Care Home: Wade Bungalow Residential Home

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What the care home does well There was information available about this home that included pictures to aid understanding and told people what the service had on offer and how much that was expected to cost. Staff continued to support residents to lead an ordinary and meaningful life, both in the home and within the community. A resident was spoken with about their life at Wade Bungalow. They told us that they thought it was OK living with the other 2 residents. They spoke about going out the previous evening to the local pub and having a drink and talking to people they knew. Observations during the inspection showed that residents were supported by a competent staff team who know and understand their individual needs. The care plans seen for each of the residents clearly described their needs including detailed plans for one resident with complex behaviours. Wade Bungalow was comfortable, clean, airy and repairs and maintenance are carried out promptly. The purpose built bungalow met the needs of the existing resident group. One relative told us `I`m very happy that my relative is at Wade Bungalow. The care staff are very supportive and everything is spot on at the moment`. What has improved since the last inspection? There had been progress made since the last visit to the home. The Service Users Guide had been reviewed and provides good information more accessible to people with a learning disability. Care plans and risk assessments had been reviewed and developed and had been made more accessible with more up to date information for staff to follow. The security of the premises had been reviewed and the locks had been changed with a register of who had a key to the premises being kept. Responding to the investigation around a theft of residents money the wider organisation had a financial procedure in place, but in addition to this the home had completed individual financial risk assessments that state what an individual resident can do for themselves and understand. This goes on to say what support was then required with finances. In addition accounts were regularly audited and additionally checked by the area manager. What the care home could do better: There were 2 areas that the home needed to develop. The first was to ensure that hot water shower facilities do not pose a risk to the vulnerable people using the service. Secondly, to protect the residents further the correct details for administration of medication must be readily and accurately identifiable and therefore medication labels should not be removed from medication packets. CARE HOME ADULTS 18-65 Wade Bungalow Residential Home Wade Bungalow Residential Home The Pightle Needham Market Suffolk IP6 8AQ Lead Inspector Claire Hutton Unannounced Inspection 23rd July 2008 01:00 Wade Bungalow Residential Home DS0000024518.V368828.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 Wade Bungalow Residential Home DS0000024518.V368828.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. Wade Bungalow Residential Home DS0000024518.V368828.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wade Bungalow Residential Home Address Wade Bungalow Residential Home The Pightle Needham Market Suffolk IP6 8AQ 01449 722681 01449 723762 h2002@mencap.org.uk www.mencap.org.uk Royal Mencap Society 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) Vacant Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Wade Bungalow Residential Home DS0000024518.V368828.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th August 2006 Brief Description of the Service: Wade Bungalow was opened in 1992 for four residents with a learning disability. The bungalow is spacious, with four bedrooms, two bathrooms and an additional toilet. There are three communal rooms; one large sitting room, a quiet room and a smaller sitting room with access to the rear garden. The kitchen is also in the dining area and a separate utility area is provided. There are gardens on three sides of the building. The staff office contains a bed for staff undertaking sleeping in duties. Wade Bungalow is situated in a cul-de-sac close to the centre of Needham Market and is close to shops, pubs, churches and other local amenities. Local transport is within easy access for routes to Ipswich, Stowmarket and Bury St Edmunds. The home has a detailed statement of purpose and service users guide. These documents provide information about the service and give details to prospective residents about how to obtain a summary of the most recent Commission for Social Care Inspection (CSCI) report. The property is owned and structurally maintained by Sanctuary Housing Association and Mencap provides the direct care. Each resident is provided with a licence to occupy setting out their basic rights and responsibilities with the housing association and Mencap. The weekly fees vary for each individual resident, fees range from £367.48 to £392.01. Not included in these fees are service users own personal items such as toiletries, clothes, personal electrical equipment, personal leisure activities and meals outside of the home. Wade Bungalow Residential Home DS0000024518.V368828.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use the service experience good quality outcomes. This was an unannounced key inspection that focused upon the core standards relating to Adults (18 – 65). The site visit took place on a weekday lasting 6 ½ hours. The inspection process included visiting all areas of the home, discussions with staff, a relative and resident, observations of staff and resident interaction, and the examination of a number of documents including resident care plans and associated documents, medication records, the staff rota, records relating to health and safety and records relating to staff recruitment. The report has been written using accumulated evidence gathered before and during the inspection. The Commission had received an Annual Quality Assurance Assessment (AQAA) completed before the inspection. This completed document was a self-assessment. We chose not to send surveys to this small service as they had only recently been done in respect of an annual service review. Therefore to get a clearer view of what people thought of this service 3 staff were interviewed in private during the inspection, a relative was met and spoken with in private and a resident was spoken with. Comments received by people who use this service are used throughout this report and are all positive. Since the last inspection of this service the registered manager is no longer in post. A new manager has been appointed and we have received an application to register them. At this inspection we left an immediate requirement in relation to an additional shower that had been fitted. The shower supplied extremely hot water that was a scald hazard to the vulnerable people who use this service. The service has since notified us that the shower has been replaced, but this has also been disconnected until the thermostatic controls are working and can ensure safety for the residents. What the service does well: There was information available about this home that included pictures to aid understanding and told people what the service had on offer and how much that was expected to cost. Staff continued to support residents to lead an ordinary and meaningful life, both in the home and within the community. A resident was spoken with about their life at Wade Bungalow. They told us that they thought it was OK Wade Bungalow Residential Home DS0000024518.V368828.R01.S.doc Version 5.2 Page 6 living with the other 2 residents. They spoke about going out the previous evening to the local pub and having a drink and talking to people they knew. Observations during the inspection showed that residents were supported by a competent staff team who know and understand their individual needs. The care plans seen for each of the residents clearly described their needs including detailed plans for one resident with complex behaviours. Wade Bungalow was comfortable, clean, airy and repairs and maintenance are carried out promptly. The purpose built bungalow met the needs of the existing resident group. One relative told us ‘I’m very happy that my relative is at Wade Bungalow. The care staff are very supportive and everything is spot on at the moment’. 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. Wade Bungalow Residential Home DS0000024518.V368828.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 Wade Bungalow Residential Home DS0000024518.V368828.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is available so that prospective residents can make an informed choice. People are provided with a contract and therefore agreements are established. EVIDENCE: The home has a Statement of Purpose and a Service Users Guide was well developed. The Service Users Guide had photographs of the service and included the fees to be charged. Copies of these documents had been given to current residents and were seen on their individual file. The complaints procedure was part of these documents and was in a pictorial format to aid understanding. The self-assessment states ‘There are robust procedures for accepting new referrals to the service and assessing the suitability of the service for that individual. The service currently has a void, which is not being filled at present due to the restrictions that this could place on the prospective service user as a result of the behaviour management plan of a current service user within the service Wade Bungalow Residential Home DS0000024518.V368828.R01.S.doc Version 5.2 Page 9 An updated service user guide has been produced in pictorial format, which is kept within each service user’s personal file and within the Local Information file on the service’. There have been no new admissions to the home since our last inspection, therefore we have not been able to inspect new assessments carried out; but we know that assessments have previously been completed prior to anyone taking up residence at this home, with care and support needs having been assessed and agreed to be met by the home. We examined 2 files that contained contracts in place for residents and these set out the terms and conditions. Wade Bungalow Residential Home DS0000024518.V368828.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have access to up to date information so that they can support people appropriately. Residents are assisted to make everyday decisions. EVIDENCE: The care plans and associated documentation for 2 residents were examined in detail. These had recently been reviewed and had been made more accessible with more up to date information for staff to follow. One care plan showed that there were clear instructions available to staff on how best to support the individual. A behavioural support plan based upon an assessment completed by professionals external to the home ensured the support given by staff was consistent and up to date. Documentation was being completed on behavioural incidents and staff spoken with knew how to complete these, which ensured a consistent approach that would benefit people with autism. Wade Bungalow Residential Home DS0000024518.V368828.R01.S.doc Version 5.2 Page 11 The same person had daily records duly completed by staff about personal support given, meals and drink offered and eaten and activities they had participated in. The record included the individual’s behaviour and mood for the day. These records were completed well and gave good information. The care planning information in place for one other individual was also examined and discussed with the manager. There was a person centred plan that had been developed, similarly to the one above. There was evidence that a formal review with the funding authority would take place the next day that would go one to review the placement. There was evidence that residents did make decisions about everyday activities. Resident choice was respected when offering activities and this was seen on the day of the visit in attending or declining the activity on offer. Daily records also documented choices offered and made. A resident was spoken with about their life at Wade Bungalow. They told us that they thought it was OK living with the other 2 residents. They spoke about going out the previous evening to the local pub and having a drink and talking to people they knew. Staff spoken with said that there was a plan for every day, but that choices and decisions were made through out the day and were respected. Staff were keen to support and promote independence and spoke of enabling residents to maintain skills at home such as participating in cleaning their own home. One relative spoken with said they felt the home met the needs of their relative. The risk assessments in care plans had been reviewed and reflected what people had spoken about such as cleaning bedrooms, working in the garden, swimming and using public transport. Wade Bungalow Residential Home DS0000024518.V368828.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People tell us that there are appropriate opportunities for leisure and personal development that met the needs of the resident group. People enjoyed a varied diet. EVIDENCE: In terms of activities and choices available to residents there was a great variety on offer. Staff have access to the weekly program for each resident, but choices about what to do are made by the individual on the day. One resident chose to attend a day service 5 days a week whilst others had other opportunities developed individually based within the community. For one individual this was quite a physical program swimming, walking and horse riding, whilst for another resident told us they chose to go to a coffee morning at the church and attend a drop in centre in Stowmarket called café 52. On the day of our visit this individual had been out for lunch with a relative to a hotel close to the home. The resident told us ‘the food is nice there’. The selfWade Bungalow Residential Home DS0000024518.V368828.R01.S.doc Version 5.2 Page 13 assessment told us ‘Mencap aims to enable and support those who use the service to actively engage and participate within their local community. Those within the bungalow are encouraged and supported to participate in a range of leisure activities. Regular contact is encouraged with families and staff support the service users to maintain that contact. Service users have a balanced diet, are encouraged to eat healthily and choose where to eat within the bungalow and this right is supported by staff. Staff support one service user to take care of the environment as he has a keen interest in recycling’. With the exception of other residents bedrooms residents were free to move around the home. However due to the routine agreed as part of the behavioural plan to support one resident when returning to the home after day care the other residents were encouraged not to enter the lounge for their own comfort and safety until the resident has had time to relax. This was discussed with the manager and staff as this disadvantaged the other residents by not having the freedom to access the lounge. In recognition of this a member of staff was employed at that time to provide additional support. This was working well, as each resident is protected. The manager was however trying to resolve this matter on a long term basis with on going discussions with the placing authorities. One relative told us ‘I’m very happy that my relative is at Wade Bungalow. The care staff are very supportive and everything is spot on at the moment’. Care staff were seen to be preparing refreshments throughout the day as and when people requested them. It was explained that residents make a choice in an evening about what they would like for their meal, but that there was a menu to guide people. The manager explained that they were in the process of developing a pictorial menu to develop communication. This involved taking pictures of meals that had been prepared for residents to choose again if they had liked them. The resident spoken with said they liked the food they had and that tonight they wanted to have fish fingers for tea. A staff member confirmed this would be served for that individual. Records showed that relatives had regular contact by telephone and relatives can regularly visit if they so wish. One relative said ‘I visit when I want to. I have a good relationship with the new manager and trust the new manager’. Residents had the opportunity to spend time on their own in their rooms if they choose, they can lock their bedroom doors for privacy, staff had a master key to override the locks in an emergency. Wade Bungalow Residential Home DS0000024518.V368828.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People were supported in a manner suited to their personal preference. Residents can also expect to have good access to healthcare services. Medication practices were generally effective to protect people. EVIDENCE: The self-assessment completed by the manager told us ‘The support provided at Wade Bungalow is based on individuals needs and wishes and each person has a designated keyworker to ensure that any support that is provided is regularly reviewed and changed as needs change and recorded within support plans so that all information is current and up to date. We evidence this in a rota that is based on the support needs of the service users, Support plans that detail the personal and healthcare support needs of those at the service, Medication pen pictures and Health Action plans’. These points were clarified and documentation seen during the visit confirm all these services are available to residents at Wade Bungalow. The health records relating to one individual who had been unwell were examined. Appropriate ongoing medical attention had been sought with a Wade Bungalow Residential Home DS0000024518.V368828.R01.S.doc Version 5.2 Page 15 referral to Walker Close. The individual had been to see a specialist today and had been supported by the manager, a key worker and a relative. Records were kept of visits to the general practitioner (GP) and other health professionals. All residents were registered and had access to the doctor’s surgery in Needham Market. A record of visits to the GP and an occupational therapist was seen in one residents care plan. In relation to medication management within the home, the self-assessment told us: ‘The service has detailed medication pen pictures for all individuals providing key information to staff on any medication prescribed for each service user’. Due to the high and complex needs of the residents none of them self medicate. Medication was kept locked in the manager’s and staff office. The home uses the monitored dosage system (MDS). The medication Administration Record (MAR) charts were seen and found to contain no gaps in staff signatures. At the front of each service users MAR charts is a pen picture, describing the medication, why the service user took it and when and the possible side effects. At the front of the medication folder there is a copy of the procedures for the control and use of medicines produced by Mencap. The policy covered the arrangements for the safe ordering and returns of unused or soiled medication. Medication for one individual was audited and found to be correct. Staff were seen to in give medication in line with their own procedure. However one individual was on a complex mixture of medications to help maintain a healthy bowel. Stickers had been taken from the boxes of medication and placed onto the MAR sheet. Overall it was not immediately clear what medication should be given and when. The manager was confident that what was being given was correct and said she would ensure the directions were made explicit for all staff to follow. Wade Bungalow Residential Home DS0000024518.V368828.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a clear policy and procedure in place for making complaints and dealing with allegations or suspicions of abuse. People are protected and their views listened to. EVIDENCE: The self-assessment completed by the manager tells us ‘As a service provider organisation, we aim to ensure that those we support and their families raise any concerns or complaints about the service that they are unhappy with or feel could be improved and those at Wade Bungalow seek to continuously improve the service that is provided by acting positively on any concerns received in a timely manner. Staff, service users and their families are aware of the complaints procedure and this is available in pictorial format’. A copy of Mencap’s complaints procedure was made available to the residents and their relatives in the Service User Guide. The complaints book was seen; there have been 4 complaints received by the home since our last inspection. This included one safeguarding referral that we commented upon in our last report. The organisation’s policy and procedure are very clear and detailed on staff’s responsibility to report allegations or suspicions of abuse, which includes informing the local authority vulnerable adult protection committee and commission for social care inspection (CSCI). The incident of theft of resident’s money was reported in Wade Bungalow Residential Home DS0000024518.V368828.R01.S.doc Version 5.2 Page 17 line with the procedure. The appropriate agencies were notified of the incident and a Protection of Vulnerable Adults referral was made. This resulted in a full investigation involving the police and social services. And as a result a staff member no longer works at the home. A discussion was held with the new manager around what had been learnt from this incident and what measures of prevention had now been put in place. The wider organisation had a financial procedure in place, but in addition to this the home had completed individual financial risk assessments that state what an individual resident can do for themselves and understand. This goes on to say what support was then required with finances. In addition accounts were regularly audited and additionally checked by the area manager. All staff had attended protection of vulnerable adults training, but 4 staff were in need of refresher training. The manager had identified this and was arranging for them to attend. There was evidence that 2 recent complaints received relating to a medication error and oral hygiene of a resident had been acknowledged investigated and appropriate action taken. All 3 staff spoken with were quite clear about their responsibilities in relation to safeguarding and to listening and reporting any concerns that the residents may raise. Wade Bungalow Residential Home DS0000024518.V368828.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Wade Bungalow was comfortable, well maintained and met the needs of the existing resident group. EVIDENCE: The self-assessment completed by the manager told us ‘Regular environmental checks ensure that the service is also safe and free from any hazards. The service encourages and supports those within the home to be involved in its upkeep and participate in decision-making relating to their environment. Service users bedrooms reflect their choices and individual personalities’. A tour of this purpose built home was conducted and we found it offered goodsized accommodation with enough communal and private space for residents to spend time on their own or be involved in a group activity. There were three sitting areas; these are well furnished with comfortable sofas and armchairs. Wade Bungalow Residential Home DS0000024518.V368828.R01.S.doc Version 5.2 Page 19 All lounges are equipped with entertainment including television and music systems. The kitchen was well-decorated and a new freezer and dishwasher had been purchased. The bungalow had an enclosed, secluded garden that was well maintained, with a patio area with chairs for barbeques in the summer months. The home had a lot of wear and tear due to the complex behaviours of the residents; generally the home is clean, airy and comfortable and repairs and maintenance are promptly carried out. At the time of our visit a contractor was visiting the home to repair the seal on the cooker. The décor was bright and cheerful with photographs of the residents on display around the home. Residents had their own rooms, which were decorated and personalised to reflect their individual tastes. Since the last inspection, the hallway had been redecorated and a new carpet laid. The laundry room had all the appropriate equipment to launder clothes appropriately. Chemicals were stored away securely for the protection of the residents. Wade Bungalow Residential Home DS0000024518.V368828.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be assured that staffing levels meet residents health and care needs and that staff are trained to do their job. Residents were protected by the homes recruitment practices. EVIDENCE: The roster in use at the home was examined and this showed sufficient staff were consistently on duty. In a morning there were 2 staff on duty and one resident went out to day care quite early. In an evening there were 3 staff on duty making a one to one of the residents. A staff member slept in at night. The residents were aware of who was on duty as there was a staff photo displayed of each staff member on duty that day. The manager was aware that there was due to be some staff vacancies and would need to go on to use relief staff and a recruitment drive was planned. The self-assessment completed by the home tells us ‘Wade Bungalow has a dedicated, committed staff team that is flexible to the needs of the service and have a high level of skill and many years of experience. The service has a dedicated team of relief staff, regular staff supervision and team meetings and Wade Bungalow Residential Home DS0000024518.V368828.R01.S.doc Version 5.2 Page 21 clear recruitment policies and procedures. The service has a high percentage of trained staff with an NVQ 2 or above. Mencap has a detailed induction programme for new staff’. Recruitment records for 2 staff were examined and these found that background checks were completed in line with regulation therefore provide the safeguards to offer protection to people living at the home. 65 of staff held an NVQ qualification in care or were working towards the qualification. Staff spoken with confirmed that the employer carried out checks such as CRB and references before starting work. Staff confirmed that they had appropriate training to do their job. One staff member said that ‘I have NVQ 3 in care, fire training, medication training, food hygiene training, health and safety and have unisafe training in dealing with behaviour that challenges. I feel I have the right training and I’m kept up to date’. The Manager was aware of some updates required in staff training with 4 staff needing updates in protection of vulnerable adults and 1 person requiring an update in food hygiene. She was awaiting the Mencap training schedule to be developed to access this for staff. The 3 staff spoken with confirmed that they received regular formal supervision. One person said ‘It is regular and I was due to have it today’. Another staff member said that they also received supervision in the form of testimonials for their NVQ and were observed from time to time whilst administering medication. Wade Bungalow Residential Home DS0000024518.V368828.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Wade Bungalow was well managed. The health, safety and welfare of people using this service was being promoted. EVIDENCE: Since our previous visit to the home we were informed that the registered manager was no longer employed at the home and a new manager had been appointed. The new manager has us sent an application to consider them for the registered manager of Wade Bungalow. Staff spoken with were satisfied with the new management arrangements. Staff said ‘ we had a tricky time and then no manager for a while, but now we have a very good manager who is approachable. I feel supported and she is making stuff better’. Another staff member said ‘She’s very good, open to talk to. She’s helpful and keeps confidences’. A relative spoken with said ‘the new manager is fantastic and I trust her’. Wade Bungalow Residential Home DS0000024518.V368828.R01.S.doc Version 5.2 Page 23 The new manager spoke about the plans for development of the service and the formal discussion they planned with social service about the placements of the residents at the home and the incompatibility of the resident group. This had manifested itself in the separate lives, in separate parts of the home that the staff had to maintain within the shared environment in order that each resident was safe and contented. This had also resulted in the inability to place a 4th resident within the home to fill the vacancy. The manager accepted that the process may not be easy, but she hoped to use a multidisciplinary approach to make the best decisions for a better outcome and quality of life for everyone at the home. The manager spoke of her plans and showed us the evidence of how she monitors quality assurance within the home. The home has a continuous improvement plan in place that is monitored by the area manager. This covers areas such as the environment, the staff team and the support of the residents. The plan stated what needed to improve, how that would be achieved, who was responsible and the timescale for completion. The manager also sends a monthly compliance report to the area manager for monitoring. In addition the organisation regularly visit the home and completed a report (called a regulation 26 report) that seeks the views of the residents and staff. The last one completed and available for inspection was for June 2008. In relation to health, safety and welfare of the residents, we found that in touring the home chemicals were appropriately locked away and that staff has access to equipment such as aprons and gloves to maintain hygiene standards. Food was stored appropriately and safe cool temperatures where appropriate were maintained and recorded. In relation to security of the premises that had been raised in the last report the manger confirmed that the locks at the home had been changed and there is a log of who has a key to the premises. Hot water was tested in a shower regularly used by residents and this was found to be within safe limits that would not harm residents. However a shower that had been installed in the bathroom that was not routinely used recorded a temperature of 53°c. This was a scald hazard to the vulnerable people who used the service. We left an immediate requirement to make this safe. The manager immediately disabled the shower by turning off the electricity to the shower. The manager wrote to us to say the shower had been replaced, but this has also been disconnected until the thermostatic controls were working and could ensure safety of the residents. The home was well managed and residents health, safety and welfare was protected by the home’s policies and procedures produced by Mencap. These were accessible and held in the manager’s and staff office with the personnel records relating to staff and residents. Wade Bungalow Residential Home DS0000024518.V368828.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 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 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 3 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 3 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 3 3 3 X 3 X Wade Bungalow Residential Home DS0000024518.V368828.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA42 Regulation 13 (4) (a)(c) Requirement The hot water supply to a shower in the bathroom was above the recommended 43°c. All parts of the home which residents have access must be free from hazards to their safety, and unnecessary risks are identified and so far as possible eliminated. Timescale for action 30/09/08 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 YA20 Good Practice Recommendations Medication labels should not be removed from medication packets. This will ensure the correct details for administration of medication can be accurately identified. Wade Bungalow Residential Home DS0000024518.V368828.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Wade Bungalow Residential Home DS0000024518.V368828.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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