Care Home: The Bungalow [Taunton]

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What the care home does well The home provides a comprehensive statement of purpose and service user guide, which provides information for prospective people using the service. Before any new person resides at the home the manager ensures that a full assessment of needs is in place and ensures that the person can visit the home and `test run` the service before deciding if it is right for them. Each person at the home has a detailed care plan. This plan outlines the preferences of the person and an agreed plan of care is in place to supportboth preferences and any specific care needs. Risks identified are assessed and plans put in place to promote choice and independence. All records are maintained confidentially. The home supports each person in his or her development through activity. Meals at the home are a social event with people using the service participating in choice and preparation whenever possible. People are supported with their healthcare needs by having the access to the appropriate healthcare professionals. Medication systems are clear and staff have received the appropriate training to ensure safe practice is maintained. People are supported to express any concerns or complaints they may have. Alternative methods of communication are used to ensure a clear understanding of the complaints process. The homes environment is comfortable and people`s rooms are personally decorated to each person`s tastes. There is suitable communal space with a comfortable lounge and dining area. Staffing levels at the home are adequate to meet the people`s needs. Staff training is in place to support the needs of people using the service. Recruitment is robust to ensure the protection of people living at the home. The management of the home appears to support both the people using the service and staff. Health and Safety measures are in place to promote protection and policies and procedures are in place to ensure good practice. What has improved since the last inspection? Five good practice recommendations were made at the previous inspection. The management of the home have addressed all of the recommendations. There is now a copy of each persons contract available in the home. Care plans are reviewed monthly and input sought of the representatives of the people using the service. The home has accessed several independent advocacy agencies to support people using the service. The dining room tables are laid in an appropriate manner to support the people using the service. Staff training is provided for all staff who administer medication and their competence is reviewed regularly. What the care home could do better: No requirements have been made as a result of this inspection. Two good practice recommendations have been made that all prescribed creams are signed when administered to ensure that a clear audit trail of administration is maintained. The staff toilet flooring is in need of repair and is recommended to be replaced to ensure that there is no risk of cross infection CARE HOME ADULTS 18-65 The Bungalow 2 Ilminster Road Taunton Somerset TA1 2DR Lead Inspector Gail Richardson Unannounced Inspection 9th October 2008 10:00 The Bungalow DS0000039965.V372914.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 DS0000039965.V372914.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 DS0000039965.V372914.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Bungalow Address 2 Ilminster Road Taunton Somerset TA1 2DR 01823 327050 01823 352994 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) Home First & Foremost Ltd Mrs Susan Elizabeth Perry Mrs Emma-Jane Mary Lewes Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places The Bungalow DS0000039965.V372914.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 6 persons in categories LD and PD Date of last inspection 10th October 2006 Brief Description of the Service: The Bungalow is situated on the outskirts of Taunton. Accommodation comprises of two lounges, a dining room, kitchen and six service user rooms with en suite facilities. The home has been decorated and furnished to a high standard. Appropriate adaptations have been provided to meet service users needs. The Bungalow is registered with the Commission for Social Care Inspection to provide care for up to six service users who have a learning and physical disability. The Registered Managers are Mrs Susan Perry and Mrs Emma Lewes who job share the role. The name of the registered provider has recently changed to Voyage Care Ltd and the company is applying for a change of registration details. The fee range is £1471.94 to £1993.11. This does not include the cost of some trips out and holidays. The Bungalow DS0000039965.V372914.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. This was an unannounced inspection, which took place over 1 day (4 hours) on the 9th October 2008 by Regulation Inspector Gail Richardson. A tour of the home took place and all bedrooms and communal areas were seen. There were 5 people currently residing at the home and the home has one vacancy. Two people were out for the day and we observed the care being received by three people using the service. The home has provided CSCI with a completed AQAA (Annual Quality Assurance Audit), which was completed by the Manager and gives details of all aspects of the home. As part of this inspection the inspector surveyed the opinions of people using the service and staff members. Comments received are used in the body of this report. The inspector spoke to one visitor and three members of staff, one of the Registered Managers was available throughout the inspection. Records relating to care including 3 care plans, 2 staff files, finances and health and safety records were examined The focus of this inspection visit was to inspect relevant key standards under the CSCI ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are; - excellent, good, adequate and poor. The following is a summary of the inspection findings and should be read in conjunction with the whole of the report. What the service does well: The home provides a comprehensive statement of purpose and service user guide, which provides information for prospective people using the service. Before any new person resides at the home the manager ensures that a full assessment of needs is in place and ensures that the person can visit the home and ‘test run’ the service before deciding if it is right for them. Each person at the home has a detailed care plan. This plan outlines the preferences of the person and an agreed plan of care is in place to support The Bungalow DS0000039965.V372914.R01.S.doc Version 5.2 Page 6 both preferences and any specific care needs. Risks identified are assessed and plans put in place to promote choice and independence. All records are maintained confidentially. The home supports each person in his or her development through activity. Meals at the home are a social event with people using the service participating in choice and preparation whenever possible. People are supported with their healthcare needs by having the access to the appropriate healthcare professionals. Medication systems are clear and staff have received the appropriate training to ensure safe practice is maintained. People are supported to express any concerns or complaints they may have. Alternative methods of communication are used to ensure a clear understanding of the complaints process. The homes environment is comfortable and people’s rooms are personally decorated to each person’s tastes. There is suitable communal space with a comfortable lounge and dining area. Staffing levels at the home are adequate to meet the people’s needs. Staff training is in place to support the needs of people using the service. Recruitment is robust to ensure the protection of people living at the home. The management of the home appears to support both the people using the service and staff. Health and Safety measures are in place to promote protection and policies and procedures are in place to ensure good practice. What has improved since the last inspection? What they could do better: The Bungalow DS0000039965.V372914.R01.S.doc Version 5.2 Page 7 No requirements have been made as a result of this inspection. Two good practice recommendations have been made that all prescribed creams are signed when administered to ensure that a clear audit trail of administration is maintained. The staff toilet flooring is in need of repair and is recommended to be replaced to ensure that there is no risk of cross infection 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 DS0000039965.V372914.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 The Bungalow DS0000039965.V372914.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 5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. An updated Statement of Purpose and Service User Guide is available to provide details for any prospective person using the service. People are supported to ‘test run’ the home prior to admission. Each person has a contract which details the terms and conditions of residency. EVIDENCE: There have not been any new admissions to the home since the last key inspection. The manager described the admission process. She described comprehensive information about the person being received and visits made to the person and by the person to the home before admission to ‘test run ‘ the service to see if they liked it. We looked at three care records. These included a comprehensive service user’s guide. The homes AQAA (Annual Quality Assurance Audit ) told us that they have developed the Statement of Purpose and Service User Guide in pictorial format. This has been made available in both large print and TC (Total Communication ) format, this was seen both in the persons care plan and in each bedroom. The Bungalow DS0000039965.V372914.R01.S.doc Version 5.2 Page 10 Each person has a contract which outlines and details the terms and conditions of residency, this includes current fee scales. The Bungalow DS0000039965.V372914.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 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People using the service are supported by staff in making decisions, activities and developing independent life skills. Appropriate risk taking is promoted, and risk assessments are regularly reviewed and updated. All records are stored securely. EVIDENCE: Staff surveys of the people included “We the care plan asked if they were given up to date information about the needs they care for? All 4 surveys said always. Comments received are asked for input and information we feel is relevant to add to “. We looked at three care records of people using the service. Each person using the service has a detailed plan of care, this plan outlines any specific care needs. The care plans also contain risk assessments and any care plan resulting from that risk. Care records were well maintained and comprehensive The Bungalow DS0000039965.V372914.R01.S.doc Version 5.2 Page 12 and gave staff a clear and detailed plan of care. They also included health and social care input, proof of access to NHS services, health and social care monitoring tools, the persons preferences with regards to their care and activities, contact with relatives and friends, daily records, monthly summaries, review notes and cash records. Daily progress sheet details activities undertaken, nutrition, moods and behaviour, time up and dressed and returning to bed, GP visits and body mapping as required. The care plans were formally reviewed with the social worker and relatives once a year and an ongoing monthly review and summary by staff was also evident. He homes AQAA states that ‘The Care Plan is made available in a accessible format, with the involvement and inclusion of the service user, family/friends/advocate and/or relevant agencies’. The home has accessed several advocacy agencies to support people to make independent decisions. The homes equal rights policy is displayed in the hallway in TC format. Staff were observed encouraging people to make decisions and one visitor explained that staff support their relative to choose their own clothes when shopping. People were seen to be supported to choose what to eat at lunchtime and what activities to undertake that day. The registered manager told us “Each resident is valued as unique and treated as an individual and not part of the group”. Also that “All residents are encouraged to participate in cultural and spiritual expression e.g. Christmas, Easter, birthdays by participating in creative work and events. The support team along with family and friends help identify chosen beliefs, likes and dislikes” The manager explained that the home does not currently employ any male staff but male carers and contacts are available to support individual staff members with any care preferences. People’s records were stored with other important records in the home’s office in line with the Data Protection Act. Individuals need assistance to manage their personal finances and appropriate records are kept of staff and family involvement. Financial records were seen with receipts and all transactions are audited monthly with money being stored in locked individual tins. The Bungalow DS0000039965.V372914.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. Residents are able to take part in age, peer and culturally appropriate activities, and residents use the local community. Appropriate personal and family relationships are promoted. Residents are treated with dignity and respect. A healthy diet is promoted. EVIDENCE: One staff survey said that “Specific activities have been sourced to meet individual needs” and “We always strive to introduce new experiences and activities and can always improve in this area” Another staff told us “All care is individual, communication is really good within the home with TC (Total Communication) boards, menu boards and service users have a right to choose “. Another said that the home “Fosters diversity” The Bungalow DS0000039965.V372914.R01.S.doc Version 5.2 Page 14 Each persons care plan identified their preferences and choices of activities and there were records of each daily activities and the level of participation and enjoyment. Each person’s room has a notice board and pictures are used to provide information about which staff are on duty, activities planned and any other relevant information. Each room also contains easy read formats of the homes complaints procedures and statement of purpose and service user guide. There is also a book containing the person’s choice of activities, hopes and aspirations. The homes AQAA states that they ‘Provide Individual Activity and care plans. Facilitate attendance at external learning opportunities, access to behaviour therapist, enable service users to experience a wide range of leisure activities, support to continue with existing activities, staff support to explore employment opportunities.’ All people using the service are supported with contact with families and friends and some people regularly go home for periods of time. Families are welcome to call into the home unannounced and people are supported to maintain telephone written contact. On the day of inspection two people were out of the home on a trip. One person had chosen to remain in their room and two people were observed moving around the home. People at the home were seen to enjoy one to one contact with staff and two people were observed using the sensory room to relax. In the afternoon another person went out with a family member and staff took a person into the town for shopping and a snack. There were pictures throughout the home of activities undertaken and included themed days and activities in the community and with other homes of the company group. The activity planned for the day was beauty treatments- foot massage. We were also told that staff assist people to do a health walk around Chard reservoir every two weeks, swimming on a Thursday and also a cooking session each Thursday. Sometimes people using the service go out for the evening, visiting other company homes to attend discos and parties. Earlier this year two people were supported to go on holiday abroad and two people were supported to holiday in England. There is some flexibility around meals and mealtimes to fit in with activities. On the day of inspection breakfast was a selection of cereals, toast, hot and cold drinks and fresh fruit. Lunch was a cooked meal of pasta bake with yogurt and fruit for desert. There was a planned lighter snack in the evening. A healthy diet is promoted and monitoring of weight is maintained. The meal observed was balanced, well presented and served with appropriate staff support. The atmosphere was relaxed and the dining room was laid to support the people using the service. The Bungalow DS0000039965.V372914.R01.S.doc Version 5.2 Page 15 It was observed that a number of variations were observed to cater for each person’s dietary need and preferences, this included staff being inventive to support people to eat, this included picnic meals in house. The Bungalow DS0000039965.V372914.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each person receives personal support as they require, clear and detailed records are maintained. All areas of physical and emotional need are assessed and a care plan is in place to ensure staff can meet those needs. Clear systems are in place to ensure that medication is safely managed and administered. EVIDENCE: The Bungalow DS0000039965.V372914.R01.S.doc Version 5.2 Page 17 Each care plan provides clear information and guidelines about personal care routines including risk assessments were identified. There is evidence of care planning for short-term illness and monitoring of any injury. Body mapping is used and records maintained for all wounds. Staff observed were clearly aware of the preferences of the person with their care needs. Staff spoken with demonstrated a good understanding of peoples needs. Staff told us that to help communication “We make constant use of our communication books as well as the usual meetings etc” 2 surveys were received from visiting health professionals to the home. They were positive about the home. One staff survey told us “Individual support plans reflect the importance of each individual having their own room and bathroom.” People using the service access local GP’s and district nurse teams, there are regular visits to the dentist, optician and chiropodist. All staff have had training in the care of medicines by the local pharmacist and there are six monthly in house assessments to ensure competence. No people using the service are currently managing their own medication. Medication is appropriately stored and managed and a monitored dosage system in use. There are clear protocols in place for staff to follow when giving PRN medication and staff have received training for specific medication administration. Staff also said “Trained senior support staff ensure that service users receive medication as directed by their GP”. The management of medications was very well organised and monitored however, the registered manager is recommended to ensure that all prescribed creams are recorded when administered to ensure a clear audit trail of administration. The Bungalow DS0000039965.V372914.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 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People have access to the homes complaints procedure in easy read format. Policies, procedures and staff training are in place to protect residents form abuse. Staff confirmed that they were aware of whistle blowing procedures and of their role in protecting people using the service from abuse. EVIDENCE: All 4 staff surveys knew what do if a concern was raised. One said that the home has a “We have a ‘if I am worried procedure’ which is available to all “. There is a complaints policy and procedure in the policy manual for staff. No complaints have been recorded at the home since the last inspection and CSCI have not received any complaints about this service. People using the service have a copy of the complaints procedure in their room in easy read format and a further copy is displayed in the hallway. The homes AQAA told us that ‘All service users and their families are provided with an accessable version of letting us know what you think policy and service users are each provided with help cards. Provision of an accessable version of POVA policy. Copy of local authority POVA policy in each home.’ The home has a whistle blowing and an abuse policy; staff receive training in abuse awareness as part of the induction process and have regular updates. The Bungalow DS0000039965.V372914.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 25 26 27 28 29 30Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Bungalow provides a homely, comfortable and safe environment. It is decorated and maintained to a good standard. The facilities in the house are in keeping with the homes philosophy of supporting people in an ordinary domestic accommodation. EVIDENCE: All bedrooms, communal areas and the kitchen were visited during the inspection. The living room and conservatory are very pleasant and comfortable. There is a sensory room accessed from the dining room. All bedrooms were spacious, comfortable, well decorated and furnished. Personal audiovisual equipment and many other personal individual touches made each room completely different according to each person’s taste. Bedrooms and en-suites had adaptations to meet the mobility needs of their occupants. Hoists and other moving and handling equipment was available. The Bungalow DS0000039965.V372914.R01.S.doc Version 5.2 Page 20 The kitchen was well organised and the home was maintained in a clean condition throughout. Protective equipment and materials were observed for the control of spread of infection. All furnishings and fittings appear to be well maintained and of a good quality. The staff toilet flooring is in need of repair and is recommended to be replaced to ensure that there is no risk of cross infection. Staff maintain the home to a good hygiene standard. Food hygiene and infection control training has been provided for staff. Hazardous substances are safely locked away and COSHH sheets are in use for all relevant substances. There is no smoking in the house . The outdoor space of the home is tidy and well maintained with seating and tables. The Bungalow DS0000039965.V372914.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): 31 32 33 34 35 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a consistent staff team in appropriate numbers who know the people using the service well. Staff are well trained and appropriately supported. The recruitment procedures are robust and protect people using the service from the risk of harm. EVIDENCE: Staff surveys asked if there was enough staff to meet the individual needs of people using the service? 2 said always and 2 said usually. On the day of inspection two staff members were on duty throughout the day and two more staff were on duty but escorting people on trips. The manager attended the home for the inspection. There is usually four staff throughout the day but have a slightly staggered start in the morning. There are two waking staff on duty overnight. Staff felt that the level of staffing was adequate and said the levels were based on the dependency and numbers of people using the service. Staff turnover is low and the home does not use agency staff and relies on its own staff to cover shifts. The Bungalow DS0000039965.V372914.R01.S.doc Version 5.2 Page 22 The inspector spoke with staff on duty. They showed a good knowledge of operations in the home, of their role and that of others. Each person has a shared key worker with whom they meet regularly on a one to one basis. Staff surveys were asked if induction covered everything they needed in their job? 3 said very well and 1 said mostly. The induction program is based on the Skills for Care Common Induction Standards. All 4 staff surveys felt that were receiving enough training and one staff member commented “I have attended many courses over the years covering all aspects” Another said, “Training helps to gain more knowledge in areas to support the residents” Staff training is ongoing in all mandatory areas and all staff apart from new staff have successfully completed an NVQ in care. There is a clear staff-training matrix that enables the managers to identify any staff whose training is out of date. There is also a clear staff supervision and appraisal program to support the development of good practice. Recruitment procedures are robust and all staff have CRB (Criminal Record Bureau) and POVA (Protection of Vulnerable Adults) checks prior to commencing employment. Not all records were available as they are maintained at a head office. There was a record of when all the documents had been received and the manager confirmed that she has access to all recruitment checks prior to staff commencing employment. The Bungalow DS0000039965.V372914.R01.S.doc Version 5.2 Page 23 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 40 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Registered Managers continue to provide effective leadership to the staff team. The home is well organised and people using the service views play an important part in the development of daily life. The health, safety and welfare of residents is promoted and protected. EVIDENCE: The Registered Managers are Mrs Susan Perry and Mrs Emma Lewes, who job share the role. They work 3 days each and provide on call support out of hours. Staff indicated that they benefited from the managers’ positive leadership and that there was an effective and mutually supportive team ethos. One staff The Bungalow DS0000039965.V372914.R01.S.doc Version 5.2 Page 24 commented “The managers are very approachable and very supportive, I have every confidence in them “ Regulation 26 visits are completed each month and the company undertakes an annual audit to review the quality of the service provided. One staff told us that the home “Is always looking to do better” Health and safety records inspected included the fire log, servicing and checking of fire equipment and systems, of gas and electricity, of portable electrical equipment, of mobile equipment (including transport) for compliance with LOLER and of water safety checks. All records seen were well organised and up-to-date. There is an annual training plan for staff that covers H&S updates including fire training and moving and handling training. Working practices in the home are safe and accidents are monitored to promote prevention, there is evidenced by good monitoring and record keeping systems. Record keeping is of a consistently high standard. Records are kept securely and staff are aware of the requirements of the Data Protection Act The home maintains a supervision matrix, which showed that all staff receives supervision up to six times each year. This included one to one meetings and group meetings. Staff were asked if the manager met with them to give support and discuss how they were working? All 4 said regularly and another said, “We have supervisions regularly, team meetings and yearly appraisals”. The Bungalow DS0000039965.V372914.R01.S.doc Version 5.2 Page 25 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 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 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 3 4 3 3 3 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 4 3 3 X 3 X 3 3 X 3 x The Bungalow DS0000039965.V372914.R01.S.doc Version 5.2 Page 26 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA20 YA30 Good Practice Recommendations The registered manager is recommended to ensure that all prescribed creams are recorded when administered to ensure a clear audit trail of administration. The staff toilet flooring is in need of repair and is recommended to be replaced to ensure that there is no risk of cross infection The Bungalow DS0000039965.V372914.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Bungalow DS0000039965.V372914.R01.S.doc Version 5.2 Page 28 - 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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