Care Home: The Spinney

Similar services:

• 2 Perhaver Park
• The Vicarage
• 7 Hyde Road
• St George`s
• 5 Seafield Road
• Radfords
• Trevaylor Manor

What the care home does well Feedback from agencies involved with people living at the Spinney was positive. One professional from the specialist Learning disability service said they were particularly impressed with how they had supported one person to move from a placement that had broken down and had put together a good transition plan to help them settle quickly into their new environment. The Spinney provides a good standard of accommodation that is well suited to the people that live there. The accommodation is attractive, spacious and bright. Furniture and fittings are of a good robust standard. People moving to the Spinney are assessed and their needs are known to staff before a move takes place. Staff treat people with respect and make every effort to understand the way they communicate. They use this knowledge to encourage choice and independence when possible. People using the service are offered a good range of appropriate activities both in the home and the community. Every effort is made to them to visit and maintain links with family and friends. Good records are kept of residents health needs. Staff ensure that personal care is delivered in a way that meets individual needs and preferences as well as respecting peoples rights and privacy at all times. People have access to all NHS healthcare facilities in the local community. Regular appointments are seen as important and systems are in place to ensure they are not missed. The home arranges for health professionals and other specialist services to visit the home and provide advice when necessary. Staff members are very alert to changes in mood, behaviour and general well being of residents and understand how they should respond and take action. Staff feel there is an open culture and where they have concerns that they are able to approach the manager. All the questionnaires returned by staff stated that they have a good induction, opportunities for on-going training and good support from the manager and their colleagues. What has improved since the last inspection? The manager has met with all the staff to ensure that they have access to and understand the guidelines for managing episodes of challenging behaviour. The records for detailing incidents of behaviour have been developed to ensure that they provide sufficient information so that behaviour can be monitored, analysed and referred to other agencies when required. Staff have attended training in Challenging Behaviour and breakaway training. The staff training programme also included arrangements for all staff to undertake training in Adult Protection. The home is in the process of reviewing the way they manage medication in the home to ensure that the practices are safe and in line with good practice and current legislation.The dining room has been painted and plans are place to replace the carpet in this area of the house. The manager has developed the format for staff supervision to ensure that staff have the opportunity to raise any concerns and document issues relating to personal development and training. CARE HOME ADULTS 18-65 The Spinney The Spinney Tavistock Road Roborough Plymouth Devon PL6 7BD Lead Inspector Wendy Baines 15 th/16th Unannounced Inspection January 2008 10:00 The Spinney DS0000047871.V349255.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 Spinney DS0000047871.V349255.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 Spinney DS0000047871.V349255.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Spinney 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 Spinney Tavistock Road Roborough Plymouth Devon PL6 7BD 01752 695537 Quality Lifestyle Limited Mr Trevor Kendall Mr Shaun Drury Care Home 4 Category(ies) of Learning disability (4), Physical disability (4) registration, with number of places The Spinney DS0000047871.V349255.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: The Spinney was registered as a care home in February 2004. The home offers care to four service users who have learning disabilities who may also have physical disabilities, and behaviour that challenges services. The home has two downstairs bedrooms that are adapted to meet the needs of physically disabled service users, and two upstairs bedrooms. The property is a detached modern house that has been refurbished to a high standard, and is set in a semi-rural situation near the village of Bickleigh that has shops, a post office and a bus route to Plymouth. The home has its own transport, and has a pleasant garden. There is 24 hour staffing including waking night staff. There is a Statement of Purpose and Service Users Guide, these are available in the office. The home charges between £2,300 and £2,600 per week, the fee does not include the cost of toiletries or clothes. The Spinney DS0000047871.V349255.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is a summary of a cycle of Inspection activity at The Spinney since the last inspection visit. To help CSCI make decisions about the home the Provider gave us information in writing about how the home is run; any documents submitted since the last inspection were examined along with the records of what was found at the last visit; two site visits totaling 8 hours were carried out with no prior notice being given to the home as to the date and timing; discussions were held with the Registered manager and staff on duty; various records were sampled, such as care plans and risk assessments; questionnaires were sent to all of the staff team, the people who use the service and their families; a tour was made of the home and garden, time was spent with people using the service and the inspector was able to talk with, and observe the staff on duty. A sample group of people were selected and their experience of care was tracked through records and discussions with staff and management from the early days of their admission to the current date, looking at how well the home understands their needs and the opportunities and lifestyles they experience. Where possible time was then spent with these people, and feedback was sought from their care managers and other specialist services. This inspection approach hopes to gather as much information about what the experience of living at the home is really like, and to make sure that their views of the home forms the basis of this report. What the service does well: Feedback from agencies involved with people living at the Spinney was positive. One professional from the specialist Learning disability service said they were particularly impressed with how they had supported one person to move from a placement that had broken down and had put together a good transition plan to help them settle quickly into their new environment. The Spinney provides a good standard of accommodation that is well suited to the people that live there. The accommodation is attractive, spacious and bright. Furniture and fittings are of a good robust standard. The Spinney DS0000047871.V349255.R01.S.doc Version 5.2 Page 6 People moving to the Spinney are assessed and their needs are known to staff before a move takes place. Staff treat people with respect and make every effort to understand the way they communicate. They use this knowledge to encourage choice and independence when possible. People using the service are offered a good range of appropriate activities both in the home and the community. Every effort is made to them to visit and maintain links with family and friends. Good records are kept of residents health needs. Staff ensure that personal care is delivered in a way that meets individual needs and preferences as well as respecting peoples rights and privacy at all times. People have access to all NHS healthcare facilities in the local community. Regular appointments are seen as important and systems are in place to ensure they are not missed. The home arranges for health professionals and other specialist services to visit the home and provide advice when necessary. Staff members are very alert to changes in mood, behaviour and general well being of residents and understand how they should respond and take action. Staff feel there is an open culture and where they have concerns that they are able to approach the manager. All the questionnaires returned by staff stated that they have a good induction, opportunities for on-going training and good support from the manager and their colleagues. What has improved since the last inspection? The manager has met with all the staff to ensure that they have access to and understand the guidelines for managing episodes of challenging behaviour. The records for detailing incidents of behaviour have been developed to ensure that they provide sufficient information so that behaviour can be monitored, analysed and referred to other agencies when required. Staff have attended training in Challenging Behaviour and breakaway training. The staff training programme also included arrangements for all staff to undertake training in Adult Protection. The home is in the process of reviewing the way they manage medication in the home to ensure that the practices are safe and in line with good practice and current legislation. The Spinney DS0000047871.V349255.R01.S.doc Version 5.2 Page 7 The dining room has been painted and plans are place to replace the carpet in this area of the house. The manager has developed the format for staff supervision to ensure that staff have the opportunity to raise any concerns and document issues relating to personal development and training. 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 Spinney DS0000047871.V349255.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 Spinney DS0000047871.V349255.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): Quality in this outcome area is good. 1,2,3,4,5. This judgement has been made using available evidence including a visit to this service. The family and representatives of people moving into the home will be provided with information about the home and the services provided, however, this information is not currently provided in a format appropriate to the needs of the people who may be living in the home. All new residents have their needs assessed and visits arranged before moving in to the home. This process ensures that the placement is suitable and the individuals’ needs are going to be met. EVIDENCE: The manager has recently updated the information that is available about the home and the services provided. This is given to people who may be interested in moving to the home to enable them to make a decision about whether or not service can meet their needs. People using the service are very often not able to understand the written word therefore the home still needs to provide this information in a range of different formats so that they are available to use when somebody new moves into the home. The Spinney DS0000047871.V349255.R01.S.doc Version 5.2 Page 10 There have been no new admissions since the last inspection. The Inspector was able to spend some time with the manager discussing the process of admission when somebody new considers moving into the home. The manager said that they would visit the person and gather as much information about the individual and their needs. The home did not have a consistent format for documenting this pre-admission information. People are invited to visit the home prior to admission and have the opportunity to meet the other residents and the staff. Following completion of the pre-admission process the manager would write to everyone concerned to advise them of whether or not the home can meet the individuals needs. A transition plan and moving in date would then be agreed and the home would start to put together an initial care plan. The Inspector spoke to a representative from the specialist Learning Disability service who said that they had been very impressed with how the manager and staff at The Spinney had supported one person to move from a placement that had broken down, and had helped them to settle well into their new environment. Social Services contracts were available within all residents’ personal files. The Spinney DS0000047871.V349255.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): Quality in this outcome area is good. 6,7,8,9,10. This judgement has been made using available evidence including a visit to this service. The home has a clear and consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet peoples’ needs. The staff use their skills and knowledge to support people to make choices about their lifestyle and daily routines. The home encourages people to maintain an active and independent lifestyle whilst considering the individuals safety at all times. EVIDENCE: The Spinney DS0000047871.V349255.R01.S.doc Version 5.2 Page 12 The care records for all the people living in the home were looked at during the inspection. The records for two of the four people were looked at in more detail to determine the standard of the records and to support the inspector when making a judgement about the quality of the services provided. Each of the files included detailed information about each individuals daily care needs. Staff spoken to were able to give a clear account of this information and had a good understanding about how each person preferred to be supported with their daily routines. Most of the staff members who completed a questionnaire said that the information they needed to do their jobs well was easily accessible and written in away that was easy to understand. Care plans included guidelines for staff about dealing with episodes of difficult and challenging behaviour. Staff spoken to said that they were aware of these guidelines and had started to attend training relevant to this area of care. The manager said that since the last inspection he has met with each member of staff individually to ensure that everyone is familiar with agreed guidelines for managing challenging behaviour. The records for recording incidents of difficult behaviour have also been updated and for one resident a referral made to the Specialist Challenging Behaviour Team to support the home when recording and analysing this information. Throughout the inspection staff were supporting people to make choices about their daily routines. Staff demonstrated that they understood how each individual communicates and were able to use this knowledge and understanding to promote choice and independence whenever possible. The Inspector observed staff during the morning speaking gently and positively to residents about their plans for the day. Much of this discussion had to be repeated several times, however, staff were patient and gentle in their manner and refrained from doing tasks for the individual when they were aware that they were able to do it themselves. All of the residents living in the home require support to manage their personal finances. Some of the residents still have support from family and these arrangements were documented within care plans. A daily record is kept of each individual’s expenditure and facilities are available to store people’s money safely. The Manager said that he is still in the process of changing the arrangements for one person who has had their money held in an account that has been used for the running of the home. Two previous inspections have identified that this is not appropriate and does not ensure that the individuals’ money is adequately protected. The Spinney DS0000047871.V349255.R01.S.doc Version 5.2 Page 13 Risk assessments were available for all residents relating to activities inside and outside the home. These documents confirmed that the home supports people to maintain and develop their skills whilst recognising and minimising risks whenever possible. The inspector discussed with the manager the importance of ensuring that information recorded in the home about an individual is protected at all times. All of the records inspected were found to be well maintained and stored safely. The Spinney DS0000047871.V349255.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. 13,14,15,16,17. This judgement has been made using available evidence including a visit to this service. People who use the service are encouraged and supported to make choices about their lifestyle, and wherever possible to develop their skills. People are able to enjoy a full and stimulating lifestyle with a variety of leisure options available to them. The meals are balanced and nutritious and staff are sensitive to the needs of people who have special dietary requirements or need assistance with eating. EVIDENCE: All the people living at the Spinney have a daily plan of activities. All residents had been assessed as requiring 2:1 support when out and the manager said that the rota is organised so that everyone has the opportunity to go out each day. The Spinney DS0000047871.V349255.R01.S.doc Version 5.2 Page 15 Activities are decided dependent on the needs and preferences of each individual. The staff bring in brochures and photos of different activities and use past experiences as a way of planning the weekly events. Staff spoken to said that at times the plan has to be flexible to accommodate how an individual is feeling or if the outcome of a risk assessment concludes that an activity would not be safe or appropriate. On each of the days of the inspection residents went out individually with staff. One of the residents was happy to speak with the inspector and said that they are able to ‘do lots of things’ and enjoyed attending a regular pottery class. The care records for one resident detailed their love of walking. The staff spoken to were very aware of the residents enjoyment of this activity and said that they would go out for a walk every day. A holiday is arranged for each resident each year and funding for this is agreed as part of the initial contract. Throughout the year staff consider suitable holiday destinations based on past experiences, individual needs and personal preferences. Photo and brochures were available in the office, which staff would use when planning holidays with the residents. A representative from the Learning Disability service said that for some of the people living at the Spinney opportunities for activities in the past had been very limited. However, they were aware that since moving into the home some of the residents had started to enjoyed a much more active and fulfilled lifestyle. The manager said that every effort is made to maintain a positive relationship with family members. Some of the residents go home on a regular basis and the home is happy to support these arrangements. Feedback from relatives confirmed that the home keeps them informed of any significant events. Throughout the inspection staff were observed knocking on residents bedrooms and waiting before entering. All bedrooms have locks and residents are able to have a key to their room if they choose. One resident spoken to said that the staff were kind and caring. During the two- day visit the Inspector was able to observe the staff as they provided care and support to the residents. All the staff spoke gently and respectfully to the residents. They were able to recognise possible triggers for difficult behaviour and use this knowledge to ensure the safety of the individual and others living in or visiting the home. The inspector was able to discuss with staff the arrangements for planning meals. They said that although meals and mealtimes can be flexible to meet individual needs and daily activities a weekly plan is written to ensure that people are getting a varied and healthy diet. Care records included details of eating guidelines for staff and information about special dietary needs. Separate cooking utensils and equipment had The Spinney DS0000047871.V349255.R01.S.doc Version 5.2 Page 16 been purchased for one person with a food allergy to avoid the risk of cross contamination. Snacks and drinks were available throughout the day and residents were able to access the kitchen area and assist with food preparation with support from staff. The home has a large and bright dining area, which provides a comfortable and pleasant environment for people to enjoy their meals. The Spinney DS0000047871.V349255.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome area is good. 18,19,20. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. The systems for the recording, auditing and administering of medication is being further improved, which will improve practice and further ensure the safety, protection and well-being of people using the service. EVIDENCE: On both mornings of the inspection visit staff were observed supporting people to get up and prepare for the day. Staff spoken said that each person had a different morning routine, some liked to get up early and others liked to have a lie in particularly at weekends. The atmosphere in the home was relaxed and unrushed. Staff spoke gently and sensitively about the plans for the day and offered people options about what they may like to have for breakfast. Staff were able to recognise changes in mood and behaviour and were aware of when to leave a resident to have some space and private time. The Spinney DS0000047871.V349255.R01.S.doc Version 5.2 Page 18 Although residents were able to move freely around the home the staff were very aware of the whereabouts of each individual and were therefore able to respond promptly if required. Records contained detailed information about health needs and a record was kept of all appointments. The manager said that the home liaises with external agencies when required and feedback from health professionals and the Learning Disability Service was positive. The medication system was looked at during the inspection. A monitored dosage system is used. This is pre-packed by the Pharmacist in a bubble pack. The Inspector was able to observe staff administering medication on two occasions. Both times this was done with great care, each item of medication being checked and witnessed by two people. There were systems for checking that no medication had gone missing. The manager said that following the last Inspection a review had been completed of the homes medication policies and procedures. As a result of this review the manager had sought advice from the pharmacist and was in the processing of introducing improved recording procedures and information to further ensure the safety of everyone living in the home. This would include a separate health/medication files for each resident with a detailed description and photograph of all prescribed medication. The manager said that all staff would be receiving training prior to the new systems being implemented. The manager was aware of when decisions about the management of individuals’ health and medication needed to be agreed as part of a multiagency process. Although the staff had been trained to administer medication for one resident who suffers from Epilepsy alternative guidelines had been agreed as the home was still waiting for a care plan that must be completed by a health professional. The Spinney DS0000047871.V349255.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is good. 22,23. This judgement has been made using available evidence including a visit to this service. People who use or have contact with the service are able to express their views and concerns and have access to a formal procedure should they wish to make a complaint. Staff are aware of peoples rights and have the skills, knowledge and guidance to protect them from abuse. EVIDENCE: The home has a written complaints procedure. Some of the details on this document were not up to date and did not provide the reader with the correct name and address for contacting the Commission for Social Care Inspection. The Commission has received one complaint since the last inspection and this was passed to the provider to investigate. The manager was able to tell the inspector about how they had dealt with this issue and letters were available that had been sent to the complainant and returned when the complainant was satisfied with the outcome. The home should have a system for documenting any concerns or complaints made to the home and document how they were dealt with and the outcome. The Spinney DS0000047871.V349255.R01.S.doc Version 5.2 Page 20 Staff spoken to said that they were aware of issues concerning abuse and protection and most said they would feel confident to report any incidence to the manager. Staff were a little uncertain about the procedures they would follow if the manager was not available, although they said that the homes training programme would now include adult protection. The manager confirmed that staff have started to attend the multi-agency adult protection training and all staff have been asked about their understanding of adult protection procedures within staff supervision. In addition a new system of having a ‘ responsible person’ on each shift has been put in place. Staff would be expected to take any concerns to the responsible person in the absence of the Registered manager. The Spinney DS0000047871.V349255.R01.S.doc Version 5.2 Page 21 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): Quality in this outcome area is good. 24,25,26,27,28,29,30. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment appropriate to their needs. EVIDENCE: The Spinney is a large detached house that is registered to provide accommodation for four people. All of the bedrooms have their own private bathrooms, and three are en-suite. All of the bedrooms are of a good size and provide plenty of space for individuals to use their rooms as bed-sitting rooms. The communal areas are bright and spacious and provide people with enough communal space to move about the home without having to come into close contact with the other residents. The inspection included a tour of the whole building and gardens. The standard of furnishings throughout the home is high. The Spinney DS0000047871.V349255.R01.S.doc Version 5.2 Page 22 Bedrooms very much reflected individual tastes and preferences, and thought had been given to making rooms homely even when furnishings needed to be minimal. There were some signs of wear and tear in the house and the carpet in the dining area needed replacing. The manager said that due to the needs of the people living in the home the maintenance programme is on going. The dining area had been painted since the last inspection and the carpet was due to be replaced. A maintenance book was available in the office detailing these arrangements. One of the bedrooms had a walk-in shower and other specialist equipment to assist the individual with their personal care needs. The dining area has large patio doors leading onto a decked area over looking the garden. The garden is flat, enclosed and totally private. The manager said that all the residents enjoy spending time in the garden during the summer months. On both days of the inspection the house was found to be clean and tidy throughout. The Spinney DS0000047871.V349255.R01.S.doc Version 5.2 Page 23 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): Quality in this outcome area is good. 31,32,33,34,35,36. This judgement has been made using available evidence including a visit to this service. Staff in the home have the necessary skills, training and attitude to support the people who use the service. A recent review of the homes recruitment procedures has ensured that systems are more robust, however the absence of checks of employment history could still place people using the service at risk. EVIDENCE: All the people currently living in the home have been assessed as requiring a high level of staffing to access opportunities inside and outside the home. The staffing rota and staff team on duty during the inspection confirmed that staffing levels are in place to ensure that all residents have at least 1:1 staffing when they are at home and 2: 1 when they go out. The Spinney DS0000047871.V349255.R01.S.doc Version 5.2 Page 24 All staff spoken to were able to talk in detail about the needs of each individual and demonstrated a good awareness about how each individual likes to be supported. Staff were familiar with different communication methods of residents and were using this knowledge to promote choice and independence. Staff spoken to said that are able to access the information and guidelines they need to fulfil their role and said they felt well supported by their colleagues and management. The manager said that since the last inspection he has updated the format for supervision to ensure that staff have the opportunity to raise any concerns and discuss any areas for personal development and training. Nine questionnaires were returned by staff and all said that they received a good induction, on-going training and good support from management. The staff training plan confirmed that all staff have attended the mandatory health and safety training and attend other specialist training opportunities as part of an-ongoing programme. The manager said that following concerns raised at the last inspection ‘ Safe guarding adults’ has also been included in this programme. Records confirmed that since the last inspection staff have attended; Learning Disability awareness, challenging Behaviour and Breakaway training. The recruitment records were looked at for the staff most recently appointed to the home. An application form had been completed, with written references and relevant checks to ensure the safety of people living in the home. One of the application forms did not have sufficient details of the applicants’ employment history. The absence of this information could potentially place people using the service at risk. The manager said that this information had been gathered but could not be located during the inspection. The Spinney DS0000047871.V349255.R01.S.doc Version 5.2 Page 25 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): Quality in this outcome area is good. 37,38,39,40,41,42. This judgement has been made using available evidence including a visit to this service. The manager has a good understanding of the areas in which the home needs to improve. Consideration is given to involving, informing and training staff when changes are made to ensure best practice and consistency when providing care. EVIDENCE: Mr Shaun Drury is the Registered Manager for the Spinney. He has worked with people with a Learning Disability for many years and has been managing the home since it opened. The Spinney DS0000047871.V349255.R01.S.doc Version 5.2 Page 26 Staff spoken to and feedback sent within staff questionnaires confirmed that staff feel supported and valued as part of a team. Several staff members said that the Registered manager works in the home during the week and is always available to offer support and advice. Mr Drury was present throughout the inspection and was able to provide information about how concerns and issues raised at the last inspection have been addressed. Mr Drury said that he has reviewed all policies and procedures relating to the requirements made at the last inspection and has met with all the staff team to ensure that they are familiar with these guidelines and have the necessary skills and information to fulfil their role and meet residents needs. Records relating to incidents and the management of challenging behaviour had been reviewed and updated. Staff supervision forms had been revised to ensure that staff training is monitored and time allowed for staff to raise any concerns. Staff spoken to said that supervision was now taking place on a regular basis. The homes medication policies and procedures were in the process of being updated to ensure that there are robust and safe practices for storage, recording and administration of all prescribed medication. There was information about the homes quality assurance system and the manager said that questionnaires were due to be sent out to residents, family and other agencies. A requirement was made at the last two inspections that a representative of the company should conduct monthly-unannounced visits to the home and produce a report of these visits. The manager said that the visits and reports have been completed although copies have not as required been forwarded to the Commission. The manager stated that this would be addressed for all future visits. Risks assessments had been completed for all safe working practices and these were found to be detailed and up to date. A fire risk assessment was available relating to the home, residents and staff. Training records confirmed that staff attend fire safety training and fire equipment in the home is checked on a regular basis. Fridge thermometers have recently been renewed to ensure that they are working efficiently. The Spinney DS0000047871.V349255.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. 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 2 2 2 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 4 25 3 26 3 27 3 28 3 29 3 30 3 2 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 3 15 3 16 3 17 STAFFING Standard No Score 31 3 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 3 3 3 X Version 5.2 Page 28 The Spinney DS0000047871.V349255.R01.S.doc YES 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. 1. Standard YA7 Regulation 20 (c) Requirement The Registered Provider must ensure that peoples’ money is protected at all times. Money belonging to an individual must not be paid into accounts used in connection with the running of the care home. This requirement has been made at previous inspection s and must be addressed as a matter of urgency. Staff must not be employed in the home unless a thorough recruitment process has been completed. This must include obtaining a full employment history with all gaps accounted for. Timescale for action 15/04/08 2. YA39 19 15/03/08 The Spinney DS0000047871.V349255.R01.S.doc Version 5.2 Page 29 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 YA1 Good Practice Recommendations People should be provided with information about the home and the services provided in a format that they are most likely to understand. Information obtained about an individual prior to admission should be documented in a consistent format to ensure that all the important information is available to enable the home to make a decision about whether they can or cannot meet the individuals’ needs. The home must ensure that information regarding a person using the service is treated in confidence at all times. Clear policies and procedures should be written detailing when information can be passed or shared with other people or agencies involved in an individuals care. The complaints procedure should be updated to include the correct details for people to contact The Commission for Social Care inspection. The home have a system for documenting all complaints dealt with by the home to evidence how they were addressed and the outcome. 5 YA24 The carpet in the dining area should be replaced to avoid any tripping hazards and to maintain the current high standards of the environment. 2. YA2 3. YA10 4. YA22 The Spinney DS0000047871.V349255.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Colston 33 33 Colston Avenue Brtistol 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 Spinney DS0000047871.V349255.R01.S.doc Version 5.2 Page 31 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!