Care Home: Vancouver Road, 23

Similar services:

• Ashlong House
• Norbury Crescent (30)
• Edenvale
• Wadham Avenue
• Chatsworth Care - Dawson House
• Cowden Road, 52 - 54
• Townley Road, 2-3
• Chatsworth Care - Tudor Lodge

What the care home does well There is a good and welcoming atmosphere in the home and good interaction between staff and residents. The staff help the residents in activities, and provide support for in house and community activities. Staff know residents well and communicate well with them always speaking in a friendly and respectful manner. The home is well decorated and maintained and resident`s rooms are well maintained and reflect their own choices and preference.The manager provides a sensitive and encouraging approach to managing the home, and tries hard to ensure that residents and staff are safe and secure in the home. Training is provided by the organisation, which includes good foundation training, and staff are well informed of the best ways to support service users. Visitors are welcomed and the home does not place restrictions on visiting times. The home provides good food and good health care support. The home is well maintained and is clean and safe. What has improved since the last inspection? The home now provides residents with clear written contracts showing their responsibilities, the support the individual resident will get and the charges made. Residents are now involved in the review of their care plans and pictures are used to help some residents understand more clearly what is agreed. Risk assessments are reviewed now at least every six months and this helps to better protect residents and staff. Many of the care staff are now qualified with nine of the 14 staff now having NVQ 2/3. The staff now also get training in how to help people with mental health and learning disability support needs. This helps the staff to be better able to help the residents. CARE HOME ADULTS 18-65 Vancouver Road, 23 Forest Hill London SE23 2AG Lead Inspector Sean Healy Unannounced Inspection 27th June 2008 10:00 Vancouver Road, 23 DS0000025649.V364791.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 Vancouver Road, 23 DS0000025649.V364791.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. Vancouver Road, 23 DS0000025649.V364791.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Vancouver Road, 23 Address Forest Hill London SE23 2AG 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) 0208 6993762 0208 699 3762 vancouver@regard.co.uk The Regard Partnership Ltd Manager post vacant Care Home 8 Category(ies) of Learning disability (0), Mental disorder, registration, with number excluding learning disability or dementia (0) of places Vancouver Road, 23 DS0000025649.V364791.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Eight residents, of whom four may have both a learning disability and a mental disorder (dual diagnosis) 6th July 2007 Date of last inspection Brief Description of the Service: Vancouver Road provides a care home to a maximum of eight women and men with mild to moderate learning disabilities, who might also have other support needs. A maximum of four Residents might also have a diagnosis of a mental disorder. The overall aim is that of providing a specialist service in a nurturing and stimulating environment, which would enable users to develop or achieve independent living skills within a community setting. The home provides staff who have experience in the field of learning disability and mental health. The provider is a company: The Regard Partnership Ltd. who provides other residential homes and supported living in England and Wales. The Statement of Purpose says that the two Directors are qualified nurses, with experience in Learning Disability and Mental Health. The day-to-day running of the home is delegated to a manager, who leads a team of staff. The home is a semidetached house, with single bedrooms on three floors and a large garden. The home is not suitable for people who cannot manage stairs. The area is served by public transport, has a selection of shops and other civic amenities. At the time of this inspection there were no vacancies. Information about the service provided is made available to current and potential Residents in the homes Statement of Purpose and Residents Guide. The recent CSCI report is currently kept at the home. This is made available to residents. At 27th June 2008, the homes fees are set at between £1,300.00 and £1,550.92 per week for accommodation and support. The majority of these costs are met by the referring social services authority, and includes food and some transport. Residents have to pay for other personal expenses such as hairdressing and personal shopping. The provider’s email address is: Vancouver@regard.co.uk Vancouver Road, 23 DS0000025649.V364791.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality Rating for this service is 2 Star. This means that the people who use this service experience Good quality outcomes. This inspection site visit took place over one day on 27th June 2008 and ended on the 30th June. The inspection was unannounced, and was facilitated by the Acting Manager and the Area Manager for the provider organisation. The Registered manager had left employment in November 2006 and the current manager has applied to CSCI to become registered care manager. Three residents gave their views about how the home is managed, and three residents planning files were examined. Three support staff were interviewed and three staff files were examined to see recruitment and supervision and training records. The inspection included examination of records and policies and procedures, and a tour of the building. There were also views provided by the local authorities adult protection team on the homes reporting and intervention regarding protection of vulnerable adults. All of the requirements and recommendations made at the previous inspection had now been met. This shows a good commitment to making improvements to the home and the care provided. Generally Residents said they were very happy at this home, even though many of the staff are new. One resident wants to move out to more independent living and said that the staff and manager are helpful and supportive. The atmosphere was relaxed and friendly. The manager and staff involved Residents and spoke with them regularly. What the service does well: There is a good and welcoming atmosphere in the home and good interaction between staff and residents. The staff help the residents in activities, and provide support for in house and community activities. Staff know residents well and communicate well with them always speaking in a friendly and respectful manner. The home is well decorated and maintained and resident’s rooms are well maintained and reflect their own choices and preference. Vancouver Road, 23 DS0000025649.V364791.R01.S.doc Version 5.2 Page 6 The manager provides a sensitive and encouraging approach to managing the home, and tries hard to ensure that residents and staff are safe and secure in the home. Training is provided by the organisation, which includes good foundation training, and staff are well informed of the best ways to support service users. Visitors are welcomed and the home does not place restrictions on visiting times. The home provides good food and good health care support. The home is well maintained and is clean and safe. What has improved since the last inspection? 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. Vancouver Road, 23 DS0000025649.V364791.R01.S.doc Version 5.2 Page 7 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 Vancouver Road, 23 DS0000025649.V364791.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 5 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Prospective residents do have all the information to make a choice about where they live. The homes needs assessments are in place, and the home has been responsible in requesting information from social services when needed. Residents are provided with up to date contracts/statements of terms and conditions. EVIDENCE: There was a recommendation made at the last inspection for the home to update the Statement of Purpose and Service User Guide to include the range of fees charged by the home and explaining the service to be provided. This has now been done and the home now provides good information for current and prospective residents, which clearly shows services to be offered, the charges for the services, and a range of information about staff experiencing training, the provider organisation, and how residents can complain should they need to. There was a recommendation made at the last inspection for the home to contact relevant social services and request of them complete assessments of the care needs for some residents who did not have these assessments provided by social services. The homes manager has sent a letter to social Vancouver Road, 23 DS0000025649.V364791.R01.S.doc Version 5.2 Page 9 services care managers for three residents asking for care assessments to be completed and provided. There were letters on file showing that this has happened. One of the social service departments has responded and committed to provide an updated assessment for this resident. The manager is currently following up with the other two social services departments regarding the other two residents. All of the residents have full and complete assessments in place and the home has carried out their own care needs assessments, which are very comprehensive, for all of the residents. There was a requirement made at the last inspection for the home to include information regarding fees, the service to be provided, and the room numbers, in contracts or statements of terms and conditions for residents. This is now been done and all residents have on file a signed and dated copy of these documents. Where residents are being charged higher fees than other residents this is also explained in these documents. Two residents confirmed they had been given these contracts and that they had the contract explained to them. Vancouver Road, 23 DS0000025649.V364791.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Assessed and changing needs are fully reflected in all residents care plans and they are supported by staff to make decisions about their lives. Risk assessments are in place to protect residents and understood by staff. EVIDENCE: There was a requirement made the last inspection for the home to more fully involve residents in writing and developing their care plans, and to ensure that they were written in a language and style are that would help residents to understand them. This has now been done. Examination of three residents files showed that their care plans have been reviewed every six months and that the information in the care plans has been taken directly from care assessments. There is good evidence of involvement of residents in their care plan development. There are key worker meetings for each resident held on a monthly basis and there are also six monthly review meetings held. There are notes and minutes showing that the residents had been present and have Vancouver Road, 23 DS0000025649.V364791.R01.S.doc Version 5.2 Page 11 participated. Three residents said that they had been involved in the care planning and have been asked by staff and their care needs. They were also able to say who their keyworker was, and said they give them good support. There is now very good use of pictures throughout the assessment document and pictures are also used keyworker meeting minutes and throughout care plans. There is a new care plans system in place for one resident, and the manager has put in place plans for keyworkers to develop this new care plan system for all residents. A template care plan has been produced for each key worker to follow to enable them to understand this process. The manager has set a deadline for August 2008 complete his work. One resident has requested large font type to be used in some documentation and this is now been done. I saw copies of the Service Users Guide and contract for this resident, which included pictures and large font to help him understand these documents better. Residents care plans include good risk assessments, health care and personal care needs, Personal development, and opportunities to take part in activities both in and outside of the home. Plans include areas for development such as cooking, personal care such as nail care, support for getting dressed, and one resident attends a college course and personal life skills course. All of the residents who live at the home have learning disability support needs, and mental health support needs are also a prominent feature of the care provided. There are also some behavioural issues, which are well managed and are included in the care planning process, and the home receives support from appropriate health care professionals qualified in these areas. The residents I spoke to said that the homes manager and staff are generally good at helping them to do the things they need to do, and one resident who wants to move said that she realises that this could be difficult, but says that the staff and the manager are good at helping to sort out any problems. Overall care plans are now very well organised, and include a range of risk assessments appropriate to each resident. Risks identified include: protection against financial vulnerability, Physical aggression, travelling in the community and there is good guidance in this place showing staff how to provide the support needed. A full range of health and social interests are included in the planning system. Six at the residents of the home have their benefits managed by the registered provider. A corporate appointee for the provider deals with these matters. All residents have their own bank accounts or post office accounts and very good records are kept that all transactions. The provider has been successful in supporting one resident to sort out outstanding DSS benefits and this is provided this resident with a better financial standing. Vancouver Road, 23 DS0000025649.V364791.R01.S.doc Version 5.2 Page 12 Two residents have independent advocacy and all of the residents have good regular contact with the families. Good information is provided for all residents about how to get advocacy support if needed. Risk assessments are included in all care plans and as discussed all risk assessments are being reviewed at least every six months. Vancouver Road, 23 DS0000025649.V364791.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13, 14, 15,16 and 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are able to take part in age/peer and culturally appropriate activities, They are part of their local community, and are supported to have relationships. Resident’s rights are respected, and good meals are provided. EVIDENCE: The home provides support for residents to identify their training and development needs within their care plans. One resident attends a college course and personal life skills course. This resident commented that the staff have been very helpful about facilitating his needs in attending the course. Comments from other residents suggest that they are happy with the information and support offered to develop their educational opportunities and full use is made of the local adult education facilities. Vancouver Road, 23 DS0000025649.V364791.R01.S.doc Version 5.2 Page 14 Care plans for residents include areas for development such as cooking, personal care such as nail care, support for getting dressed, and one resident attends a college course and personal life skills course. Residents care plans include a weekly plan, which for one resident showed a substantial amount of sporting activity including playing football, and attending college five days a week. Another resident has a special interest in playing table tennis and is supported to play this at a high level within the borough, and is part of the team has been chosen to participate in the special Olympics. Another resident is also part of a football team that has been very successful. The manager of the home has been very active in developing these opportunities. One resident said he is extremely happy with being able to participate in football and table tennis and really loves sport. He is supported to attend a college course and spoke about the summer holidays there had been planned to go to the Isle of Wight. Another resident spoke about been able to participate in gardening and said that she is also been asked to be involved in the recruitment of a new assistant manager for the home. Three residents I spoke with said they were aware that they were able to vote in local and national elections if they wished. The home has good relationships with local neighbours and residents in the local community and many of the residents go out in the local community on a daily basis, visiting local shops, cafes and occasionally going to the theatre. Six of the eight residents have very regular involvement from their families. The remaining two residents have active support available from a citizens advocacy group. I spoke with one of the advocates involved who said that the home and management communicate well with them and provide good opportunities for these residents to get the advice and support they need. My discussion with staff and residents confirmed that staff have a good and supportive relationship with residents. The residents I spoke to said that the staff are respectful and always ask for permission to enter their rooms and they always open their own mail. I observed the staff speaking with residents in the kitchen and living room areas on a number of occasions and there was a positive interaction between them. The food menus are displayed in the home with a choice of two main meals daily. The home records the food residents have eaten and three residents said they could have any food they like apart from the menu if the ingredients are available. The home provides a planned shopping and cooking system, which includes Residents. Almost all of the residents spoken to said that the food provided by the home is good, that they are involved in shopping, and often involved in cooking to some degree. Food provided is healthy and nutritious and good records are kept of food eating. The home includes discussion about the food offered in weekly meetings with residents and minutes of these Vancouver Road, 23 DS0000025649.V364791.R01.S.doc Version 5.2 Page 15 meetings show the home is active in dealing with any problems or concerns about food. Vancouver Road, 23 DS0000025649.V364791.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Respectful and sensitive support is provided for Residents regarding personal care, health and emotional needs. Residents are supported to retain administration of their medication and medication is well managed. EVIDENCE: All Residents are independent in their personal care and no specialist equipment is needed. Personal care support is limited to only prompting occasionally and staff do not provide support in bathrooms or toilet areas. Times for going to bed, getting up and meals are flexible for each Resident, and six Residents confirmed this. All Residents’ files examined showed health care needs are well managed with good input from a range of health care professionals. Residents are aware of their health care support needs and all confirmed that they had been registered with a GP and regularly attend a dentist. Some Residents have mental health support needs and where appropriate have a community psychiatric nurse involved in their care planning. There is support provided by psychology and psychiatry and challenging needs practitioners, especially in Vancouver Road, 23 DS0000025649.V364791.R01.S.doc Version 5.2 Page 17 the area of communications and motivation. Residents files showed there is extensive use of pictures to help residents understand documentation if they were unable to read, and in the use of better weekly activity plans. The home has a written Medication policy that is clear and up to date. Six residents are using prescribed medication and no controlled medication is being used. Medication is stored in a locked room in a private area, and this is safe and secure. The Boots Pharmacy blister pack is used to administer medication. Records are well maintained with minimal omissions recorded. The Boots pharmacist attends the home twice a year and did a full inspection of the management, storage and administration of medication on 16th June 2008. This report showed management and administration of medication to be very good. The home has helped one resident to learn to self medicate and this went well for a period of time. This resident has since decided to ask the home to manage the medication for personal reasons. There was one instance of medication going missing and this was investigated fully by the home. The investigation was inconclusive but led to a belief that this was connected with a member of staff who resigned prior to disciplinary action. Vancouver Road, 23 DS0000025649.V364791.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The Residents feel their views are listened to and acted on, and that they are adequately protected from abuse and neglect. EVIDENCE: The home has an up to date complaints policy in place, which is available at the home. All residents have been give a copy of this and it is also clearly referred to in the homes Service User Guide. There was a recommendation made at the last inspection for the home to provide a written response and outcome for residents and others when they make a complaint. This is now being done and there is a letter on file for each occasion when a complaint has been made. All complaints have been investigated within 28 Days. There have been four complaints made since the last inspection. The home has responded to these efficiently and good records have been maintained. This shows a substantial reduction in the number of complaints being made, which was 18 complaints at the last inspection. All residents I spoke to said they are aware of how to make complaints if they need to but also said that the manager is always around to deal with problems and that he deals with things quickly and tells them what he has done to sort things out. The complaints were usually around some residents being upset by the behaviour of fellow residents, such as noise, and arguments. On these occasions the management fully investigated the complaint immediately, and agreed a means of dealing with the problem with the resident concerned. Vancouver Road, 23 DS0000025649.V364791.R01.S.doc Version 5.2 Page 19 There is an up to date adult protection policy available at the home. Three staff interviewed showed a good understanding of their responsibilities in recognising and reporting suspicions of abuse. Four referrals have been made to the local authorities adult protection team since the last inspection. The homes management appropriately and quickly referred all of these and good records were maintained. The local authority lead on adult protection confirmed that the home is communicating well regarding adult protection and other issues and provides information quickly and clearly. The home has a good relationship with the local police who are involved sometimes in helping advise residents about their rights and responsibilities. This is a positive example of the home using other professionals to help residents receive support and advice in a proactive way to prevent problems escalating. There is one adult protection situation, which is still awaiting an outcome report by the home. The manager is aware of this and is in the process of completing the report. Some of the staff expressed a request for the opportunity for further discussion and training regarding the processes of the adult protection policy so in order to feel safer and confident in fulfilling their roles. Given the sometimes-difficult circumstances arising within the home regarding behavioural challenges it is recommended that the registered provider respond to this request. This does not reflect poorly on the staff’s current abilities in safeguarding and protecting residents as the staff have demonstrated a good knowledge of the response required in recording and reporting. (Refer to Recommendations YA35) The manager has been more recently required to carry out investigations regarding adult protection issues and has not had any formal training in the process and boundaries for doing these investigations. The adult protection reports I examined were good and well written but there is a need for clearer definition to be provided about the processes and parameters for carrying out these investigations so that managers feel confident and supported. (Refer to Recommendations YA 35) Vancouver Road, 23 DS0000025649.V364791.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home is homely, comfortable and safe and is kept very clean and well maintained. EVIDENCE: There was a recommendation made at the last inspection made at the last inspection for the home to consider extending the office space to make it more usable for residents and staff. The home has now explored this possibility and decided that it is not possible to do this without affecting the freedom of movement in the hallway area. The home’s premises are suitable for the purposes of providing a service for the people who live there. The ground floor is wheelchair accessible and all of the service users are fully mobile. The home is a good size, well lit, and well decorated, and is maintained to a high level of cleanliness and hygiene. All health and safety issues are well managed. Risk management was an area that needed improvement at the last inspection and the homes management has now addressed this. Risk assessments are in place for each resident, which Vancouver Road, 23 DS0000025649.V364791.R01.S.doc Version 5.2 Page 21 include environmental risks, such as the use of equipment in the kitchen and fire safety. Each Resident has their own room and there are two bathrooms, one separate toilet and shower room, and an additional toilet shared amongst eight service users. The home is central to local buses and shops and is in a quiet residential road. The manager keeps a list of repairs requested, which include dates and times of repairs reported and repairs carried out. Four residents rooms were looked at, and these were seen to be very well maintained, clean, and decorated according to the wishes of the resident. Three residents said that they are happy with their rooms and they are able to make them look how they wish. Various areas of the home have now been redecorated including the hallway, the dining room, the lounge area, and the stairway. New shower guards have been fitted in the shower room, and non-slip flooring has been ordered for the shower room and laundry. New furniture is also being provided including an edit suite in the lounge, and residents confirmed that they were involved in choosing the furniture and the colours for decoration. The garden has been redesigned as part of a Princes Trust project, in which one resident was involved. This resident said she was very proud of being able to do this, and all the residents now benefit from an improved garden. Vancouver Road, 23 DS0000025649.V364791.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 and 36 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staff are competent and experienced and qualified to provide the service. Recruitment and employment is well managed. Staff now receive appropriate training and are well supervised. EVIDENCE: There was a requirement made at the last inspection for the home to ensure that a minimum of 50 of the care staff be qualified to NVQ level 2/3. Nine of the 14 care staff currently employed now have NVQ 2/3, and a number of other staff are currently studying for NVQ level 3. This shows an improvement in the number of qualified staff since last inspection, and this requirement is now met. The home has a good induction process in place which is now classroom based for at least three days at commencement of employment. Three staff files examined were those of staff had been employed since last inspection. All of them showed that staff had been adequately inducted in accordance with a structured induction process, and all of the staff also received good induction training in a broad range of areas relevant to the care provided. Of the three Vancouver Road, 23 DS0000025649.V364791.R01.S.doc Version 5.2 Page 23 staff interviewed two said they felt the induction training was good and one said it was excellent. All three staff showed a good knowledge of the care needs of the residents and showed a calm and non-confrontational approach to working with challenges presented in some areas of their work. All had experiencing and training in providing support for people with Learning Disabilities and mental health support needs. Although a number of the staff were new they had settled in well and had developed a good rapport with residents. I observed all of the staff to communicate well with residents in a friendly and open manner throughout the inspection visit. Three residents said that the staff are good and supportive. Recruitment and employment records are held centrally at the office and they are inspected by a CSCI Provider Relationship Manager. The home’s manager is fully involved in the recruitment process. Standard questions are used for interviews and the manager of the home checks references before passing these to the central office. In order for the home to keep a record of staff recruitment and employment at the home, a staff recruitment and pro forma document has been produced by personnel to be maintained at the home. This allows staff recruitment procedures to be fully checked when inspected. Examination of three staff files, and of this pro forma system, showed that complete records are now being maintained at the central office, and information about to recruitment of all staff employed in is kept at the home as required. The home has now started to involve residents in the staff recruitment process, with some residents currently involved in the interviewing of deputy manager candidates. There was a made at the last inspection for the home to include mental health and management of challenging behaviour in the training prospectus for staff. This has now been done. Five of the staff have now had challenging behaviour training and all had a degree of mental health training. As was the case at the last inspection the home has a good induction and training process in place, which has been improved from the use of videos and books, facilitated by an outside trainer at the home, to a fuller classroom based induction covering health and safety, fire safety, food hygiene, moving and handling, medication, abuse and basic first aid. The induction course is completed over three days. There is staff training and development plan in place for individual staff. It is recommended that further more in depth mental health training be provided for care staff to include aspects of the Mental Capacity Act relevant to their work. (Refer to Recommendations YA35) The adult protection reports I examined were good and well written. The home has been asked on a number of occasions to carry out safeguarding investigations by the local authority. The registered manager has usually done this. However discussion with the manager and staff showed that there is a Vancouver Road, 23 DS0000025649.V364791.R01.S.doc Version 5.2 Page 24 need for clearer definition to be provided about the processes and parameters for carrying out these investigations, so they feel confident and supported. It is recommended that the manager and staff be given the opportunity for further training relevant to their posts by the provider regarding the safeguarding policy and in carrying out safeguarding investigations. (See also Standard 23) (Refer to Recommendations YA 35) Staff are consistently being supervised by the manager monthly and good records are being kept. There is a supervision schedule in use showing planned future supervisions. Staff interviewed confirmed that they feel they are receiving good support and direction to do their jobs. There is an annual staff performance appraisal system in place now, and staff confirmed that they have been given appraisal forms to complete for the upcoming appraisals. Few of the staff have as yet had an appraisal but as many staff are new this is acceptable and it is clear that there is now a solid commitment by the manager to complete appraisals for all staff. Vancouver Road, 23 DS0000025649.V364791.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): 37, 39 40 and 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home now has a consistent and committed manager in place who manages the home well. Resident’s views on quality of care are now being sought and are being included in the homes development plans, and in the homes policy development. Health, safety and welfare of staff and residents are promoted and protected. EVIDENCE: At last inspection of July 2007 a new manager for the home had been appointed who is experienced in the field of Learning Disabilities and Mental Health support. This manager still remains at the home and has now developed a good knowledge of residents support needs through hands on experience on a daily basis. He has been on holiday with residents and has been actively Vancouver Road, 23 DS0000025649.V364791.R01.S.doc Version 5.2 Page 26 involved in supporting some residents to play football and to coach the team to attain a good level of success. He holds an Honours Degree in Psychology, and has specific experience in working with autism. He has completed training in: infection control, diabetes, dementia, supervision, epilepsy, and control of infection, and challenging behaviour. The manager has a good working relationship with the staff team and the staff interviewed said that he is very supportive and always available to lend a helping hand when needed. The residents said that he is easy to talk to, and is always available at the home. The manager has almost completed NVQ4 in care and management (RMA) and has applied to CSCI to become registered care manager. The post of deputy manager is currently being recruited to. There have been significant improvements made in the consultation processes between the home and the residents. Annual opinion surveys are carried out asking for their views on how the home is managed, the staff support offered and the physical environment. There are also monthly house meetings which most of the residents attend. The manager facilitates this and notes are kept and given to residents using pictures to help understanding. These consultations have resulted in redecoration of the home and resident’s rooms, the purchase of new furniture for the living room and changes in menus in response to views expressed at weekly discussions about food quality. The registered provider carries out monthly inspection visits and the provider also has a Quality Assurance team that carries out inspections annually and provides an action report for improvements needed. There is an Annual Development Plan for the home resulting from the above consultations and inspections. Health and Safety in the home is well managed. The home has an adequate health and safety policy, which includes risk assessment, fire safety, food hygiene, moving and handling, and all of these are included in the staff induction and training programme. Fire equipment checks are being done on a weekly basis and the home has certificates for electrical and gas appliances which are up to date. Kitchen and bathroom areas are maintained to a high level of cleanliness and safety. Vancouver Road, 23 DS0000025649.V364791.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 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 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 X 3 X Vancouver Road, 23 DS0000025649.V364791.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA35 Good Practice Recommendations The registered provider should provide further training for care staff and the manager in the processes of the safeguarding policy in order to further consolidate team confidence The registered provider should consider providing more in depth mental health training for care staff to include aspects of the Mental Capacity Act relevant to their work. 2 YA35 Vancouver Road, 23 DS0000025649.V364791.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Vancouver Road, 23 DS0000025649.V364791.R01.S.doc Version 5.2 Page 30 - 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!