Care Home: Upshire Residential Home

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What the care home does well Staff provide service users daily opportunities to take part in community based activities and pastimes. The communal accommodation and grounds are very spacious. The atmosphere in the home was friendly and relaxed.Upshire Residential HomeDS0000071447.V378022.R01.S.docVersion 5.3Comments made in surveys received from relatives of service users and other visitors included: ‘the home is quite happy and well run’, ‘most people are happy and do things they like’, ‘I leave (after I visit) knowing my daughter is well cared for and happy’, ‘overall staff offer a very good friendly service’. What has improved since the last inspection? Care plans seen included service users needs and gave clear information for staff on how those needs could be met. Risk assessments included the information needed and guidance for staff of actions to be taken to minimise the risk of injury to service users. Care plans had been reviewed every month. Reviews had involved the service user and their key worker. New floor covering had been laid in the staff wc. The laundry room had been redecorated and the flooring in the food storeroom had been repaired. Redecoration of the walls and ceilings in the 2nd floor corridors had continued. Some bedrooms, corridors and stairs had been fitted with new carpets, and some bedrooms had been redecorated. Window frames on the outside front on the home had been repainted. New staff had undergone induction training which followed the Skills for Care Common Induction Standards for social care staff. The manager had begun holding 1 to 1 supervision/support meetings with staff. The results of the home’s Quality Assurance system had been fedback to service users with a written summary seen of the findings and of any actions taken. The registered provider had visited the home each month and had written a report on each visit. Staff had been given update training on moving and handling. What the care home could do better: Further repair work is needed to some work surfaces and the flooring in the laundry room. We need to see records to confirm that staff are provided regular recorded 1 to 1 supervision and support over an extended period.Upshire Residential HomeDS0000071447.V378022.R01.S.docVersion 5.3 Key inspection report CARE HOME ADULTS 18-65 Upshire Residential Home Woodredon House Woodredon Farm Lane Upshire Essex EN9 3SX Lead Inspector A Thompson Key Unannounced Inspection 15th September - 8th October 2009 10:15 Upshire Residential Home DS0000071447.V378022.R01.S.doc Version 5.3 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Upshire Residential Home DS0000071447.V378022.R01.S.doc Version 5.3 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Upshire Residential Home DS0000071447.V378022.R01.S.doc Version 5.3 Page 3 SERVICE INFORMATION Name of service Upshire Residential Home Address Woodredon House Woodredon Farm Lane Upshire Essex EN9 3SX 01992 763922 01992 763922 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) Southwark Park Nursing Home Limited Mrs Teresa Jane Cairns Care Home 29 Category(ies) of Learning disability (29) registration, with number of places Upshire Residential Home DS0000071447.V378022.R01.S.doc Version 5.3 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD The maximum number of service users who can be accommodated is 29 27th August 2008 2. Date of last inspection Brief Description of the Service: Upshire Residential Home (Woodredon House) is a large fully detached property set in approximately five and a half acres of private grounds. Upshire is registered to provide accommodation for up to 29 adults who have a learning disability. Accommodation is provided in seven single and eleven shared bedrooms. Communal space consists of two lounges, one inner hallway/atrium and one dining room, all situated on the ground floor of the home. The grounds surrounding the home are extensive and well maintained. Many rooms benefit from views of the surrounding countryside towards Waltham Abbey to the west and Epping Forest to the south. Access by road is along a single track lane off the nearest main road, where there is a bus stop. This is approximately a ten minute walk from the home. The nearest shopping facilities are in the village of Upshire. Larger towns closest by are Waltham Abbey and Epping, which are a car drive of approximately one and three miles away, respectively. The home has its own mini bus to ensure service users have full access to the local and wider community. Weekly fees at the time of this inspection were advised as £542.67. CQC inspection reports can be obtained from the home, or via the CQC internet website. Upshire Residential Home DS0000071447.V378022.R01.S.doc Version 5.3 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating of this service is 2 stars. This means the people who use this service experience GOOD quality outcomes. This unannounced key inspection took place on Tuesday 15th September 2009 with a second visit on 8th October to complete the process. We contacted the home shortly before the site visits to ensure that the manager would be available. The content of this report reflects the inspector’s findings on the days of the inspection along with information provided by the service and feedback by service users, staff and other parties. The registered manager of the home was present on both days of our visit. The manager completed and returned their Annual Quality Assurance Assessment AQAA to us in time for the inspection. This is a self assessment required by law which gives homes the opportunity of recording what they think they do well, what they could do better, what has improved in the previous twelve months as well as their future plans for improving the service. Some of the information and detail provided within the AQAA has been included in this report. Discussions were entered into with the manager, service users and staff on duty. CQC survey questionnaires were also provided to service users, staff and stakeholders. We received five completed surveys and reference to feedback from these has been made within this report. Random samples of records, policies and procedures were inspected and a tour of parts of the premises and grounds took place. All matters relating to the outcome of the inspection were discussed with the manager of the home, with full opportunity for discussion given and/or clarification where necessary. What the service does well: Staff provide service users daily opportunities to take part in community based activities and pastimes. The communal accommodation and grounds are very spacious. The atmosphere in the home was friendly and relaxed. Upshire Residential Home DS0000071447.V378022.R01.S.doc Version 5.3 Page 6 Comments made in surveys received from relatives of service users and other visitors included: ‘the home is quite happy and well run’, ‘most people are happy and do things they like’, ‘I leave (after I visit) knowing my daughter is well cared for and happy’, ‘overall staff offer a very good friendly service’. What has improved since the last inspection? What they could do better: Further repair work is needed to some work surfaces and the flooring in the laundry room. We need to see records to confirm that staff are provided regular recorded 1 to 1 supervision and support over an extended period. Upshire Residential Home DS0000071447.V378022.R01.S.doc Version 5.3 Page 7 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Upshire Residential Home DS0000071447.V378022.R01.S.doc Version 5.3 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 Upshire Residential Home DS0000071447.V378022.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People considering moving into the home can be confident that the admission processes ensures that the home can meet their needs. EVIDENCE: The home’s combined Statement of Purpose and Service Users Guide was seen. This included the information needed to help new services users make an informed choice when considering moving into Upshire. The majority of service users are placed and funded by local authorities. Records confirmed that these bodies had provided an assessment of needs to the home before admission. In addition to this the manager undertakes a written assessment of needs for all prospective service users prior to admission. Upshire Residential Home DS0000071447.V378022.R01.S.doc Version 5.3 Page 10 No new service users had been admitted since our last inspection but assessments looked at for people admitted in 2008 included the information needed. Assessments had details of the individual’s previous lifestyle, likes and dislikes around routines, choices and preferences. There was an assessment of need with headings of background information, emotional need, physical health and wellbeing, self care ability and biographical information. Prospective new service users are able to visit the home prior to making any decision on admission. Service users spoken with said they had visited Upshire several times, and had stayed overnight on some of the visits, before they moved in permanently. One person said they were glad they had decided to live at Upshire. Upshire Residential Home DS0000071447.V378022.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The information in care plans ensures that peoples needs could be met in a way they would wish. EVIDENCE: Three care plans were inspected. The format used was unchanged since the last inspection. Files inspected were seen to include information regarding personal details of the service user with next of kin contact. The name of the service users GP, dentist and optician were also recorded. Upshire Residential Home DS0000071447.V378022.R01.S.doc Version 5.3 Page 12 Assessed needs were detailed under headings of, emotional wellbeing (includes likes, dislikes, preferences), physical care (includes sight, hearing, mouth care, foot care), biographical information, self care ability/needs, personal care ability/needs, toilet needs, mobility considerations, lifestyle factors, assessed risks. Each heading looked at contained written implications, requirements and resources expected from staff and the service on a day by day basis, to facilitate working towards and meeting the service users individual and overall needs. Care plans had been reviewed monthly by the service user and their keyworker. Records of these meetings were seen and showed that service users views were recorded and taken account of. Service user meetings are held at the home to ensure people are kept informed and can make there views known. The most recent meeting had been held in August 2009 and a record had been kept of the areas covered. Discussion had included activities, complaints, food, laundry and daily choices. Service users spoken with confirmed that they thought staff took account on a day to basis, of their wishes and opinions about choices and routines available. They also said that staff listened to them when they wished to express a view or opinion. Upshire’s assessment format includes questions to the service user on their preferences, likes and dislikes on subjects including lifestyle, food, and activities. Observations and discussion with service users and staff evidenced to us that these preferences are taken account of daily. The manager said that advocacy services are available to people, through a Social Services link, with an independent service called ‘Cornerstone Advocacy’. The manager added that several people had used this service and had gone out with advocates. Risk assessment formats were in place for service users within their individual care plans. Those seen showed the perceived risk and the interventions needed by staff and others to try to minimise the risk. Upshire Residential Home DS0000071447.V378022.R01.S.doc Version 5.3 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): This is what people staying in this care home experience: 12, 13, 15, 16 & 17 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Upshire can expect to have a lifestyle that matches their expectations through opportunities for activity, and enjoyable food. EVIDENCE: Care plans included the activities people take part in. Thirteen service users regularly attend a local college, and five also attend a day centre. Discussion with service users, staff, management and examination of records evidenced that college courses attended include drama, dance, computer skills, basic education i.e. maths and English, forestry work, yoga and cooking. Some service users spoken with were eager to talk about what they did at college and said they enjoyed going. Upshire Residential Home DS0000071447.V378022.R01.S.doc Version 5.3 Page 14 Several service users also said they enjoyed attending community based facilities and activities, although some said they preferred not to always join in. We asked service users where they visited, places mentioned were libraries, pubs, cinema, leisure centre, seaside and churches. They also spoke about going regularly on shopping trips and some on trips home. Entertainers are brought into the home and a local arts group had just begun to visit the home to stage a monthly singing session. The manager said that this will soon be expanded on to include regular drama, arts and craft sessions for service users. It was evident from observations, discussions and records seen that staff continue to fully support service users to see and keep in touch with their families and friends. The manager confirmed that the home’s mini bus is still used to take service users for regular home visits. Staff will also collect relatives from their own homes, or nearest main transport link, and bring them to Upshire to enable regular visits to the home. Staff were seen to knock before entering private rooms. All rooms are lockable and many service users continue to hold their own keys, although some do not wish to do this. The grounds were fully accessible to all but some required full staff support for this. During the inspection staff were observed to interact and respond appropriately with service users and not just with other staff. Some were seen engaging on activities with service users and several people went out with staff during the day. Service users were asked about the food. All spoken with said they got enough to eat, they also said they got a choice of menu and most who commented said the food was good to eat. Some service users also said that they helped out in the kitchen. The home’s nutritional records and menus were seen. These evidenced a range of choices provided. The main daily meal is early evening with two choices (and a third available), decided on earlier by service users. Specialist nutritional advice and guidance is accessed from a community-based nutritionist via GP referral. The small kitchen provided on the ground floor of the home is still available as a training facility in domestic and independent living skills, and is used daily by some service users to prepare themselves snacks and drinks. The manager said that supper snacks are available at Upshire and include sandwiches, cereals and toast. Upshire Residential Home DS0000071447.V378022.R01.S.doc Version 5.3 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Upshire can expect to receive personal and healthcare support in an appropriate and dignified way that meets their expectations and needs. EVIDENCE: Service users spoken to said they choose their own clothes and make up, where appropriate/able. Most female and some male service users choose to have their haircut by the home’s hairdresser. Some of the male service users continue to visit a barber in the local town. Rising and retiring times are based on personal choice and vary around daily activities planned. Service users said they could have a lie in at weekends and went to bed when they wanted. Upshire Residential Home DS0000071447.V378022.R01.S.doc Version 5.3 Page 16 All service users have designated key workers and staff spoken with demonstrated an appropriate awareness of individual daily needs and preferences. Service users were relaxed during observed discussions with staff. Care plans contained a section entitled ‘lifestyle choices and preferences’. The manager said that service users continue to be supported by staff in visiting their GP. The optician and dentist are also visited in the community but a domiciliary service is provided for those who require this. A chiropodist visits the home to provide podiatry services. The manager felt that the home still has a good professional working relationship with GP’s, who undertake regular health monitoring and medication reviews for individual service users at the GP’s surgery. The GP will see service users the day of asking if staff request this. Full staff support, including transport, is provided for service users who attend community clinics and outpatient clinics. Good working relationships continue between staff in the home and the local NHS health provider community team. Regular contact and visits are also received from community psychiatric nurses who provide a referral route to the local consultant psychiatrist. Continence support/guidance is provided by community based services. The medication system in use in the home is a four weekly monitored dosage system (pre-packed by the pharmacist). New supplies are delivered to the home by the pharmacist and are checked in by a trained member of staff. Records are kept of any unused medication returned to the pharmacist. Staff records showed that staff who deal with medication had received training for this role. Training had covered administration, types of medicines, reasons for use, side effects, potential problems, special precautions and medication handling issues. The home’s written policy and procedure on receiving and administering medication is regarded as appropriate for the service provision of Upshire. Medication administration records were inspected, two gaps were noted and the manager undertook to remind staff to ensure records are properly completed. Upshire Residential Home DS0000071447.V378022.R01.S.doc Version 5.3 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Practices in the home safeguard service users and ensure that concerns are listened to and addressed. EVIDENCE: The home’s complaints procedure offered guidance to prospective complainants on who to complain to along with time scales for responses. There was also a standard template for staff to record concerns or compliments. All service users and their relatives are provided with a copy of the procedure, so that they are aware of the complaints process. During discussion with service users they said they would speak to their key worker or the manager about any issues they were not happy with or were worried about. There had been one recorded complaint since the last inspection, but this was not about the service provided at Upshire. The issue did relate to a service user commissioning matter, and the manager had taken appropriate action to ensure that this was forwarded to the relevant authority with a positive outcome. Upshire Residential Home DS0000071447.V378022.R01.S.doc Version 5.3 Page 18 The home’s policy on the protection of vulnerable adults, and procedures for investigating allegations or alleged incidences of abuse includes examples of various forms of abuse. The home also had the new Social Services guidelines on safeguarding vulnerable adults and a copy of the guidelines on POVA (protection of vulnerable adults) issued by the Department of Health, for all staff to refer too. There was a written whistle-blowing policy in the home, which is given to staff to remind them of their responsibilities to report any suspected poor practice. The manager is qualified (certificate seen) to provide training to staff on adult protection issues. Evidence was seen of this training, which was regarded as comprehensive, covering types of abuse, who could be abused and by whom and what to do if abuse is suspected. Upshire Residential Home DS0000071447.V378022.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users live in a mostly clean and comfortable environment but could not be sure that all areas of the home are well maintained and hygienic. EVIDENCE: Generally the ground floor of the premises was considered bright, airy and free from offensive odours, and many rooms throughout the home (communal and private) benefit from views of the surrounding woodland and fields. Since our last inspection premises improvements had continued. These had included additional recarpeting and redecoration to the 1st and 2nd floor corridors and to the stairs and landings linking these floors. Upshire Residential Home DS0000071447.V378022.R01.S.doc Version 5.3 Page 20 Some bedrooms had been decorated and had new carpets, and there was new flooring in the staff wc. External window frames had also been painted, the flooring in the food storeroom had been repaired and the laundry had been redecorated. Further work was needed in the laundry room as there was another small hole in the floor and some work surfaces were chipped/scratched and may therefore be unhygienic. Repairs to the laundry need to include fitting new/improved floor covering and ensuring work surfaces are clean and impermeable. Whilst touring the home on our first visit we noticed that the carpet in the rear lounge had some stains on it and that some chairs in the front lounge looked a little dirty and stained. We mentioned this to the manager and on our second visit we saw that the carpet and chairs had been cleaned. Although the location of the home should be considered as generally isolated, a local transport link (a bus service) is available approximately ten minutes walk from the home, and daily community access is provided for service users by regular use of the home’s minibus. Many private bedrooms in Upshire are spacious and two shared bedrooms and one single benefit from ensuite facilities. All service users who expressed an opinion said that they were satisfied with the private accommodation provided them, and that they were encouraged to have personal possessions and belongings in their rooms. All bedrooms looked in had wash hand basins and many had been personalised to individual taste. Personal possessions seen included DVD players, video recorders, televisions and hi-fi’s. Some service users had their own mobile telephones, others use the home’s portable phone, or the phone in the small kitchen for private telephone calls. There were five communal bathrooms in the home, four of which had wc’s, one bathroom had a fixed hoist. There were also seven separate wc’s for service users use around the home. Upshire Residential Home DS0000071447.V378022.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service are supported by a team of properly recruited and trained staff. EVIDENCE: Staff training records were inspected. Training provided to staff had included, medication, infection control, first aid, adult protection, food hygiene, dementia, health and safety, moving and handling, epilepsy awareness, dealing with death and bereavement and fire safety. Information provided in the AQAA states that all fifteen permanent care staff had achieved their NVQ level 2 awards. The manager has the Registered Manager award and is a qualified trainer for NVQ 4, dementia awareness, health and safety, food hygiene, moving and handling, adult protection and fire safety. This qualified the manager to train staff in-house on these subjects. Upshire Residential Home DS0000071447.V378022.R01.S.doc Version 5.3 Page 22 Staffing rotas seen showed that minimum staffing provided was four carers on duty daytime shifts up to 2000 hours, then a minimum three carers on duty until 2100 hours. Night time staffing is two on waking duties. Separate and additional staff were rostered to undertake cooking, cleaning, maintenance and administrative duties. The home’s policy on recruitment practices and procedures covered the recruitment processes, philosophy of the home, company rules, service users charter, equal opportunities and personnel issues. Recruitment records for some staff employed since the last inspection were inspected. These evidenced proper recruitment procedures had been followed, with an application form completed, two references obtained, a CRB check actioned, proof of identity checked and a photograph obtained. Staff said they had received induction training when they started their jobs at Upshire. Records looked at confirmed this and showed that after initial first day orientation induction staff then commence full induction based on the Skills for Care Common Induction Standards for social care staff. Staff spoken with confirmed that contracts and conditions of service are issued to them and they had police checks when they started working at Upshire. Applicants are invited to the home before interview to meet with service users, to ensure their views are always considered before offering an interview. Staff are supported in their work and the manager had now commenced regular 1 to 1 supervision for staff. The format used covered work tasks, service user and relatives issues, training, attitudes to work and any personal issues. Staff confirmed they were supported by the manager but the written records of supervision did fully cover the time since our last inspection. We therefore need to see that support is provided over an extended time span. This may include keeping evidence of group supervisions. Upshire Residential Home DS0000071447.V378022.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is managed and run in their best interests. EVIDENCE: The manager has worked at the home for thirty years and is very experienced with the service user group at Upshire. The manager holds the registered managers award and several trainer awards (see comments under staffing for details). Since our last inspection administrative support for the manager has been increased to 30 hours a week. We regard this increase as a positive development for the service. Upshire Residential Home DS0000071447.V378022.R01.S.doc Version 5.3 Page 24 A further improvement since our last inspection is that the registered provider has been consistently carrying our monthly visits to the home. A report had been written after each visit which showed the areas looked at. These were seen. The home’s quality assurance (QA) forms were looked at. The format included headings of, food and catering, personal care support, daily living, premises, staff attitudes. Forms completed by service users earlier in 2009 were seen, and feedback on comments in these had been relayed back to people at a meeting. There was also a written summary of the findings and of any actions taken. Random samples of records required to be kept were inspected. These included, staff recruitment, nutrition, menus, staffing rotas, care plans, assessments, medication and regulation 26 reports. All seen had been acceptably maintained. Staff had received training in moving and handling, food hygiene, infection control and health and safety. First training updated were due and the manager produced evidence to show that this training was booked for October 2009. Hot water supply in the home is regulated at a temperature of or near to 43 degrees celsius to reduce the risk of scalding. Manual checks on the hot water temperature had also been been made and records of these was seen. Records confirmed that the home’s portable electrical appliances, the electrical installation, fire alarms and equipment had been tested, and there was a premises risk assessment in place. There was no mains gas supply to the home. Upshire Residential Home DS0000071447.V378022.R01.S.doc Version 5.3 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 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X 3 3 X Version 5.3 Page 26 Upshire Residential Home DS0000071447.V378022.R01.S.doc 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. 1. Standard YA24 YA30 Regulation 23 Requirement The laundry room needs further attention including repairing a hole in the floor and ensuring surfaces are clean and impermeable. This is to provide a hygienic, safe and well maintained environment for staff and service users. 2. YA36 18 Evidence needs to be available to 31/03/10 show that staff receive regular supervision. This will confirm that staff are supported in their roles. Timescale for action 31/12/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Upshire Residential Home DS0000071447.V378022.R01.S.doc Version 5.3 Page 27 Care Quality Commission Eastern Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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