Care Home: The Bungalow

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What the care home does well Service users` assessments, care plans, risk assessments and all documentation relating to peoples` care and support is detailed, thorough and informativeThe organisational systems in the homes office, including all files and polices are very well maintained and managed. The management and team have been successful in maintaining a welcoming, pleasant, calm and happy atmosphere within the home. There is an established staff team, which helps give the service users the confidence and assurance that they will be cared for and supported by a fairly static and consistent team. The training provided is of a really good quality and it is apparent that people are appreciative of the training they receive. It is also recognised that the service users benefit from well-trained staff. It is evident that the provider is continually seeking to improve the environmental standards within the home. Overall the home is very well managed, with a supportive and committed staff team. What has improved since the last inspection? The provider has successfully addressed the requirements and recommendations made following the last inspection from the commission. The admission procedure has improved, helping to give the people using the service and the staff team the assurance that peoples` needs will be clearly identified. This also gives the staff the necessary guidance and information to meet these needs. It is apparent that all documentation relating to peoples health care needs has also been improved There are now relevant and appropriate individual risk assessments in place, helping to show that people are empowered to be as independent as possible. The medication procedures have also improved including, staff medication training. The provision of `Safeguarding Adults` training is being regularly provided, demonstrating that vulnerable people are being supported by adequately trained staff. The availability of the staffs recruitment documentation in the home for inspection purposes is also a welcomed improvementThe increase of the national vocational qualification (NVQ) training is also an improvement in the training opportunities made available to the staff. The complaints procedure is now clearer, giving service users, relatives and staff the opportunity and confidence to make a complaint or raise a concern if they wish to. All of the required health and safety inspections and checks are now regularly maintained; giving the assurance that people`s health and safety is important. What the care home could do better: The homes kitchen needs to be modernised, in order for it to be more pleasant and accessible to all service users (See environment section). The driveway (loose flags) is in need of being repaired, this will help ensure that people`s safety is sufficiently maintained and managed. The provider should ensure that all official/formal documentation should contain dates and be appropriately signed. Ensure that the manager is registered with the commission for social care inspection (CSCI). CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 The Bungalow 121 Worden Lane Leyland Preston Lancashire PR25 3BD Lead Inspector Phil McConnell. Key Unannounced Inspection 22nd May 2008 10:00 The Bungalow DS0000040741.V358817.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 DS0000040741.V358817.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People and Care Homes for Adults 18 – 65*. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Bungalow DS0000040741.V358817.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Bungalow Address 121 Worden Lane Leyland Preston Lancashire PR25 3BD 01772 457585 01772 434973 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) Social Services Directorate Vacant Post. Care Home 4 Category(ies) of Learning disability (4) registration, with number of places The Bungalow DS0000040741.V358817.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The home is registered for a maximum of four service users to include: Up to 4 service users in the category LD - Learning Disability. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Staffing must be provided to meet the needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. 28th June 2007 Date of last inspection Brief Description of the Service: The Bungalow is situated in a residential area of Leyland close to the town centre and associated facilities. It offers respite care for up to 4 younger adults with a learning disability and some additional physical disabilities. The Bungalow offers a friendly, domestic environment and is maintained to a good standard throughout. Accommodation is in single bedrooms, with lounge areas, dining area, and adequate bathroom and toilet facilities. The grounds are open and spacious with ramped access for the benefit of people using the service. People who use the service are encouraged and supported to become involved in community-based activities. The Bungalow DS0000040741.V358817.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 stars. This means the people who use this service experience good quality outcomes. Various information was gathered in order to assess the key standards that are identified in the National Minimum Standards for Care Homes for Younger Adults, including: the Annual Quality Assurance Assessment (AQAA) which had been completed by the manager, an unannounced inspection visit to the service on the 22nd May 2008, some service users surveys were returned to the commission for social care inspection (CSCI) and they were positive about the service being received. The manager (Karen Smith) was available throughout the inspection visit. Four service users’ files were examined and all relevant documentation was in place. Three staff files were examined and they also contained all the necessary information that is needed for inspection purposes, including recruitment documentation. (See staffing section) There was the opportunity to observe the support and care being provided to people who were using the service during the visit. There was also the opportunity to speak to a service users relative and to some of the staff who were on duty during the day. All of the discussions were very positive. The home’s policies, procedures and all other documentation including health and safety files and certificates were examined. (See management section). A full tour of the home was also carried out. (See environment section). All of the requirements and recommendations that had been made following the last inspection visit had been satisfactorily addressed. What the service does well: Service users’ assessments, care plans, risk assessments and all documentation relating to peoples’ care and support is detailed, thorough and informative. The Bungalow DS0000040741.V358817.R01.S.doc Version 5.2 Page 6 The organisational systems in the homes office, including all files and polices are very well maintained and managed. The management and team have been successful in maintaining a welcoming, pleasant, calm and happy atmosphere within the home. There is an established staff team, which helps give the service users the confidence and assurance that they will be cared for and supported by a fairly static and consistent team. The training provided is of a really good quality and it is apparent that people are appreciative of the training they receive. It is also recognised that the service users benefit from well-trained staff. It is evident that the provider is continually seeking to improve the environmental standards within the home. Overall the home is very well managed, with a supportive and committed staff team. What has improved since the last inspection? The provider has successfully addressed the requirements and recommendations made following the last inspection from the commission. The admission procedure has improved, helping to give the people using the service and the staff team the assurance that peoples’ needs will be clearly identified. This also gives the staff the necessary guidance and information to meet these needs. It is apparent that all documentation relating to peoples health care needs has also been improved There are now relevant and appropriate individual risk assessments in place, helping to show that people are empowered to be as independent as possible. The medication procedures have also improved including, staff medication training. The provision of ‘Safeguarding Adults’ training is being regularly provided, demonstrating that vulnerable people are being supported by adequately trained staff. The availability of the staffs recruitment documentation in the home for inspection purposes is also a welcomed improvement. The Bungalow DS0000040741.V358817.R01.S.doc Version 5.2 Page 7 The increase of the national vocational qualification (NVQ) training is also an improvement in the training opportunities made available to the staff. The complaints procedure is now clearer, giving service users, relatives and staff the opportunity and confidence to make a complaint or raise a concern if they wish to. All of the required health and safety inspections and checks are now regularly maintained; giving the assurance that people’s health and safety is important. 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 DS0000040741.V358817.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) The Bungalow DS0000040741.V358817.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. There is a thorough pre admission assessment process in place, helping to show that peoples needs will be correctly identified and assessed if they can be satisfactorily provided. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four service users’ files were examined, including the last person to receive a short break/respite service at The Bungalow. All of the files contained individual photographs of the person, this helps to personalise files and avoid confusion because of the constant change of people using the service. The Bungalow DS0000040741.V358817.R01.S.doc Version 5.2 Page 10 Social Services Pre admission care assessments were in place and they contained relevant, appropriate and good information to determine a person’s individual needs. There was also evidence of thorough internal pre admission assessments being carried out. This was a previous recommendation. The AQAA states, “We provide information about the service and have a meeting to discuss and plan how we can meet the needs of the individual. Introductions to the service are person centred and tailored to meet the individual requirements” and “The service has introduced a new booking system which enables individuals to take up use of the service in a more person centred way”. It was evident that a new booking system is in place, which appears to be much better organised than it was previously. One person said, “my daughter looks forward to coming here, she loves it here”. There was a full history of service users stays and records kept of contact with relatives. The staff spoken to during the inspection visit had a good understanding of the assessment procedure for new prospective service users, saying that it includes, a home visit, a visit to The Bungalow and usually a tea visit prior to a short break provision being provided. This enables the person and the staff to become more familiar with each other, in order to make their stay as enjoyable as possible. This all helps to demonstrate that the provider is committed to ensuring that the pre admission assessment and initial introduction to The Bungalow is based on meeting peoples’ individual needs. The Bungalow DS0000040741.V358817.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14 and 33 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7and 9. Quality in this outcome area is good. People are supported and empowered to make informed decisions and take assessed risks, which promote and enhance their independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: New care plans have been implemented since the last inspection visit. The Bungalow DS0000040741.V358817.R01.S.doc Version 5.2 Page 12 The plans contained good relevant and appropriate information, which help to give the care staff the necessary information to provide the assessed needs of the individual person. It was apparent that peoples’ care plans are mainly completed with the information that is gathered by the assessment process. The manager said, “Plans are formally reviewed on a six monthly basis and reviewed and amended at every persons visit if necessary”. The AQAA states, “We establish and review and maintain detailed care plans and risk assessments. We attend reviews held at partner agencies. We work in partnership with individuals, their relatives and other professionals to ensure that the service remains responsive to the needs and preferences of the individual”. It was documented in the previous report that ‘Peoples’ care needs are not clearly identified or well documented’. It was evident that the provider has successfully addressed this issue. It was evident that service users are included, involved and encouraged to make choices and take decisions that affect their daily lives. It was also clear that people’s relatives or representatives are actively included. One relative said, “Things are great here, my daughter is far more independent here than at home”. It was evident that people are encouraged, empowered and enabled to be more independent. The manager commented, “New risk assessments have been implemented with an individually designed template. The risk assessments were previously generic. They are now much better”. A risk assessment observed for one person, clearly demonstrated how this person was being supported to be as independent as possible. The surveys returned were all positive regarding people having the opportunity to make decisions and a have a say in their support and care. In observation it was clear that service users are treated with respect, and dignity in an inclusive and empowering way. The Bungalow DS0000040741.V358817.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. Service Users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. Service users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): The Bungalow DS0000040741.V358817.R01.S.doc Version 5.2 Page 14 12, 13, 15, 16 and 17. Quality in this outcome area is good. People are supported, encouraged and enabled to be involved in stimulating and appropriate activities. This helps give people an assurance of being valued and a sense of wellbeing. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As already mentioned peoples’ care plans are concise and detailed giving, clear guidance and information about the various interests and activities that individuals are involved in. The AQAA states, “Records of the types of things that individuals have been supported to do are available within their personal files” and “The service has become more responsive and flexible in supporting the ‘lifestyle choices’ of the individuals we support”. Some of the comments received from relatives were, “Things are great, and they send home a quite detailed record of events and activities, including what she has had to eat” and “I was relieved that he settled in so well”. It was commented, “We ask people before their stay if they have any particular interest or hobby, and this helps with the staffing levels”. The AQAA states, “We endeavour to provide new opportunities to build on life skills and experiences in accordance with the needs and choices of the individual”. It was also apparent that a major part of the planning process for people going to stay at The Bungalow includes ‘matching’ people up. This helps to ensure that people with similar interests are staying at the home at the same time. In speaking to members of staff and from feedback received, this planning and consideration of compatibility has generally been very successful. It was also evident that people were individually involved in different activities and pursuits in the local community. There was also documented evidence to show that people are supported and encouraged to access meaningful leisure pursuits away from the immediate area. The Bungalow DS0000040741.V358817.R01.S.doc Version 5.2 Page 15 It was evident that inclusion, community participation and community presence is positively and actively promoted, enabling people to maximise their independence, whilst also initiating self worth, confidence and wellbeing. Records of all meals are maintained and it was evident that consideration is given to promoting nutritious and well balanced diets. It was also observed that individual dietary needs are recorded on individuals ‘stay sheets’. The Bungalow DS0000040741.V358817.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) Service users retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicines. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. Peoples’ personal support and health care needs are appropriately provided, helping to give the assurance that people are treated with respect and dignity. This judgement has been made using available evidence including a visit to this service. EVIDENCE: It was evident that the people who use the service provided by The Bungalow are positively encouraged to be as independent as possible regarding their personal care. The Bungalow DS0000040741.V358817.R01.S.doc Version 5.2 Page 17 Some of the people who stay at The Bungalow for short breaks do require some support with their personal care needs and this is carried out with their full agreement. The AQAA states, “We work in partnership with our Primary Care Trust (PCT) and we have established positive links with heath care facilitators and community nurses to ensure consistent care and support is maintained”. People have ‘Heath Action Plans’ in place and the provider ‘works proactively’ with their health partners to ensure that the health needs of the people they support are regularly reviewed, in order to help ensure that peoples health care needs are monitored and any changing needs are identified and met. If there is a need for someone to see a GP or attend an appointment during their stay, support is provided and the outcome is recorded and the information is passed on to the service users relative. People have up to date health needs checklists, health action plans and as already mentioned very detailed care plans. Specific health care guidelines for two of the service users were observed during the inspection visit. It was evident that aids and adaptations are provided to assist people with their individual care needs. There was an appropriate medication policy in the home and the medicines were securely and correctly stored (previous requirement) and administered, with medication charts being accurately recorded and up to date, with two signatures for each administration. Service users’ files also contained signed ‘medication declarations’. This document gave permission from either the service user or their representative for the care staff to administer medication. All of the staff team have received satisfactory training in the medication process. (Previous requirement). Since the last inspection visit it is evident that the provider has fully addressed the issues regarding the storage of medicines and the ‘medication administration’ training of staff. This helps to demonstrate that correct medication procedures have been implemented and are being maintained. The Bungalow DS0000040741.V358817.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16-18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 22-23 (Adults 18-65) and Standards 16-18 and 35 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. Good safeguarding adults procedures are in place, helping to give the assurance that vulnerable people are protected from harm or abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure has been reviewed since the last inspection visit (There is now a satisfactory policy and procedure in place) and appropriate documentation is available near to the entrance of the home. (Previous requirement) “Documentation is available at the front door to enable people to note down any remarks and pass them on” and “The service has a corporate complaints procedure and a whistle blowing policy in place”. The staff who were spoken to during the inspection visit were familiar with the complaints policy and with the whistle blowing policy. It appears that the provider actively promotes the complaints procedure. The Bungalow DS0000040741.V358817.R01.S.doc Version 5.2 Page 19 The AQAA states, “The complaints procedure has been reviewed and shared with the people we support” and “We actively seek feedback from individuals who use our services and the procedure for expressing complaints and concerns is explained upon introduction to the service and again during surveys, reviews and conversation”. New service users or their representative are given a copy of the complaints procedure and discussion takes place, to ensure that there is a full understanding of the procedure. The surveys returned to the commission showed that service users and their relatives would know how to make a complaint if they needed to. Two complaints had been received since the previous inspection and these had been resolved within the 28 day recognised period. Formal ‘Safeguarding Adults’ training is being provided on a regular basis and in discussion with some of the staff it was apparent that people are familiar with safeguarding procedures. A new ‘Safeguarding Adults’ policy and procedures was available for inspection at the home. The information and guidance was very clear and thorough, however there was no date on the document to show when it was published. The manager was informed of this during the inspection. It would be recommended that this and all other documentation contain the initial date of implementation and any subsequent review dates, with signatures of the people completing the documentation. The home contained relevant evidence that all members of staff have had criminal record bureau clearance checks carried out (CRB), helping to show that the organisation is committed to protecting the people in their care. The Bungalow DS0000040741.V358817.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. Overall the environmental standards are quite good, helping to give the assurance that people live and work in a safe, comfortable and pleasant home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Bungalow DS0000040741.V358817.R01.S.doc Version 5.2 Page 21 A full tour of the home was completed and throughout it was found to be of a good standard, it was clean, homely and fresh smelling. Although the décor is clean looking, it is looking a little old fashioned (communal areas), however the AQAA states, “Our plans for the next 12 months is to fully redecorate and re-carpet the establishment”. There is an ensuite-wet room and it was stated by the manager, “this bedroom is used mainly for people with more complex/physical needs. It’s fantastic and it’s made a massive difference to the people who use the service”. Two of the homes bedrooms have also been redecorated to a good standard. There is a large lounge/dining room and a smaller lounge/TV room. The large kitchen was clean and well organised; although it was observed that the kitchen is looking quite dated and is in need of some modernisation / refurbishment. The kitchen would benefit from integrated appliances, especially the cooker and if possible at a height that would benefit the people who use wheelchairs. The radiator in the kitchen is non-functial where it is placed and either needs removing or repositioning to a more suitable place. The laundry is also a good size and well equipped to meet the needs of the people using the service. The homes cleaning products are appropriately and securely stored in an outside shed. Just by coincidence, during the inspection visit, the outside of the building was being repainted, the fire alarm was inspected and also the engineer had called to inspect the lifting hoists. The outside grounds are very well maintained with mature gardens. It was observed that the driveway has a number of broken and loose flags. It was commented by the manager, “We have a risk assessment in place and the drive is being repaired in two weeks time” Overall since the last inspection visit a number of positive changes have taken place and it is envisaged that the provider will continue to make further improvements to the home. This will help maintain the changes that have already occurred and make further improvements to the environment for the people who use the service and the people who work at The Bungalow. The Bungalow DS0000040741.V358817.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is good. The staff team have been correctly recruited and have the necessary skills and experience to provide a good standard of care to vulnerable people. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the last inspection visit there were some staff vacancies, fortunately The Bungalow is now fully staffed; giving the assurance that people will be appropriately supported by a consistent and skilled team. The Bungalow DS0000040741.V358817.R01.S.doc Version 5.2 Page 23 Three staff files regarding recruitment information were examined and they contained all of the relevant information needed for inspection purposes including, criminal record bureau checks (CRB), application forms and job descriptions. (This was a previous requirement). The recruitment procedure was seen to be robust and thorough. This helps to demonstrate that people are only employed when all of the needed checks are satisfactorily carried out. Other information available in peoples’ files was, induction training documentation, supervision notes and training and development documentation. The management of the files was very well organised. Comments from some of the staff were, “All of the staff are striving to provide a good quality service” “we now have an excellent team, really good atmosphere in the home” and regarding the training, “I have done an Alzheimer’s course, which lasted for two days” and “The training gave me a good insight and I really enjoyed it”. It was clear that staff feel valued and appreciated. It was also evident during the inspection visit that a good rapport existed between the members of staff and the service users, which again showed that people are happy and content in their work. The limited provision of the national vocational qualification (NVQ) training was also mentioned in the previous report, however this has also been addressed with over 60 of staff having achieved the award and the remainder of staff ‘having secured places’ on the next course. Some of the comments regarding the staff team were, “the staff are wonderful” “the staff are always good” and the surveys returned to the CSCI were all very positive about the staff. The Bungalow DS0000040741.V358817.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. Service users live in a home which is run and managed by a person who is fit to be in charge of good character and able to discharge his or her responsibilities fully. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): The Bungalow DS0000040741.V358817.R01.S.doc Version 5.2 Page 25 37, 39 and 42. Quality in this outcome area is good. The home is very well organised and managed, helping to give the assurance that people receive a good quality service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The present manager has been at The Bungalow for just 12 months and in that time some very positive changes have taken place. The manager has over 17 years experience of working in social care, some of which in a managerial role. She is adequately qualified having achieved the NVQ at level 4 and also obtained the registered managers award (RMA). The manager has applied to be the registered manager with the commission for social care inspection (CSCI). In discussion with the staff, it was clear that the changes that have been made are very much appreciated. It was also apparent that the manager is seen to be approachable, supportive and well organised. Some of the comments regarding the manager were, “She is a very good manager and very is supportive” “the manager is approachable, listens and is always ready to give time” and “probably the best manager I have had in all of my working life”. One relative said, “the changes have been really good, things are so much better”. As already mentioned the general management regarding all of the homes documentation was very well organised. Also mentioned earlier in this report some of the corporate policies did not contain a date of completion/implementation. It would be good practice to have dates and relevant signatures on all documentation that is specific to the service delivery. This was discussed with the manager following the inspection and an assurance was given that this particular issue would be addressed with senior management. The Bungalow continues to maintain the ‘Investors in People’ award, which is an external quality assurance-monitoring organisation. The manager has also recently introduced a telephone quality monitoring survey of the many relatives of the service users. Although in it’s infancy the The Bungalow DS0000040741.V358817.R01.S.doc Version 5.2 Page 26 response from relatives has been quite positive, with people saying that they appreciate any opportunity to share their feelings and opinions about the service being delivered. This shows that the quality monitoring of the service being delivered is important to the provider. The health and safety policy and procedures were examined and found to be up to date. All of the required inspection safety certificates were in place and up to date, including, electric, gas, hoists, legionella, and fire alarm (tested weekly). The lifting hoists and the fire alarm were independently inspected during the inspection visit. (Both within the required timescale). The records for monthly fire drills were also observed. These all demonstrate that the provider is committed to providing a safe and secure environment for people to live and work in. The Bungalow DS0000040741.V358817.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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 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 X CONDUCT AND MANAGEMENT Standard No Score 37 3 38 X 39 3 40 X 41 X 42 3 43 X 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 The Bungalow Score 3 3 3 X DS0000040741.V358817.R01.S.doc Version 5.2 Page 28 NONE 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 3 Refer to Standard YA24 YA24 YA37 Good Practice Recommendations The service users and the staff would benefit from the kitchen being refurbished/modernised. The driveway is in need of being repaired or replaced. The manager should be registered with the commission for social care inspection (CSCI). The Bungalow DS0000040741.V358817.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 DS0000040741.V358817.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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