Care Home: Valley Way House

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Valley Way House Dollis Valley Way Barnet Hertfordshire EN5 2UL three star excellent service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Duncan Paterson Date: 1 5 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Valley Way House Dollis Valley Way Barnet Hertfordshire EN5 2UL 02084416515 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): roseline.anyanwu@barnet.gov.uk London Borough of Barnet Name of registered manager (if applicable) Roseline Oluchi Anyanwu Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 6 6 6 0 0 0 care home 6 learning disability physical disability sensory impairment Additional conditions: Date of last inspection A bit about the care home Valley Way House is a six- bedded care home on the New Fieldways complex, situated within the Dollis Valley Way estate in high Barnet. The home is a respite unit offering short-term care to adults from the age of 18 to 65 years of age, with severe learning difficulties, sensory impairments and autism whose behaviour challenges other services. One bedroom is specifically available for emergency placements. There are six single bedrooms, which are en-suite. There is also an integral lounge and dining room looking onto the garden. There is also a well- equipped kitchen and laundry room. The home is accessible to wheelchair users. The home has a minibus within the complex. Notting Hill Association manages the building and the London Borough of Barnet operates the home. The stated aims of the home are to provide respite care for adults who have learning difficulties and physical difficulties. The last inspection report and purpose and function document are available for inspection within the homes entrance hall. The fees are #255 pounds per night, which is subsidised by the local authority. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home This key inspection took place on 14th and 15th October 2008. The inspector was accompanied by a CSCI Expert by Experience and his personal assistant on the first day of the inspection. The comments of the Expert by Experience are included in this report. The inspection involved spending time with the people using the service, observing practice and discussions with the manager and staff. The Annual Quality Assurance Assessment (AQAA) returned by the service was taken into consideration as well as returned surveys from the people using the service, relatives and staff. The inspection also involved a tour of the premises and assessment of a range of the service records, procedures and forms. What the care home does well There are many good and excellent aspects to this service. The physical standards are excellent and provide people using the service with comfortable, well equipped and attractive surroundings. Staff commented positively on how the equipment, such as ceiling track hoists, have benefited people. The area in which the service excels is in providing people with friendly, caring, sensitive individual care. Many of the staff spoken to said that the best thing about the service was putting people first. One staff member in a returned survey said that, we try to meet peoples needs to the best of our ability. We treat all people equally with respect and dignity. This approach from staff was observed throughout the inspection. For example, the Expert by Experience noted that staff and people using the service, got on very well with staff seeming to know what people liked and did not like. Another area where the service excels is the role played by the manager. She has worked at the service for 15 years and has been able to build a caring, committed team who enjoy their work and work towards the service aims and goals. Many staff have worked at the service for a long time and this brings consistency and a wealth of experience. What has got better from the last inspection The last key inspection of February 2007 took place very soon after the service had moved to the current new building. At that time there were some teething problems with the new building but these have now been addressed with some minor exceptions. Work is ongoing, for example, to rectify the drainage from one bathroom. The service is now settled in the new building and enjoying the benefits of the improved physical standards. The manager has brought in new equipment, such as monitors which are used at night to assist in care provision. Similarly, a larger TV has been bought to make it easier for people with visual impairments. What the care home could do better A very good service is currently provided. This inspection has identified some areas which would consolidate the good standards achieved such as obtaining feedback from external stakeholders such as care managers and health care professionals. The inspection has also identified some areas which the manager was aware of and had started to address. For example, there is a need to resolve the issue of availability of transport so that a wider range of activities can be provided. Similarly, there is a need to recruit more male staff. Both these areas are ones which the manager is currently addressing. The staff training records need to be more effectively organised so that it is clear what training staff have completed and where refresher training may be needed. The manager took immediate action to address this but will need to be clear that for some health relating matters that all staff have received the training. The service is good at identifying areas for development. For example, the business plan sets out plans to produce a pictorial statement of purpose and service users guide. The aim is to produce these in this financial year. An area identified by the Expert by Experience was that of internal door signage. The current signs are relatively small. Larger ones with backgrounds will be easier to see. Finally, the manager is to leave the service in late 2008. She leaves behind a well run and much loved service where people enjoy coming to either to stay or work in. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Duncan Paterson 11th Floor, West Wing 26-28 Hammersmith Grove Hammersmith London W6 7SE 020 8735 6374 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this 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 the service are provided with a caring, friendly and sensitive service. The aims of the service are clear, staff understand them and work proactively to make the aims a reality. The arrangements to introduce new people to the service are good and include home visits and time getting to know people. Evidence: The statement of purpose sets out the aims of the service in an easy to read style. The aims are simply expressed and capture what the service is about. One of the stated aims is to provide quality short term care and an enjoyable experience for people. This is an aim that staff can identify with. For example, staff, when interviewed, described the service as being just like this stated aim. One care worker said the service was good at, putting people at the centre, where we can look after them well and give choice as a priority. Another care worker described the service as a, friendly, homely place. Another care worker, responding to the survey said Its a joy to come to Valley Way each shift. To give high care to each person makes me proud to be part of the team. The evidence of this inspection is that the manager and staff have been successful in creating a team of care staff to provide care who are motivated, happy to be at home and keen to provide people using the service with a friendly, well considered service. The friendliness, understanding and good practice shown by staff was noted by the Expert by Experience. He saw that staff got on well with people using the service and that staff knew what people liked or did not like. He reported that people were put at ease and were able to relax when they returned to the service in the afternoon. Staff were observed to be friendly and caring in their interactions with people and they Evidence: obviously knew people well and could respond to them considerately. All the people staying at the service on the day of the inspection were not able to communicate verbally. However, staff clearly knew people well, greeted them warmly and used observation, listening and makaton skills to assist with communication. The Expert by Experience observed some good practice where staff encouraged people to be in the kitchen as they liked, the smell, feel and taste of food. The manager described the process where new people were introduced to the service. This involved home visits, work with relatives and then trial visits to the service. This practice was endorsed by staff who described their contact with relatives and the carrying out of home visits. One staff member described the rapport with relatives as , good. Staff also confirmed the practice of introducing people to the service to the Expert by Experience. He reported that staff had told him that they, visit people to get to know them and their likes and dislikes. The 2008-2009 Business Plan for the service sets out the plan to produce a new pictorial statement of purpose and service users guide. This was discussed with the manager who said the work was not complete yet. Having such a guide will improve the overall information available about the service for people and it will need to be carried on by the managers successor. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The people using the service receive really good, careful and considerate care from staff. Staff enjoy working at the home and some excellent relationships have developed. Care plans are detailed and giving choice to people is something that staff are good at. Evidence: It is in this area, of individual needs and choices, where the service does best. The foundations for good care are in place. The staff enjoy the work, the manager has a good relationship with all including the staff, relatives and people using the service, there is good staff retention and the new building has seen the introduction of good quality accommodation as well as new equipment for the benefit of all. As described above, staff work with people using the service in a friendly caring manner. Many staff have worked at the service for a number of years and know people using the service and their families well. Such staff are able to bring a level of consistency and experience to their work. One member of staff, for example, felt that the homely environment lead to, good staff retention. There were a number of examples seen where staff offered choice to people. For example, being flexible in what people wanted to do when they arrived at the service and offering walks, or time in the kitchen. The Expert by experience observed staff being proactive in offering choice about the evening meal. He described seeing, a staff member come round with a tray of food packets so that they could show people what food they could have. Choice was also offered for the evening meal with a member of staff preparing a number of meals depending on what people wanted. Evidence: There was positive feedback from relatives via the returned surveys. One person said that, the manager and staff provide an excellent service. Staff are always happy and cheerful and helpful in all matters. The care plans for the people using the service during the inspection were inspected. The format is comprehensive with a front sheet providing individual information including information about equality and diversity. There is a care plan with goals which is reviewed regularly and then sections with additional assessment information, guidelines for care provision and input from other professionals such as health professionals and care managers. Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Staff are committed to providing people using the service with an enjoyable experience. Access to a transport vehicle will increase the opportunities for activities and therefore peoples quality of life. Food provision is good with choice provided and staff working flexibly to meet peoples needs and wishes. Evidence: As a service providing respite care the demands on staff are different to a care home. There are 34 people registered with the service, each receiving a number of respite stays throughout the year. Six people stay at any one time. Staff plan the stays carefully and aim to make sure that there is compatibility with the people staying. Generally, people using the service attend day centres during the day arriving at the service in the afternoon. There is less time available for activities and entertainment on weekdays therefore leaving the weekends as the prime time for activities. As this is a respite service the emphasis is on providing an enjoyable and stimulating time for people. This inspection was carried out during a weekday and the findings stem from observation of a typical weekday at the service. Staff were seen to warmly welcome people to the service and work either individually or in pairs with people. Staff had delegated tasks such as preparing the evening meal and, as described above, this was taken as an opportunity to involve people using the service. Other people were involved in going for walks, relaxing in the lounge or in the first floor sensory room. The Expert by Experience spent time with people in the lounge before and during the Evidence: evening meal. Feedback from surveys and from interviews with staff highlighted the need for a transport vehicle so that a wider range of activities, including outings, could be arranged. Many people felt that this would improve the service. Currently, outings did take place but these were more difficult as public transport was needed. This was discussed with the manager who advised that the service used transport and a driver supplied by Barnet Council. The most recent driver had had to stop because of health issues and they were awaiting a Criminal Records Bureau check for a new driver. When that had been cleared this transport would be available again. An aim for the future is for the service to have its own vehicle but that will require raising funds. A recommendation is given about the need for access to a vehicle. Food provision has already been described above. During the inspection some good practice was observed including the offering of choice to people about what food to have as well as flexibility from staff in preparing a range of meals for people rather than one meal for all. The kitchen is large and modern providing ample space for food storage as well as space for a number of people to work together comfortably. Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Arrangements for the provision of personal care is good. Staff know people using the service well and have detailed care plans in place. There are relevant records and guidelines in place relating to peoples health care needs. Evidence: Evidence is taken from case tracking of the people using the service on the day of the inspection. As already described, this service is for respite care, and as such, staff at the home are not the main carers. The majority of people using the service live with their families. However, staff are good on a one-to-one basis with people using the service and can provide good personal care. One issue that arose was the fact that there is currently only one male member of staff. This can at times be difficult to manage and it is recommended that additional male staff be recruited. This was discussed with the manager who advised that this had been identified as a need for the service and that it was being addressed in the current round of recruitment. The service has arranged itself so that appropriate care, including some delegated health care tasks, can be provided. Each person has a care plan with goals for care agreed and reviewed regularly. Each person also has assessment information and additional information from care managers. This is usually care managers from Barnet Council. In addition to this, depending upon peoples needs, there are assessments and guidelines in place for how to care for people where care may be complex. For example, there may be speech and language guidelines for people who may have swallowing difficulties. And staff may be undertaking delegated nursing tasks for a small number of people. These type of activities require professional input for staff training and the drawing up of guidelines. These were in place and the manager and staff demonstrated a good Evidence: understanding of their role and of the needs of people using the service. The need for the training records to be re-organised (more detail about this is provided below) meant that it was not clear that all staff had received training such as for delegated nursing tasks. This was discussed with the manager who took immediate action. However, there needs to be evidence that staff have been suitably trained and a recommendation is given about this. The medication administration records and storage arrangements were inspected. Again, the evidence is taken from the records of people using the service at the time of the inspection. The arrangements are good. Each person has a medication profile and there are clear records of medication brought into the service with each person as well as administered. Staff demonstrated a good understanding of each persons medicines. One person had a relatively complex medication profile and staff were knowledgeable about the medicines and when they needed to cross check with GPs. The medicines are stored securely. Although there is a thermometer a record of the daily temperature of the medication area is not being kept. As an additional safeguard it is recommended that a daily record is kept. Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this 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 can be confident that complaints will be responded to properly. Improving the presentation of complaints and compliments records will enable the service to demonstrate excellence in this area. Safeguarding arrangements are suitable with staff knowledgeable and trained. Evidence: There have been four complaints about the service over the past year. The records of these complaints were inspected as were the records of compliments received. There is a need to present the complaints details in a clearer, more readable format. Some of the records were difficult to follow and identify how they had been responded to. After discussion with the manager and deputy manager it was clear that the complaints had been responded to appropriately. However, in order that the service can demonstrate excellence in this area consideration needs to be given to either a new complaints format or a clearer presentation of complaints and their investigation. Similarly, the many compliments received about the service are not presented in as positive a light as they could be. Consideration should be given to drawing up a compliments presentation folder. The service is part of Barnet Council and uses the councils safeguarding adults procedures. A copy of these was available. Staff confirmed that they had had safeguarding training and training records were seen to confirm this. Staff demonstrated a good understanding of safeguarding matters as well as the elements of providing dignified care for people. The arrangements for looking after peoples money were inspected. There is a relatively straightforward system where exercise books are used to record money in and out of the service. Small amounts of money are held as people only usually stay for short period of a few days. The money is kept securely in a safe. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The physical standards are excellent. The building is modern, clean, comfortable and well equipped. People using the service can be confident that their needs will be met. Staff consider that the new building has allowed them to improve the service they provide. Evidence: The service moved to this new building less than two years ago. The current building is modern, comfortable, clean and attractive. It is well liked by staff and the people using the service. There are six bedrooms all with en suite facilities and all equipped with ceiling tracking hoists which has been a great improvement both for people using the service and staff. The staff all credited the new building with having meant an improvement to their service. One staff member summed up staffs feelings when she said that, I feel that the service has improved. The new building has really helped there is more space and the showers in bedrooms are much better. The Expert by Experience toured the building and noted a number of good things. Very clean and tidy. A nice big kitchen, living and dining area, a large garden and bedrooms tidy with hoists, as well as dangerous chemicals locked away. At the last key inspection a number of teething problems with the building had been identified. These have been addressed although on the day of the inspection work was underway to address problems with drainage from a bathroom. The building is owned by a housing association who are responsible for the maintenance. The manager identified various improvements since the last key inspection. For example, a monitoring system had been installed which assisted night staff with looking after people at night. They were able to use the system to check if people had got up. A larger TV had been bought, new equipment for the sensory room and a new special chair. Evidence: The Expert by Experience identified that some of the interior signs on doors and cupboards were quite small and therefore difficult to read for people with visual impairments. It is recommended that larger signs be used. Some feedback from relatives was received about the garden. It was felt that the garden needed to be leveled so that it could be used more by people using the service, especially those who use wheelchairs. This was discussed with the manager and staff and the garden viewed. It is the case that parts of the garden slope and wheelchairs would not be able to use them. However, there is a patio area which is accessible for wheelchair users. There are regular relatives meetings and this is something that can be discussed at such a meeting in the future so that possibilities of development in the garden can be considered. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this 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 the service benefit from motivated staff who are well supported by an effective manager and deputy. Clearer records of staff training has started to be developed and this will assist the management team to analyse training and address shortfalls if required. Evidence: There are many positive aspects about staffing at this service. There are many dedicated staff members who clearly enjoy their work and are well suited to it. Many of the staff team (the manager and deputy amongst them) have worked at the service for a long time and help to provide a consistent service. The Expert by Experience spoke to staff and reported that one staff member told him, Ive worked here for 16 years. I enjoy it and wouldnt change anything. The Expert also observed staff working considerately with people and welcoming them to the home when they arrived. Another member of staff, responding to the survey, reported that there was, good communication between the staff team as well as a hard working team. There has only been one new member of staff start work since the last key inspection. The recruitment process was inspected and found to have been completed properly with references and a Criminal Record Bureau check obtained. The majority of staff have either NVQ Level 2 or Level 3 qualifications and there are lots of training opportunities for staff. Barnet Council provide lots of the training for staff - the service benefiting from being part of the council service provision. The training records were inspected and it was identified that they could be better organised. An A4 lever arch file was used for all staff and it was not possible to tell for all the training courses whether all staff had attended. This was the case, for example, for the delegated nursing tasks mentioned above. The manager and deputy manager Evidence: responded immediately and started work to re-organise the training files so that each member of staff had their own file covering staff training and supervision. This will be a much easier to follow system. A recommendation is given that the training records are fully updated so that it will be clear if staff require refresher training. The staffing rota was viewed. Usually there are three care staff, as well as the manager or deputy manager, when people using the service are present. More staff can be provided should that be needed. Staff, when interviewed, felt that this staffing number was adequate. Night staff have been increased to two waking night staff. Staff said that they had regular supervision and this was confirmed when the supervision records were inspected. Staff said that they felt supported. Additional support is provided via regular staff meetings. Records of these meetings were seen. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The manager has created a well organised service that is much liked by staff, relatives and the people using the service. The service is well run with staff who are motivated to provide the best service they can. Evidence: The manager has worked at this service for 15 years with the latter years as manager. She brings experience and expertise to her role and strong leadership and support for staff. She is well liked and respected by all. Many positive comments were received about the manager during this inspection. For example, a relative responding to a survey said, The manager is always available. A staff member said that, she has high standards and has supported and trained everyone. The manager has been successful in creating a positive work environment where staff are valued and where there is agreement for the stated values of the service. Staff are motivated to work at their best in the service. The quality assurance paperwork was inspected. There were recent survey returns from relatives as well as a report which detailed the findings. The majority of the feedback obtained was positive. There was some less positive feedback about activity provision which relates to the difficulties there have been in obtaining transport. The quality assurance process is robust and allows people to have a say and an influence over the service. However, the process will be strengthened when other stakeholders, such as care managers and health care professionals, are included. There have been no recent surveys of these type of visiting professionals. The manager was confident that the service was held in high regard and therefore having that endorsed through survey returns will benefit the service. Evidence: A sample of the policies and procedures were viewed. These are carefully written and provide staff with good all round, easy to read information about the service. There is a process for staff to confirm that they have read policies. The records relating to fire safety, health and safety and the servicing of equipment were inspected. These were all available for inspection and were being kept up-todate. There were records of testing the water system for legionella, for example. There is a 2008-2009 business plan for the service which sets out the aims and plans for development. This is a useful tool and the manager has been able to set out in that plans which her successor can take forward. The service is part of Barnet Council and is in receipt of funds for service provision. A current certificate of insurance was seen. Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 1 14 Work to produce a pictorial statement of purpose and service users guide should continue. A transport vehicle should be available to people using the service at all times so that a wider range of activities can be provided. Additional male care staff should be appointed to allow greater flexibility in care provision. There should be evidence (via training records or equivalent) that staff have received training in the carrying out of delegated nursing tasks. The temperature of the medication store area should be taken and recorded each day. The complaints and compliments records should be presented in a clearer, more easily read format. Larger internal signs on doors and cupboards should be used. Staff training records should be fully updated. 3 4 18 19 5 6 7 8 20 22 29 35 9 39 Stakeholders, such as care managers and health care professionals, should be surveyed for their views of the service and included in the quality assurance processes. Helpline: 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 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 © (2008) Commission for Social Care Inspection (CSCI). 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. 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