Care Home: Wadham Avenue

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What the care home does well People living in the home a sense of belonging and security and have a positive experience of using the service. Staff treat people with dignity and respect and good relationships exist between residents, support staff and the managers. There is a `person-centred` approach and philosophy of valuing people throughout the service. Individuals are encouraged and enabled to participate in areas of their own and in the life of the home. People are enabled to make personal choices; to develop their life skills and to have self worth. Peoples` individual and diverse needs and aspirations are met thereby successfully meeting the service aims and objectives. Peoples` care plans are well developed to provide an individually tailored service in response to their individually assessed needs. People are encouraged to participate in recreational, educational and community activities that are enjoyable and satisfying to them. The importance of family contacts and friendships is recognised and maintained. Health care plans comprehensively identify and meet residents` health needs. Individuals` religious, cultural and diverse needs are identified and supported, providing assistance to access places of worship if needed or inviting ministers of faith to the home. Individuals receive information about how to complain in an easily accessible format. The absence of complaints reflects a high level of satisfaction in the service. The home is bright, furnished and decorated to a good standard, providing a positive and homely living environment. Staff are sufficiently skilled, knowledgeable and supported by management. There is consistency of staffing with low turnover of staff. Staff demonstrate their care and commitment to improving the quality of life experienced by individuals. What has improved since the last inspection? There are no outstanding requirements at this inspection. Improvements have been made across the service delivery. These include health action plans, care plans and risk assessments which are completed six monthly with more staff involvement; staff training has increased; activities for residents have increased and policies and procedures have been updated and implemented. What the care home could do better: One requirement is given to ensure that all staff receive accredited first aid training. The Manager gave assurance that this will be addressed. Some recommendations are given to improve practise further, including risk assessments to be formally reviewed even if there are no changes; the complaints policy/handbook to be updated with the current CSCI details and the managers` supervision sessions to be recorded. CARE HOME ADULTS 18-65 Wadham Avenue 2 Wadham Avenue Walthamstow London E17 4HT Lead Inspector Nurcan Culleton Unannounced Inspection 27th November 2007 09:30 Wadham Avenue DS0000007299.V355309.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 Wadham Avenue DS0000007299.V355309.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. Wadham Avenue DS0000007299.V355309.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wadham Avenue Address 2 Wadham Avenue Walthamstow London E17 4HT 020 8531 6081 020 8531 6081 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) Mrs Florelda Willis-Barnes Mrs Florelda Willis-Barnes Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Wadham Avenue DS0000007299.V355309.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: 2. Learning Disability - Code LD The maximum number of service users who can be accommodated is: 4 1st December 2006 Date of last inspection Brief Description of the Service: Wadham Avenue, known as Linton Lodge, The Annexe, to the service, is a large semi-detached house, located in Walthamstow on the Chingford boarder. It was established in 1995 and is registered as a care home providing 24 hour care for four adults with a learning disability of both sexes within an age range from 18 years upwards. The home provides care and support, including personal care, to support individuals to achieve independent living. The Statement of Purpose states the overall aim and philosophy is to provide a warm, comfortable and homely environment within which residents can participate, feel secure and relaxed in the knowledge they have a home. The sole owner acts also as the Registered Manager. The home is approximately five minutes walking distance from a range of shops and Post Office and a short bus ride away to Walthamstow High Street. Close by are a number of parks and recreation facilities. Parking is available on the street outside the home. The service fees start from a minimum of £980 per week and varies upwards according to assessed levels of need. Wadham Avenue DS0000007299.V355309.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is of the unannounced inspection on 27st November 2007. The Registered Manager and Deputy Manager were present to assist the inspector. The inspector also spoke with one individual currently using the service. The inspector examined the homes’ records and documents, including the residents’ and staff files, records of daily or weekly activities and events, health and safety records and certificates, operational logs recorded by staff and took into account the service AQAA (Annual Quality Assurance Assessment). This enabled the inspector to gain an overview of the quality of service received and experienced by individuals using the service and was compared against the service aims and objectives. The inspector also toured the premises to inspect the individuals’ living environment. What the service does well: People living in the home a sense of belonging and security and have a positive experience of using the service. Staff treat people with dignity and respect and good relationships exist between residents, support staff and the managers. There is a ‘person-centred’ approach and philosophy of valuing people throughout the service. Individuals are encouraged and enabled to participate in areas of their own and in the life of the home. People are enabled to make personal choices; to develop their life skills and to have self worth. Peoples’ individual and diverse needs and aspirations are met thereby successfully meeting the service aims and objectives. Peoples’ care plans are well developed to provide an individually tailored service in response to their individually assessed needs. People are encouraged to participate in recreational, educational and community activities that are enjoyable and satisfying to them. The importance of family contacts and friendships is recognised and maintained. Health care plans comprehensively identify and meet residents’ health needs. Individuals’ religious, cultural and diverse needs are identified and supported, providing assistance to access places of worship if needed or inviting ministers of faith to the home. Individuals receive information about how to complain in an easily accessible format. The absence of complaints reflects a high level of satisfaction in the service. The home is bright, furnished and decorated to a good standard, providing a positive and homely living environment. Staff are sufficiently skilled, knowledgeable and supported by management. There is consistency of staffing with low turnover of staff. Staff demonstrate their care and commitment to improving the quality of life experienced by individuals. Wadham Avenue DS0000007299.V355309.R01.S.doc Version 5.2 Page 6 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. Wadham Avenue DS0000007299.V355309.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 Wadham Avenue DS0000007299.V355309.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): 1-5 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Prospective and existing residents have the information they need to make an informed choice about where to live. The service fully demonstrates its capacity to meet individuals’ needs and aspirations thereby successfully meeting its service aims and objectives. The service listens and responds well to individuals targeting support where needed. EVIDENCE: The home has a good Statement of Purpose giving comprehensive information about the service aims, objectives, philosophy of care, services and facilities. Residents are also provided with information about the service in the form of two documents, a Residents’ Handbook and Residents’ Brochure. It is recommended that these documents are integrated into one document to produce information in the ‘Service User Guide’ format as specified in National Minimum Standards. The handbook and brochure are written in a ‘userfriendly’ format intended for the residents. This also includes the summary of the Statement of Purpose. The home has contracts with local authorities for individuals outlining the homes’ terms and conditions. It is recommended however that the amount and method of payment of fees and conditions of Wadham Avenue DS0000007299.V355309.R01.S.doc Version 5.2 Page 9 placement is also included in the ‘Service Users Guide’, particularly where contributions are expected to be paid by residents. The home accepts referrals from carers, prospective residents, local authorities and health services, though to date there have not been any private referrals. Local authority assessments are received prior to individual placements. An integrated Assessment from the Learning Difficulties Services was seen available in one residents’ file. The Registered Manager or Deputy Manager also carry out a pre-admission initial assessment of needs. Suitable arrangements are made for the person, carers and social worker to make subsequent visits to suit the individual. The service puts much effort into ensuring that prospective residents needs are thoroughly assessed prior to admission and will involve other professionals, such as teachers familiar with individuals’ communication methods, and family members. This is to ensure the placement is appropriate for the individual and to become familiar with individual needs in order to develop suitable support plans. The homes’ mission statement states that “each person will be treated with respect and dignity as a valued individual in both the home and community”. The Registered Manager and Deputy Manager gave several examples of how individuals have grown in confidence and developed skills with staff support, enabling individuals to live independently in the community, demonstrating how effectively the service meets its stated aims and objectives. Examples are how individuals have been trained in culinary skills to prepare light snacks for themselves; individuals being able to go out independently; individuals without confidence being able to access social clubs, and community resources including educational facilities and individuals who now live independently in the community. Observations made on the day of inspection confirmed that good relationships have been built between the staff and resident in the home, creating an environment that is positive, enabling and conducive to individuals’ wellbeing and further development. Peoples’ religious, cultural and diverse needs are identified and taken into account to provide individual support. Residents’ access places of worship independently if able, or ministers of faith are invited to the home if appropriate. The service is listens well to individuals, responding to their expressed wishes and needs and targeting support where needed. Wadham Avenue DS0000007299.V355309.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): 6-10 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Individuals’ care plans are well developed, providing a tailor-made service responsive to meeting individual needs. There is a ‘person-centred’ approach and philosophy of valuing people throughout the service, encouraging and enabling individuals to participate in areas of their own and in the life of the home. EVIDENCE: The care and support offered is of a personal nature, taking into account the person’s individual needs and wishes. Local authority care plans are available in files as received prior to the residents’ admission. The home’s care plan is thorough in identifying individual needs in a clear and accessible format for staff to follow. Care plans start with a summary of overall goals and actions referring to individual needs identified in more depth in the Wadham Avenue DS0000007299.V355309.R01.S.doc Version 5.2 Page 11 main care plan. The care plan identifies the person’s needs and skills under headings of Activities and Daily Living/Social and Family Relationships/Mental and Physical Health/Mental and Physical Health /Leisure and Hobbies/Social Development/ Independent Skills and Personal Care/Finance/Cultural and Spiritual Needs/Accommodation. Each area comprehensively identifies the residents’ needs, stating the current situation, goals, actions and evaluation. The current situation incorporates the residents’ own views/likes and areas of independence and where support is required, in a way which reflects the homes’ ‘person-centred’ approach and philosophy of valuing people as individuals. Several examples were cited and corroborating evidence seen in files of individual persons’ having major changes to the quality of their lives by the intervention and support of staff. The quality of care plans seen underpins the home’s strength in understanding the support needs of individuals and embody the ‘person-centred’ approach responsive to individual needs. Individual’s needs are reviewed in setting time aside for in-depth discussion at team meetings and supervision. Care plans and risk assessments are updated every six months or following any changes in need to reflect the needs and support plan required. It is recommended that these reviews are also recorded in the file of the individual in addition to minutes of team meetings or supervision for transparency and ease of access to records in residents’ files. Good risk assessments are in place for staff to concentrate on areas where key areas of risk and support are identified in order to support people to maintain their independence. Individuals are thereby enabled to move around freely in their environment and in the community with individual support. Risk assessments seen stated the same needs since last year without evidence of review as a result of no changes to their assessment. It is recommended however that risk assessments are formally reviewed to state whether or not there changes in need. This is to ensure there is clarity that risk assessments have been reviewed and updated where necessary regardless of any changes. The homes’ Mission Statement specifies: “we will support each individual to make informed decisions affecting their daily routines and lifestyles…ensure that each person develops their ability to choose and communicate interests, wishes, needs and preferences in both everyday matters affecting them and in broader areas.” It also states that the service will advocate for residents or if possible or provide an independent advocate if necessary for those who may have difficulties acting effectively on their own. As regards managing residents’ finances, the home acts as financial appointee if appropriate provided the resident cannot manage their finances independently and has no one else to advocate or support them. Wadham Avenue DS0000007299.V355309.R01.S.doc Version 5.2 Page 12 The home aims to ensure that all individuals play a full and active part in all areas of their own and the life of the home. This is evident in the extent of engagement and participation in the activities undertaken by individuals, including as seen on the day of inspection, with encouragement and support from staff and the commitment shown them. Wadham Avenue DS0000007299.V355309.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): 11-17 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Support is given to individuals in all aspects of their lives to enable them to develop their life skills; to make individual choices which are valued and reflect their tastes and personality and to help with their personal and social development. The importance of family contacts and friendships is recognised and maintained. EVIDENCE: The service states it’s aim is to provide the high standards of care through their experience and relationships with individuals. Observations made at this inspection confirms that this aim is effectively achieved. The service’s stated principles aspired to by the service are as follows: individual growth and Wadham Avenue DS0000007299.V355309.R01.S.doc Version 5.2 Page 14 development; community presence, community participation, choice and control, equality and equity of service. This is seen throughout the daily practises of the home; how support is delivered to individuals, the quality and maintenance of records and systems and procedures to evidence the support service provided. Emphasis is placed on monitoring individuals’ state of being, skills, and daily activities. Individuals’ progress is measured against their identified needs and plans are reviewed to assist in individuals’ further development. Individual support is given to residents enabling them to develop their life skills and life style, thereby giving them choice and control in their lives. Residents participate in all aspects of daily activities in the home, such as washing dishes, taking out laundry, helping to make beds, making light snacks and cakes. Staff take an active part in the activities undertaken by residents to ensure residents get the most out of the activity. The use of educational services, work experience and community facilities are accessed to suit the needs and choices of the individual. Day care provision needs are discussed prior to admission and agreed during the transitional period with the individual. Individual preferences for activities are well known to staff who incorporate these into individuals daily or weekly routines. Personal activity charts are developed, including a full weekly programme to suit the individual, such as shopping, domestic work at home (activities specified), visit to the library, physiotherapy and attendance at day centres. The local Mencap day centre is one community resource which is used by residents and accessed via Dial-A-Ride. Activity books, in addition to other records in residents’ files, give clear and detailed accounts of all activities undertaken by residents, both inside and outside of the home, including the extent to which residents engaged with and benefited from each activity. Individuals’ personal friendship networks, family contacts and those important to them are recorded and how best these relationships can be maintained is written into their care plan. Special occasions, such as residents’ birthdays, are celebrated with residents and their family or friends in the home. The home also has in place a policy on sexuality and relationships, respecting individual’s right to enjoy intimate relationships. Residents’ views and participation is valued, seen in minutes of residents’ meetings. It is recommended that actions taken or any outcomes to ideas raised at these meetings are recorded. The menu seen shows residents are provided with three varied and healthy meals per day, if in the home, plus snacks should they be required. Fresh fruit is also available freely. Individuals are supported to be involved in menu planning, shopping, the preparation and cooking of meals, and to use the utility area for light snacks and drinks. Wadham Avenue DS0000007299.V355309.R01.S.doc Version 5.2 Page 15 Meals reflect dietary, cultural and religious needs. Food preferences including dietary requirements for medical, cultural or religious reasons are included in care plans. Wadham Avenue DS0000007299.V355309.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): 18-21 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Health care plans comprehensively identify residents’ health needs, how to meet them and who is responsible to support them. Staff value and respect each individual building close relationships with residents. EVIDENCE: Respect for the privacy and dignity of each individual is demonstrated through the close and respectful relationships staff develop with each resident. Each individual resident has a lockable cabinet in the dining room/lounge for residents to safely secure their own items of possession. Staff seek the views of residents in order to provide a service which is sensitive and responsive to them. Individuals’ health needs are taken into account when care planning and on an ongoing basis which is monitored and recorded by staff. Individuals use ordinary community services such as the GP, CPN, dentist, optician, chiropody, and district nursing. Where appropriate, individuals access support from other Wadham Avenue DS0000007299.V355309.R01.S.doc Version 5.2 Page 17 specialist services, such as physiotherapy, mental health, speech therapy and occupational therapy. In addition to the care plan, staff compile individual ‘Health Care Action Plans’. These comprehensively identify the individuals’ health issues and support required, by whom, giving a review date. The plan identifies the healthcare professionals who also have overall responsibility for supporting the residents’ health needs for each identified health issue. At the time of inspection no individual was taking medication. A medication administration policy is in place. The home have previously used Boots blister packs when assisting individuals with their medication and staff have received training in the administration of medicine. Individuals admitted to the home are under 65 years. The Statement of Purpose states however that should a resident become seriously ill or develop a life threatening condition, then every effort will be made to support the resident to remain in the home for as long as they wish, with support and guidance from relevant professionals, such as a District Nurse, GP or Community Health Team. The policy on the reporting of a death and coping with bereavement was seen. It includes the statement that cultural aspects of the death should be considered and relevant religious minister contacted where appropriate. Wadham Avenue DS0000007299.V355309.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): 22-23 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Individuals receive information about how to complain in a format which is easily accessible. The absence of complaints reflects a high level of satisfaction in service provision. The home’s policy and procedure provides sufficient guidance to staff who are trained on how to protect individuals and respond to suspected abuse. EVIDENCE: The home’s complaints policy and procedure is also produced in a ‘user friendly’ pictorial form available to all residents in their complaints handbook. The address of CSCI is in the policy, however the old NCSC information is also stated at the top and must be removed. The CSCI details in the main complaints policy and procedure must also be updated. There have been no complaints since the last inspection and the resident who spoke to the inspector expressed that she was satisfied with the service and had no complaints. Staff receive training on adult abuse and protection and a satisfactory adult abuse and ‘whistle blowing’ policy and procedure is also in place. Wadham Avenue DS0000007299.V355309.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24-30 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The home is bright, well furnished and decorated, providing a positive and homely living environment for residents. There are sufficient shared spaces for communal and social activities and single bedrooms to provide privacy. Bedrooms are personalised by residents to reflect their individual personality and character. EVIDENCE: The property is a spacious and bright two-storey building, fitted and decorated to provide a homely and inviting environment. It has a spacious lounge, dining/reception area and a large kitchen and laundry room. It offers four double bedrooms, all for single occupancy only. All bedrooms are equipped with wash- basins with hot and cold running water. One bedroom seen contained personalised items and pictures on the walls. There are sufficient bathroom and toilet facilities in excess of the minimum requirements. The Wadham Avenue DS0000007299.V355309.R01.S.doc Version 5.2 Page 20 home has fitted carpets throughout. Television/DVD and stereo equipment is provided in the lounge/dining area. The dining area is equipped with facilities to allow individuals the freedom to make hot and cold drinks or prepare light snacks, and to entertain visitors. A patio area with tables and chairs leads to a large garden that is private, secluded and planted with a range of fruit and nut trees. These are enjoyed by individuals who pick fruits from the garden to use in making fruit pies and in cooking. The Deputy Manager informed that the crack observable in the lounge ceiling is as result of damage by trees in the next door residents’ which is being addressed by the Registered Manager. Wadham Avenue DS0000007299.V355309.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31-36 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Staff are sufficiently skilled, knowledgeable and supported and show their care and commitment to improving the quality of life and outcomes experienced by individuals. Staffing arrangements are appropriate and the recruitment process is thorough to ensure that only suitable and skilled staff are selected. EVIDENCE: Appropriate levels of staffing are provided to reflect the needs of residents. There are four permanent staff members employed and the number of staff on duty varies depending on the time of day and residents’ needs. However the home is always staffed on a 24 hour basis, with a member of staff sleeping in. The Registered Manager is assisted by the Deputy Manager who predominately maintains the management functions of the home. All documents required for staff files were available upon examination to evidence that robust recruitment procedures are in place and that staff are selected on their abilities, experience and level of skills. Wadham Avenue DS0000007299.V355309.R01.S.doc Version 5.2 Page 22 Staff are given a handbook containing necessary information which they need to know about their responsibilities and the homes’ operational procedures. Staff spoken to confirmed they had good knowledge of their roles and responsibilities, assisted by very supportive management, training and supervision. Staff inform that in their view, residents’ needs are well met as they are valued and involved in all aspects of living in the home. Staff demonstrated they are aware of individuals’ needs due, in their view, to spending a lot of time with each person to become familiar with their needs. This was evident on the day of inspection when staff were observed to fluently communicate with a resident only after being able to spend long periods of time enabling them to understand how she communicates. In this way, the service, which aims to provide good quality care, is reflected in the experience, attitude and commitment of staff to improve the wellbeing of residents and their quality of life. Staff receive good induction to help them become familiar with the service and processes involved in supporting residents. Whilst the two day induction programme presents as being thorough, it is recommended that the programme is checked against the Skills For Care national competency standards for induction to ensure it contains all the necessary elements. It is also recommended that information in staff files is better filed and secured as some documents contained in them were loose and could be lost. Staff are currently undertaking a Btec HND in Health and Social Care. A staff member on leave has completed an NVQ Level 2 course. However not all staff who work one to one with residents have first aid training therefore staff are required to take accredited first aid training. Supervision of support staff is undertaken by the Deputy Manager every six weeks to two months and the Registered Manager supervises the Deputy Manager, however it is recommended that the Deputy Manager’s supervision sessions are recorded, as they are for support staff, to ensure transparency of information and supervision given to all staff. Wadham Avenue DS0000007299.V355309.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37-43 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. There a good philosophy of care in the home, based on valuing people, promoted by the strong management and leadership in the home. Efficient systems and procedures are in place to ensure the effective running of the service. Health and safety practises are well observed in the home for the ongoing safety and protection of individuals. EVIDENCE: The Registered Manager and Deputy Manager effectively demonstrate that their style of management stems from their philosophy of valuing individuals using the service and ensuring their needs are central to the delivery of service. The service is structured essentially to meet the primary aim of Wadham Avenue DS0000007299.V355309.R01.S.doc Version 5.2 Page 24 providing a quality service to meet the needs of the individuals using it. The systems and procedures in place are sound and effectively meet this objective. The Registered Manager motivates and provides clear leadership and direction to her staff, coordinating the service, ensuring staff perform well and deliver the aims of the service. The Registered Manager is a qualified social worker and does not have a formal management qualification. The good quality of service demonstrates that there is no adverse impact as a result of the Manager lacking a formal qualification. It is nevertheless recommended that a management qualification is pursued in line with national minimum standards to compliment her management functions of the home. The Deputy Manager, who has worked in the home for a year, has an HNC in Public Administration and a certificate in first line management. She is also currently undergoing a diploma in management studies. The Deputy Manager has previously worked in the home as a care worker and has worked in the voluntary sector in social care. The home is aware of the extent to which people are satisfied with the service through their verbal feedback, expressed by people using the service, family members or professionals. However, it is recommended that these views are recorded and a formal quality assurance system is introduced, such as surveys and recorded comments, to evidence the level of satisfaction of service experienced by other people and to assist in service planning and development. The home maintains its records to a good standard. Policies and procedures are comprehensively available and organised in a folder as they each apply to the National Minimum Standards. Some of the records state that the home is registered for three people rather than four and need to be updated to reflect the home’s current registration. Similarly some documents need to have the contact details of the Commission updated. The home is fitted with smoke detectors, fire fighting equipment, emergency lighting and a main alarm system. The fire alarm is tested at frequent intervals and drills are held to establish emergency procedures. The home is a nonsmoking environment. The majority of health and safety records and safety certificates are in place, with the exception of a water safety certificate and a Portable Appliance Test (PAT) at the time of inspection. It is recommended that the home ensures the safety of its water systems against Legionnaires Disease. Whilst the PAT had been undertaken in the past, there was no certificate to evidence this at the time of inspection, though a copy of a PAT test completed after the inspection was subsequently received. Additionally, whilst some staff have received training in first aid, some have not and others’ may need to have their training renewed. It is required that all staff receive accredited training in first aid, particularly when sole working with individuals. Wadham Avenue DS0000007299.V355309.R01.S.doc Version 5.2 Page 25 Wadham Avenue DS0000007299.V355309.R01.S.doc Version 5.2 Page 26 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 4 3 4 4 4 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 3 ENVIRONMENT Standard No Score 24 4 25 4 26 4 27 4 28 4 29 N/A 30 4 STAFFING Standard No Score 31 4 32 4 33 4 34 4 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 4 3 3 LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 3 3 4 3 4 4 2 N/A Wadham Avenue DS0000007299.V355309.R01.S.doc Version 5.2 Page 27 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA42 Regulation 13 3(C) Requirement Ensure all staff have accredited training in first aid. Timescale for action 19/02/08 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 YA1 Good Practice Recommendations Integrate the Residents’ Handbook and Resident’s Brochure for information to be in line with a recommended ‘Service User’s Guide’. The amount and method of payment of fees and conditions of placement is included in the ‘Service Users Guide’. Details of reviews to be recorded in the individuals’ files in addition to minutes of team meetings. Record any actions taken or outcomes to ideas raised at residents’ meeting. Ensure risk assessments are formally reviewed to formally state whether there have been any changes in need or whether risks and action plans remain the same. 2 3 4 YA6 YA8 YA9 Wadham Avenue DS0000007299.V355309.R01.S.doc Version 5.2 Page 28 5 YA22 Remove the old NCSC information in the residents’ complaints’ handbook and update with current CSCI details. Also update the CSCI details in the main complaints policy and procedure. Ensure documents in staff files are well filed and secure. Check the home’s induction programme against the Skills For Care national competency standards for induction to ensure it contains all the necessary elements. Ensure the Deputy Manager’s supervision sessions are recorded. Develop a quality assurance system to formally obtain people’s views about their satisfaction of the service to assist with service planning and development. Ensure the safety of the home’s water systems against Legionnaires Disease. 6 7 8 9 10 YA34 YA35 YA36 YA39 YA42 Wadham Avenue DS0000007299.V355309.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU 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 Wadham Avenue DS0000007299.V355309.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. 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