has chosen gardening as a college course. The AQAA states that they involve people in all aspects of living in the home by promoting independent living skills. One person living in the home enjoys keeping their own room clean and tidy and was pleased to show the inspector round. As reported at previous inspections, people are supported to maintain links with their families and relatives make regular visits to the home, sometimes every few days. Two people living in the home also have friends who visit and have meals with them. The Bungalow tries to ensure the family atmosphere is maintained and meal planning is very much as in any small household. There is not a rigid plan, but staff check what people want for dinner on a daily basis according to what they are doing and then record it on daily menu sheets. Records examined confirm that there is a good variety of home cooked food available. On a tour of the premises, food stocks were seen to be plentiful and of good quality. Records examined show that, if anyone has specialist needs around nutrition, the dietician is involved in planning and advising on appropriate meals. The manager said that the people living in the home “have become part of the community in Ardleigh and visit the local pub on a regular basis”. When asked what the home does well, a member of staff responded, “Promote clients social The Bungalow DS0000017956.V367195.R01.S.doc Version 5.2 Page 14 inclusion”. There is also evidence that people go to a social club on a Wednesday evening, where they socialise with friends. A member of staff who completed a survey said, “When we take the service users to their weekly disco they’re so smartly dressed. We take pride in their appearance”. People living in the home all show an interest in a variety of music and they are planning to attend a musical evening at the local college. The manager also explained that they intend to “introduce ‘sound beam’ as an in-house activity as service users have shown a strong interest”. She explained that ‘sound beam’ is an activity based on sound and vibration as a means of communication. The Bungalow DS0000017956.V367195.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service can expect to receive personal and healthcare support that meets their needs. The Bungalow has systems in place to ensure the safe administration of medication and the protection of people living there. EVIDENCE: Care plans examined contained ample detail to ensure people receive the support they need in ways that they wish. Details include, “Meal times care plan must include presenting a choice of breakfast cereal to XX and more milk needs to be added to the cereal to aid swallowing” and “amend the independent living skills to more realistic tasks around the home due to poor short term memory and concentration span”. One plan details strategies to help the person’s emotional well being, such as bathing in the evening and playing classical music to help the person relax. The manager states in the AQAA that people, “are encouraged with their selfhelp skills in relation to personal care” and care plans document details of people’s preferred ways of being supported with their personal care needs. The Bungalow DS0000017956.V367195.R01.S.doc Version 5.2 Page 16 In the sample of three care plans examined the information about health and medical needs was particularly well documented. One care plan had an ‘Emergency Medication Plan’ around epilepsy. There were seizure monitoring forms and relevant information to guide staff. Staff training records examined also show that staff have received relevant training around emergency procedures to follow and medication to be administered in the case of ‘status epilepticus’ or uncontrolled seizures. This training was delivered by the community nurse specialist for epilepsy. The manager states in the AQAA, “We involve health professionals at all times in relation to service users changing needs, and service users’ parents are also actively involved in this”. There was ample evidence in people’s personal records of input from a range of healthcare professionals, including occupational therapists, dietician, clinical nurse specialists, continence advisor and G.P. The continence advisor visited on the day of the inspection to discuss any changing needs that people may have. The manager stated in the AQAA that, “All personal and healthcare records are documented and updated within the service user plan. Feedback of the medical appointments is given over handover and discussed in length in care plan meetings” and this was confirmed in records examined. Care plans also contained weight charts that were completed monthly, information on prevention of pressure sores and physiotherapy exercises. On the day of the inspection medication records and storage was examined. Medicine Administration Record (MAR) sheets were completed appropriately. The cupboard used for storing medication would benefit from being better organised. The medicine cupboard is old and, although securely fixed to the wall in a room not accessible by people living in the home, the lock is old and not robust. Consideration should be given to how medication storage could be improved. The manager states in the AQAA that they plan “to replace our medication storage with more a more secure system and to provide a controlled drugs cabinet so it is readily available if the likelihood occurred where service users were prescribed controlled drugs”. Personnel records confirm, as stated in the AQAA, that “all senior and acting senior staff attend medication training courses”. A relative spoken with said the care their relative receives is “excellent” and “[their] communication is developing well in the small environment of the home”. Staff spoken with on the day of the inspection all demonstrated a detailed knowledge of people’s needs around health and personal care. The Bungalow DS0000017956.V367195.R01.S.doc Version 5.2 Page 17 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. People who use the service have access to an effective and understandable complaints procedure that ensures that they are listened to and there are procedures in place to protect the people who live there. EVIDENCE: As previously reported, the home operates a robust procedure for dealing with complaints and records them appropriately. The manager states in the AQAA that people using the service and their representatives “receive a copy of the home’s complaints procedure” and that “all complaints received are recorded and acted upon within the appropriate timescales”. Also the complaints procedure is an agenda item in staff meetings and the manager said that, “staff are reminded of how to deal with complaints [and] to be open and honest when they have problems between one another”. There have been no formal complaints recorded since the last inspection. On the day of the inspection the manager was able to demonstrate a good awareness of appropriate processes for dealing with complaints. A visiting relative spoken with said that they have the information they need about the home’s complaints procedure and would be confident that they could bring up any concerns. Staff spoken with understand their responsibilities around safeguarding people (previously called Protection of Vulnerable Adults or POVA). Personnel records contain evidence that staff have received safeguarding training. A relative The Bungalow DS0000017956.V367195.R01.S.doc Version 5.2 Page 18 spoken with had “no concerns whatsoever” about the welfare and wellbeing of their relative. Personnel records examined confirm that staff undergo Criminal Record Bureau (CRB) checks before commencing employment and the AQAA states that “all new recruits are provided with POVA booklets when carrying out induction training”, so staff are fully aware of their responsibilities around safeguarding vulnerable people. The Bungalow DS0000017956.V367195.R01.S.doc Version 5.2 Page 19 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 good. This judgement has been made using available evidence including a visit to this service. People living in The Bungalow benefit from a comfortable environment that is homely, well maintained and clean. EVIDENCE: The manager states in the AQAA that they “ensure service users bedrooms are decorated and furnished to reflect their needs and tastes”. A tour of the premises confirmed people’s rooms were individually decorated to a high standard and there was ample evidence of personal possessions such as photographs. One person took pride in showing their room to the inspector. People living in The Bungalow are encouraged to take an active part in keeping the home clean and tidy. One person takes responsibility for cleaning their room. People are also encouraged to participate in recycling and staff are supporting them to understand “the importance of being environmentally friendly”. The Bungalow DS0000017956.V367195.R01.S.doc Version 5.2 Page 20 The Bungalow is well maintained and provides a homely environment for the people who live there. A visit by the environmental health inspector highlighted some cracks in the tiled kitchen floor. This was dealt with promptly and the kitchen now has new impermeable non-slip flooring. Further improvements to the kitchen include a new sink and the renewal of some of the cupboards. Minutes of a recent parents’ meeting document that a range of home improvements were discussed. The main bathroom has had a new shower cubicle and changing mat. There is also a new electric bath chair. The lounge carpet has been replaced recently and other carpets throughout the home have been cleaned. There were no unpleasant odours and The Bungalow is fresh and clean. As previously reported, the garden area is well maintained and provides a pleasant area for people to sit in the good weather. On the day of the inspection the patio area and garden were seen to be well used by people playing ball games or sitting having drinks and snacks. Both inside and outside areas are easily accessible for people who use wheelchairs. The Bungalow DS0000017956.V367195.R01.S.doc Version 5.2 Page 21 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 good. This judgement has been made using available evidence including a visit to this service. People living in The Bungalow can be confident that their needs will be met by a competent, well trained staff team. People living in the home can be confident that the recruitment checks undertaken help to ensure appropriate staff are employed. EVIDENCE: Information provided in the AQAA indicates that, out of a full staff team of ten full-time carers and six part time carers, fourteen people have completed a National Vocational Qualification (NVQ) at level 2 or above. These figures are more than the minimum of 50 of carers with NVQ as recommended in the National Minimum Standards. A sample of three personnel files examined contained all the documentation required by regulations, including two written references, proof of identity, Criminal Record Bureau (CRB) enhanced disclosures, a completed application form and statements that people are fit to carry out their role. Staff files were well organised. The Bungalow DS0000017956.V367195.R01.S.doc Version 5.2 Page 22 The manager was able to demonstrate a good awareness of the importance of a robust recruitment process so that people are supported by good staff who have been recruited appropriately. Completed surveys returned by members of staff confirm that they were not employed before relevant checks were carried out. One person said, “Any workers who start now do not start until CRBs are back”. The manager stated in the AQAA that they have, “Improved the induction process”. A sample of personnel records examined contained evidence that there is an induction process in place to ensure new staff receive the information they need to carry out their job. A member of staff who completed a survey said, “Your induction does cover everything you need to know” and another said, “My induction was very good. It helped me understand everything and where anything is”. Personnel records examined contained individual training and development plans that record when training is carried out and when it is due to be updated. Staff have received training that includes food hygiene, fire safety, moving and handling, infection control, physical intervention, first aid, medication, health and safety and NVQ. Other training relevant to specific health needs of individuals is also carried out, such as epilepsy and the administration of emergency treatment for seizures. This training was delivered by community nurse specialists in epilepsy. Staff who completed surveys all made positive comments about the training they receive. Comments include, “The training I’m given is above and beyond the minimum requirements”, “The training courses that we are all put on are very good”, “[they] always update staff with relevant training” and “This company ensure all staff have the right training they need to do the job”. Staff have received training about safeguarding people (previously called Protection of Vulnerable Adults or POVA) and PRICE training (Protecting Rights in a Caring Environment). Staff spoken with on the day of the inspection were able to demonstrate that they understood their responsibilities around recognising and reporting any suspicions of abuse or poor practice and people living in the home can be confident that they are supported by a staff team who ensure they are safeguarded from harm. Due to the complex needs of the people living in The Bungalow the team have been involved in a training programme to develop skills and strategies to improve communication. The training is called Inclusive Communication in Essex (ICE). It has been developed by speech and language therapists to promote and improve carers ability to communicate more effectively with people with complex communication needs and difficulties. One member of staff, who was spoken with on the day of the inspection, has been appointed co-ordinator with responsibility for training the rest of the staff team and is very positive about the benefits the training will bring. A member of staff who The Bungalow DS0000017956.V367195.R01.S.doc Version 5.2 Page 23 completed a survey said, “We have the right knowledge and training to help with people’s different needs”. Staff supervision records were examined and there have been improvements since last inspection with supervisions being carried out approximately two monthly. The manager has introduced a structure where senior staff carry out some of the supervisions for carers and the manager supervises seniors and some of the care team. Supervision notes contain details of issues discussed and actions agreed. There is also evidence that annual appraisals of people’s performance are carried out. The minutes of staff meetings were examined and demonstrate that a range of topics are discussed including Mental Capacity Act assessments, ICE training, individual’s care needs, keyworkers responsibilities. Staff spoken with felt that they were well supported and completed surveys also contained positive comments including, “Supervision well carried out”. The Bungalow DS0000017956.V367195.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Bungalow is competently managed and run in the best interests of the people who live there. The health and safety of people living and working in the home is promoted and protected. EVIDENCE: The AQAA received from the manager was completed with a good level of detail and the information was well supported by the evidence examined on the day of the inspection. The manager has completed the Registered Manager’s Award (RMA). The manager spoke with knowledge and confidence about the needs of the people living in The Bungalow and is able to demonstrate measures that have been taken to make improvements to the service since she has been in post. These include regular liaison with relatives through “parents meetings and The Bungalow DS0000017956.V367195.R01.S.doc Version 5.2 Page 25 regular contact”, building good working relationships with staff through regular supervisions and staff meetings, revising and updating some policies and documents used in the home. Staff who completed surveys were positive about the way the home is being managed. One person said, “The manager gives us any support we need with our jobs and training” and another, “The manager is very good. She is always there to help us”. Ample evidence was presented to confirm that the management team actively seek the views of people living in the home and their representatives and act on the information that they receive. Records show that surveys were sent to relatives and other interested parties. Parents meetings held at least every few months and minutes show they are well attended by the relatives of the majority of people living in the home. Minutes of staff meetings were also available and demonstrate that the views and opinions of members of staff are also taken into consideration and acted upon. Relatives and members of staff spoken with are confident that their views are listened to. A sample of maintenance records examined confirmed the home has a regular programme of maintenance, as stated in the AQAA, ensuring that people who live in The Bungalow benefit from a pleasant, clean environment that is safe. The Bungalow DS0000017956.V367195.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 X 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 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 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X The Bungalow DS0000017956.V367195.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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. Refer to Standard YA20 Good Practice Recommendations An appropriate facility for the storage of controlled drugs should be available in the event someone in the home may be prescribed medication that requires this type of secure storage. The Bungalow DS0000017956.V367195.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 The Bungalow DS0000017956.V367195.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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