Care Home: The Homestead

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What the care home does well People and their representatives have information, including trial visits to the home in order that they can make an informed choice about moving to the home. People`s needs are clearly set out in their care/person centred plans. Monitoring of risk assessments is maintained to ensure the safety of people in the home. Individuals are encouraged to make decisions about their lives both inside and outside of the home. The available choice of food provided was considered a good standard. The home has consistent recording and documentation to evidence that individuals receive personal care and attend health care appointments to ensure their wellbeing and welfare. The home`s medication procedures are robust to ensure the safety and wellbeing of individuals. The home has a robust complaints procedure to demonstrate that complaints will be acted upon and a Safeguarding Adults (Adult Protection) policy and procedure to ensure that individuals are adequately protected by the same policy and procedure. The premises and arrangements for hygiene are good enabling people to live in a homely, clean, hygienic and comfortable environment. The home offer an induction and training development programme to ensure that staff are competent to support the needs of the individuals. Robust staff recruitment practices have been maintained to ensure the protection of individuals. The overall management of the home is robust and individuals and their representative`s views are considered. Health and safety arrangements are in place to ensure the safety and welfare of all people in the home. What has improved since the last inspection? The AQAA advises that the home has made a concerted effort to eradicate any institutional practices in the home for example individuals will be supported to use community based GP practices, dental practices and opticians instead of home visits.The home has maintained the development of person centred planning and has improved the communication profiles of individuals in order that their specific ways of communicating are understood by people in their lives. A more flexible approach in the way individuals are supported for example getting up, when to eat and day service attendance has been developed and this was observed by the inspector during the inspection and also by reading peoples daily notes. The homes staff have increased the opportunities for a more individualised range of in house and community based activities and introduced snacks boxes for all individuals to ensure that snacks of their choice are available at all times. What the care home could do better: It has been recommended that the risk assessments are more fully detailed to specifically state why bedroom doors have been locked in order to ensure that the home is not seen to be restricting individuals freedom or causing harm or distress to the individual. It has been recommended that the home introduce more pictures regarding supporting people with choosing their meals in order to maintain peoples interest in making their choices. It is recommended that the monitoring and recording of individual`s behaviours that test the service be strengthened. It has been recommended that the home develop a written assessment of the potential first aid needs and risks associated to the resident group in order to ascertain if all staff should undertake first aid training or an appointed person may suffice within the home on each shift. Reference to the Management of Health and Safety at Work Regulations 1999 guidance may be of assistance. CARE HOME ADULTS 18-65 Homestead (The) (Sidlow) The Homestead Reigate Road Lower Duxhurst Sidlow Surrey RH2 8QH Lead Inspector Suzanne Magnier Unannounced Inspection 7 January 2008 11:00 th Homestead (The) (Sidlow) DS0000013680.V356059.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 Homestead (The) (Sidlow) DS0000013680.V356059.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. Homestead (The) (Sidlow) DS0000013680.V356059.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Homestead (The) (Sidlow) Address 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) The Homestead Reigate Road Lower Duxhurst Sidlow Surrey RH2 8QH 01293 774740 01293 824152 Surrey and Borders Partnership NHS Trust To be confirmed Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (1), Sensory impairment (1) of places Homestead (The) (Sidlow) DS0000013680.V356059.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th January 2007 Brief Description of the Service: The Homestead, 17 Reigate Road is a home for 8 individuals with a learning disability in a rural area on the outskirts of Reigate and Redhill. The home is detached and set back from the main road (A217) and provides kitchen, dining area, living room, a conservatory and 9 single bedrooms. The enclosed garden is spacious, providing an area for dining outdoors. The home has a range of transport available and there is ample parking space to the front of the property. The charge for a single room is £69,978.00 per annum. There are no additional charges for basic care. Homestead (The) (Sidlow) DS0000013680.V356059.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. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the care home was an unannounced ‘Key Inspection’. Some additional standards were assessed and have been included within the report. Ms S Magnier, Regulation Inspector, carried out the inspection. The acting manager and deputy manager represented the home. For the purpose of the report the individuals using the service are referred to as people/residents living in the home. The inspector arrived at the service at 11.00 and was in the home for four hours. It was a thorough look at how well the home is doing. It took into account detailed information provided by the home and any information that CSCI has received about the service since the last inspection. The inspector spent time talking with and observing people living at the home in order to seek their views about the home and the care they receive. No responses to questionnaires that the Commission had sent out had been received prior to the inspection and the completion of the report. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. Documents sampled during the inspection included the home’s Statement of Purpose and Service User Guide, care plans, person centred plans, daily records and risk assessments, medication procedures, a variety of training records, staff recruitment files, menus, the homes complaints procedures and procedures for protecting people from abuse, and several of the services policies and procedures. Following the previous key inspection in January 2007 the service has met all the requirements made. The home had submitted the Annual Quality Assurance Assessment (AQAA) on the day of writing the report, some details of which have been added to the report. From the evidence seen by the inspector it is considered that the home would be able to provide a service to meet the needs of individuals who have diverse religious, racial or cultural needs. No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection. Homestead (The) (Sidlow) DS0000013680.V356059.R01.S.doc Version 5.2 Page 6 The inspector would like to thank the people living in the home, the staff and the managers for their time, assistance and hospitality during this inspection. What the service does well: What has improved since the last inspection? The AQAA advises that the home has made a concerted effort to eradicate any institutional practices in the home for example individuals will be supported to use community based GP practices, dental practices and opticians instead of home visits. Homestead (The) (Sidlow) DS0000013680.V356059.R01.S.doc Version 5.2 Page 7 The home has maintained the development of person centred planning and has improved the communication profiles of individuals in order that their specific ways of communicating are understood by people in their lives. A more flexible approach in the way individuals are supported for example getting up, when to eat and day service attendance has been developed and this was observed by the inspector during the inspection and also by reading peoples daily notes. The homes staff have increased the opportunities for a more individualised range of in house and community based activities and introduced snacks boxes for all individuals to ensure that snacks of their choice are available at all times. 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. Homestead (The) (Sidlow) DS0000013680.V356059.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 Homestead (The) (Sidlow) DS0000013680.V356059.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): 1, 2, 3, 4, 5. People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. People and their representatives have information, including trial visits to the home in order that they can make an informed choice about moving to the home. The home’s admission and assessment procedures ensure that individual’s needs are appropriately identified and met. EVIDENCE: The home has a statement of purpose and service user guide. Both documents were sampled by the inspector and were well written, contained pictorial forms and symbols, and were interesting and engaging to assist people to make a choice if they wanted to live in the home. It was noted that some residents in the home did not use formal speech to communicate and the inspector relied on observation throughout the inspection to determine how individuals responded to their homes environment. The home has had no admissions since the previous inspection. The inspector discussed the admission procedures of the home with the deputy manager who confirmed that a full assessment would be undertaken prior to individuals Homestead (The) (Sidlow) DS0000013680.V356059.R01.S.doc Version 5.2 Page 10 moving into the home with additional information being sought from the persons care manager or relevant others. The deputy manager demonstrated that she was knowledgeable regarding the criteria and the importance of individuals needs assessment in order to ensure that the home could meet the needs and aspirations of the individual. The inspector noted that the home have tenancy agreements for people in the home which detailed what the service offered and was informative regarding costs of services. The home has maintained close bonds between people living in the home and staff and it is apparent through observation that the individuals diversity of needs and preferences of lifestyles are promoted to ensure that all people continue to have a sense and awareness of their individuality. Homestead (The) (Sidlow) DS0000013680.V356059.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. People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. People’s needs are clearly set out in their care/person centred plans. Monitoring of risk assessments is maintained to ensure the safety of people in the home. Individuals are encouraged to make decisions about their lives both inside and outside of the home. EVIDENCE: The home has maintained a good standard of care/person centred plans. The inspector sampled three care plans and noted that the format of the plans was engaging and interesting and contained some evidence that each person, where able, had been involved in some way with the development of their plan. Each plan contained clear documentation of how the person liked to be addressed, their preferred way to communicate, people that were important in their life, their likes and dislikes, if they preferred to be supported by male or Homestead (The) (Sidlow) DS0000013680.V356059.R01.S.doc Version 5.2 Page 12 female staff, how they liked and chose to receive support and personal care, how staff could support them with difficulties in their lives, and the individuals ethnic and cultural background. It was noted that the home offers support to individuals with a range of complex needs and this diversity was well managed by the home. The care plans contained well-documented clear agreed working practice which staff implemented to offer a consistent and predictable response to the needs of people in the home. Within the person centred plans the inspector-sampled details of people’s family and friends in the form of a document called ‘ circle of friends’. Special events and occasions, holiday memories and the individual’s aspirations were also noted. The inspector observed that some people with sensory impairment were provided with books and other objects to feel and touch which contained different textures to offer a stimulating experience to the individual. It was also noted that each care plan had been kept under review to reflect the changing needs of the individual and arrangements in place to continue to support the person through the home’s key working practice. Six people were at home during the inspection and the inspector noted that all the individuals were at ease and able to move freely around the communal areas of the home and spend time in their bedrooms if they chose to with staff supervision. The atmosphere in the home was calm and orderly and staff undertook their tasks in an efficient and calm manner, which supported the calming atmosphere in the home. There was evidence to support that residents meetings are held and the views and opinions of individuals sought about their home and what they would like. During the inspection it was noted that people, where able are encouraged to be involved in the running of the home. The inspector observed one individual clearing the dining tables following lunch and loading the dishwasher with the crockery. The home has maintained robust risk assessments, which include a variety of activities undertaken by individuals. The assessments sampled had been appropriately reviewed and signed by staff to ensure the safety and welfare of the individuals and staff. Homestead (The) (Sidlow) DS0000013680.V356059.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, 14, 15, 16, 17. People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. The home promotes and maintains peoples involvement in their community, offers opportunities for personal development, appropriate activities and maintaining friendships. Individuals are encouraged to be involved in the running of the home as much as possible and improving daily living skills. The available choice of food provided was considered a good standard. EVIDENCE: Whilst sampling the care/person centred plans it was noted that all individuals at the home were encouraged by staff to lead purposeful and meaningful lives and take part in social activities. The activities which people undertake included having barbeques, visiting places of interest, going to the coast/seaside, going on shopping trips, doing Homestead (The) (Sidlow) DS0000013680.V356059.R01.S.doc Version 5.2 Page 14 personal laundry, attending day services and clubs, going on holidays, going to the pub/restaurants and attending local day services, reading and looking at books and magazines. The care plans samped indicated that reviews of people’s day service participation takes place in order to ensure that the service still meets the individuals needs and choice. The AQAA advises that where individuals are encouraged to participate in new activities risk assessments are completed regarding the activity in order to ensure the safety and well being of the individual as far as possible. The home has there own vehicle and the inspector heard staff offering people the opportunity to go out in the vehicle following lunch for a drive and also to transport others to various planned activities. The managers told the inspector that the home encourages people’s family and friends to maintain links with the home. The AQAA advises that the home are aware of the changing needs and circumstances of some peoples relatives and consultation is being arranged as how people would prefer to keep in contact with the home for example writing letters. The home are aware that they can seek to engage external advocacy for individuals should the need arise. The managers explained that no individuals at the home have shown an interest in religious observances although staff would be supportive to individuals should they wish to attend any religious ceremonies or establishments. During the tour of the premises the inspector noted that individuals bedroom doors were locked apart from one person who had their own key. When asked about this the deputy manager explained that bedroom doors were locked in order to ensure the safety and well being of the residents. Specific examples were given and the inspector was advised that all staff have keys to each bedroom door in order to support people to their rooms should they choose to go into them. The inspector sampled some individuals risk assessments regarding behaviours that tested the service which were linked to the need for bedroom doors to be locked. It has been recommended as best practice that the risk assessments are more fully detailed to specifically state why bedroom doors have been locked in order to ensure that the home is not seen to be restricting individuals freedom or causing harm or distress to the individual. The inspector observed that the home’s dining area which was spacious and airy and contained suitable furniture to support people to eat their meals in a comfortable setting. Fresh fruit and vegetables were available to individuals and the cupboards, fridge and freezer were well stocked and food stored in compliance with food hygiene regulations. The inspector sampled the home’s menus and noted that they offered a variety of meals, which were considered nutritious. The deputy manager advised that Homestead (The) (Sidlow) DS0000013680.V356059.R01.S.doc Version 5.2 Page 15 all residents have choice and for those that are able they tell the staff what they would like to be included on the menu. For others the staff are aware of what the individuals prefer and are observant to offering choice and these choices are documented within individuals care plans. It has been recommended that the home introduce more pictures regarding supporting people with choosing their meals in order to maintain peoples interest in making their choices. The AQAA advises that the staff have introduced snacks boxes for each individual to ensure they have a supply of snacks of their choice available at all times as this has also helped to support individuals whose behaviour may test the service. The inspector noted during the inspection that one person indicated by using sign language that they were thirsty and staff recognised and acted promptly to offer the individual a drink, which averted any distressed behaviour. Homestead (The) (Sidlow) DS0000013680.V356059.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. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has consistent recording and documentation to evidence that individuals receive personal care and attend health care appointments to ensure their wellbeing and welfare. It is recommended that the monitoring and recording of individuals’ behaviours that test the service be strengthened. The home’s medication procedures are robust to ensure the safety and wellbeing of individuals. EVIDENCE: The AQAA advises that the home has made a concerted effort to eradicate any institutional practices in the home for example individuals will be supported to use community based GP practices, dental practices and opticians instead of home visits. The three care plans sampled included clear records to demonstrate that the individuals receive personal care in the way they prefer and health care Homestead (The) (Sidlow) DS0000013680.V356059.R01.S.doc Version 5.2 Page 17 appointments were attended. All individuals at home during the inspection were observed to be well dressed and groomed. Health care records to monitor individuals specific health care concerns were well documented and health care records evidenced that the home had close working relationships with specialised health care professionals including dieticians, speech and language therapists and continence management advisors. Records indicated that care plan reviews had taken place in order to ensure that the home continues to meet the changing needs of individuals. The home offer complimentary therapies which included aromatherapy, records indicated that in general individuals were content to receive the therapy which was delivered at their pace. There was clear evidence, by written guidelines, that staff supported individuals in a predicable and consistent manner in order to reduce any individual’s behaviours that tested the service. Individual’s daily records were sampled and were well documented to reflect the lifestyle and care provided to individuals throughout a 24-hour period. Whilst sampling records it was noted that there were occurrences when an individual would hit other people in the home and these issues were discussed with the deputy manager who advised that the occurrences had lessened and specialised support had been sought previously to reduce the behaviour. It has been recommended that the home consider using a monitoring tool for example an ABC chart to try to further understand the triggers, which precede the individual hitting other vulnerable people living in the home. Records indicated that the home reports such incidences to the individuals care managers and the commission. The AQAA advises that the home ensure that all people living in the home are treated as individuals and that they are respected at all times. The home have planned an annual diversity week to promote and raise awareness of diversity and disability issues and during the week staff will be organising a variety of activities to promote different cultures and beliefs. The home has a comprehensive, medication policy and procedure regarding administration of medication. The medication is stored in a locked cabinet in the home in order to protect people from harm. The inspector sampled two medication administration charts, which detailed clear records of safe administration of medicines. Staff records demonstrated that they had received training in the administration of medicines. There were clear written staff protocols for the administration of ‘as required’ medications in order to protect the individuals from abuse or harm. Homestead (The) (Sidlow) DS0000013680.V356059.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. People who use the service experience good quality outcomes in this area. This judgement has been made a range of evidence including a visit to this service. The home has a robust complaints procedure to demonstrate that complaints will be acted upon and a Safeguarding Adults (Adult Protection) policy and procedure to ensure that individuals are adequately protected by the same policy and procedure. EVIDENCE: The home has a complaints procedure and the deputy manager explained that no complaints had been received by the home. The home has been subject to one safeguarding referrals since the previous inspection which has now been closed. Surrey and Borders Partnership NHS Trust have one ongoing internal investigation, which the acting manger advised would hopefully be concluded by the end of January 2008. The manager explained that staff had received training in safeguarding vulnerable adults and awareness of safeguarding issues was also explained in the staff induction training. The inspector, to verify this information, sampled training plans. The home also has a whistle blowing policy, which was sampled by the inspector. Throughout the home the inspector observed several documents relating to staff awareness of detecting and responding to abuse. The homes manager explained that a copy of the Surrey Multi agency safeguarding protocols were not in the home during the inspection as they had been taken to another home but would be brought back to the service the following day. Homestead (The) (Sidlow) DS0000013680.V356059.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, 30. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The premises and arrangements for hygiene are good enabling people to live in a homely, clean, hygienic and comfortable environment. EVIDENCE: On the day of the inspection the home was clean, well ventilated and free from offensive odours. Observations confirmed the home had a good standard of décor with good quality furniture and fittings. One individual showed the inspector their bedroom, which was well decorated and contained an assortment of personal belongings, appropriate furnishings and was observed to be their own private space. The home had a policy on infection control and adequate laundry facilities. Hand washing facilities were prominently sited in the home and staff practiced infection control measures by washing their hands regularly to prevent the spread of infection. Homestead (The) (Sidlow) DS0000013680.V356059.R01.S.doc Version 5.2 Page 20 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. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home offer an induction and training development programme to ensure that staff are competent to support the needs of the individuals. It has been recommended that the home develop a written assessment of the potential first aid needs and risks associated to the resident group to ascertain if all staff should undertake first aid training. Robust staff recruitment practices have been maintained to ensure the protection of individuals. EVIDENCE: The staff team of ten is multi cultural. There is a mixed gender consisting of five male staff that generally attend to the male residents living in the home. The inspector was advised that the home have a registered nurse on duty at all times and currently has seven full time carer vacancies. The acting manager advised that despite advertising last year no applicants were recruited to the home. The home use the services of a local agency and the inspector sampled agency staff files to indicate that they had received appropriate training and had been fully vetted prior to working in the home with vulnerable people. The Homestead (The) (Sidlow) DS0000013680.V356059.R01.S.doc Version 5.2 Page 21 agency staff members are employed at the home on a regular basis to offer continuity and care for individuals. Four staff files were sampled and the standard of record management was appropriate for the safe vetting of individuals to work with vulnerable people. The staff files contained application forms, which had been fully completed, CRB checks had been obtained, suitable references had been sought and faceto-face interviews had been conducted and specific jobs descriptions were in place. The managers explained the process of the recruitment/selection, induction and training that staff undertake in order to ensure that the individuals living in the home are protected and supported by appropriately trained staff. Records sampled by the inspector indicated that some staff had completed training for first aid, safeguarding vulnerable adults, moving and handling, food hygiene, fire safety and safe administration of medication. It has been recommended that the home develop a written assessment of the potential first aid needs and risks associated to the resident group in order to ascertain if all staff should undertake first aid training or an appointed person may suffice within the home on each shift. Reference to the Management of Health and Safety at Work Regulations 1999 guidance may be of assistance. Additional specialised training had also been undertaken by some staff to support individuals in their care. The AQAA advises that 45 of the staff team have achieved their National Vocational Qualification (NVQ) Level 2 trained with 2 staff awaiting to start the award. Homestead (The) (Sidlow) DS0000013680.V356059.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The overall management of the home is robust and individuals and their representative’s views are considered. Health and safety arrangements are in place to ensure the safety and welfare of all people in the home. EVIDENCE: The acting manager advised that the homes registered manager had left the service in September 2007 to undertake a training programme. The current arrangements for the management of the home were temporary until the organisation has undertaken the recruitment of a permanent manager. The current acting manager is a registered manager at another Surrey and Border NHS Trust registered service and is currently working over the two Homestead (The) (Sidlow) DS0000013680.V356059.R01.S.doc Version 5.2 Page 23 services. The CSCI must be informed in writing of the current and future arrangements regarding the management of home. During the course of the inspection the inspector noted that the pace of the home was designed to meet the needs of the people living in the home. It was evident through observation that the managers had good knowledge about managing the care home and had the skills and experience to ensure the safety and well being of all persons in the home and provided a consistent, effective and happy atmosphere for people living in the home. It was evident that some individuals were encouraged and able to voice their opinions about the service and attend home meetings if they chose to. The home has a quality assurance process, which actively seeks the views of all people connected to the home. The inspector sampled a variety of health and safety records, which included water, fridge and freezer temperatures, cooked food temperatures, accident and incident records, gas and electric safety certificates, fire drills, practices and noted that the fire extinguishers had been serviced. The inspector sampled three individual’s financial records and cash tins which are held securely within the home. The records sampled were well-recorded and accurate with receipts for expenditure available. Homestead (The) (Sidlow) DS0000013680.V356059.R01.S.doc Version 5.2 Page 24 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 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 2 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 3 X 3 X X 3 X Homestead (The) (Sidlow) DS0000013680.V356059.R01.S.doc Version 5.2 Page 25 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 YA16 Good Practice Recommendations It has been recommended that the risk assessments are more fully detailed to specifically state why bedroom doors have been locked in order to ensure that the home is not seen to be restricting individuals freedom or causing harm or distress to the individual. It has been recommended that the home introduce more pictures regarding supporting people with choosing their meals in order to maintain peoples interest in making their choices. It has been recommended that the home consider using a monitoring tool for example an ABC chart to try to further understand the triggers, which precede the individual hitting other vulnerable people living in the home. It has been recommended that the home develop a written assessment of the potential first aid needs and risks associated to the resident group in order to ascertain if all DS0000013680.V356059.R01.S.doc Version 5.2 Page 26 2 YA17 3 YA19 4 YA35 Homestead (The) (Sidlow) staff should undertake first aid training or an appointed person may suffice within the home on each shift. Reference to the Management of Health and Safety at Work Regulations 1999 guidance may be of assistance. Homestead (The) (Sidlow) DS0000013680.V356059.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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 Homestead (The) (Sidlow) DS0000013680.V356059.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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