Care Home: Weir End House

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What the care home does well Residents are very well settled and all say they are happy living at Weir End House. Their families are also satisfied with the service. Relatives` comments in their surveys include "Overall I feel the care is excellent" and "The free and easy atmosphere is very welcoming and all the staff are considerably kind". Residents are encouraged to make choices and decisions about their own lives. They each have a care plan they help to make. Plans show their wishes, needs and goals and support they need to meet their needs and achieve their goals. Residents are enabled to take part in activities they enjoy, to develop their life skills and be part of the community. They are also supported by the home to keep in touch with their family and friends. One relative says "They encourage residents to make independent choices and to mix in the community". Staff offer the residents very good support with their personal and health care. One relative comments "X is always clean, well groomed and smart". Staff also manage medicines safely for people if they are not able to do so themselves. Residents are encouraged to express their views about the home and how it is run. They say that they feel able to talk to staff if they are not happy and are confident they would listen to their concerns and deal with them properly. The home is well kept, homely and very comfortable. Residents help staff to keep the house clean, tidy and fresh and maintain the grounds. Each person has made their bedroom personal and can use them as their private space. The staff team is very stable so staff and residents know each other well. The home also has enough staff who are well trained. This means staff are able to understand people`s needs and know how best to support and keep them safe. The home is well run by a manager with the right skills and experience. Staff receive good support and work well together. This means staff are committed to ensuring residents have a nice home, quality care and lead interesting lives. What has improved since the last inspection? Staff enabled residents to go out and take part in more community activities. Some people are now more independent and they have made new friends. Each resident has a separate care plan about their health. Theses plans help them to manage their own health and know how to lead a healthier lifestyle. Work continues to make the home nicer for people living there. They chose the colours for some bedrooms and other areas that have been redecorated More staff achieved a qualification in social care. This gives them knowledge and skills to do their job better and so provide good support to the residents. CARE HOME ADULTS 18-65 Weir End House Weir End House Glewstone Ross-on-Wye Herefordshire HR9 6AL Lead Inspector Christina Lavelle DRAFT REPORT: Key Unannounced Inspection 10th September 2008 1.45-5.45pm Weir End House DS0000024745.V372076.R02.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 Weir End House DS0000024745.V372076.R02.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. Weir End House DS0000024745.V372076.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Weir End House Address Weir End House Glewstone Ross-on-Wye Herefordshire HR9 6AL 01989 567711 01989 767077 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) www.craegmoor.co.uk Parkcare Homes Ltd Mrs Ann Fletcher Care Home 13 Category(ies) of Learning disability (13) registration, with number of places Weir End House DS0000024745.V372076.R02.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 categories: 2. Learning disability (LD) 13 The maximum number of service users who can be accommodated is: 13 30th April 2007 Date of last inspection Brief Description of the Service: Weir End House was first set up as a care home in 1989. The current provider is part of a much larger organisation called Craegmoor Healthcare, which runs many care services throughout the country. The manager (Mrs Ann Fletcher) is also registered in respect of a separate home, Woodpecker Lodge, which is in the same grounds.. The home provides accommodation and personal care for thirteen adults who must need care due to learning disabilities. Some people living there may also have a stable mental health disorder and/or have behaviours that challenge a care service. The home has no vacancies currently and most people have lived there for years and are all aged from 39 up to 59. Weir End House is a large, detached Georgian house situated about a mile from the market town of Ross-on-Wye. The property is set in extensive and lovely grounds that include a walled vegetable garden and a woodland area. There is an annexe next to the main house in which three residents have bedrooms. The home offers two shared and nine single bedrooms for people living there, two with en-suite facilities. The home has one very large and another sizeable sitting rooms, a separate dining room and a conservatory for everyone to use. There are also shared toilets and bathrooms, a laundry, kitchen and office. Information about the service is provided in a statement of purpose document, a service users’ guide and the home’s inspection reports. The guide and latest inspection report can be obtained from the home and the guide is also available in a user-friendly format. The weekly fee for the service varies depending on individuals’ assessed needs, as agreed with their funding authority. Extra costs include for toiletries, magazines, chiropody, swimming and other recreational activities and any amount over £200 for an annual holiday for each resident. Weir End House DS0000024745.V372076.R02.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 3 star. This means that the people living at the home experience excellent quality outcomes. This is a key inspection of the service provided at Weir End House. This means all the Standards that can be most important to adults living in care homes are assessed. This visit to the home was made without telling the staff and people living there beforehand. Time was spent talking with some residents about the support they receive and their lifestyles. One care worker was interviewed and asked about their role, recruitment, training and support. The manager also discussed how the service is run and changes made since the last inspection. Surveys had been sent to the home for residents, their relatives or advocates and staff. Ten residents’, seven staff and five relatives’ surveys were returned and the feedback from these surveys and the discussions during our visit are referred to in this report. The manager had also completed an annual quality assurance assessment (AQAA), as is now required. This asks managers to say what they think their service does well and could do better, what has improved in the last 12 months and about their plans for further improvements. Some relevant policies, procedures and records were looked at and all other information received by us, the Commission, about the service since the last inspection is also considered. This includes events the home had told us about that affected the welfare and safety of residents (we call these notifications). There has not been any complaints made to us or the home about the service. What the service does well: Residents are very well settled and all say they are happy living at Weir End House. Their families are also satisfied with the service. Relatives’ comments in their surveys include “Overall I feel the care is excellent” and “The free and easy atmosphere is very welcoming and all the staff are considerably kind”. Residents are encouraged to make choices and decisions about their own lives. They each have a care plan they help to make. Plans show their wishes, needs and goals and support they need to meet their needs and achieve their goals. Residents are enabled to take part in activities they enjoy, to develop their life skills and be part of the community. They are also supported by the home to keep in touch with their family and friends. One relative says “They encourage residents to make independent choices and to mix in the community”. Staff offer the residents very good support with their personal and health care. One relative comments “X is always clean, well groomed and smart”. Staff also manage medicines safely for people if they are not able to do so themselves. Weir End House DS0000024745.V372076.R02.S.doc Version 5.2 Page 6 Residents are encouraged to express their views about the home and how it is run. They say that they feel able to talk to staff if they are not happy and are confident they would listen to their concerns and deal with them properly. The home is well kept, homely and very comfortable. Residents help staff to keep the house clean, tidy and fresh and maintain the grounds. Each person has made their bedroom personal and can use them as their private space. The staff team is very stable so staff and residents know each other well. The home also has enough staff who are well trained. This means staff are able to understand people’s needs and know how best to support and keep them safe. The home is well run by a manager with the right skills and experience. Staff receive good support and work well together. This means staff are committed to ensuring residents have a nice home, quality care and lead interesting lives. 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. Weir End House DS0000024745.V372076.R02.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 Weir End House DS0000024745.V372076.R02.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Prospective residents can be confident that the home would be able to support them. This is because an accurate assessment would be made of their care needs and the home would also know about their preferences and goals from involving them and/or their representatives in their assessment and admission. EVIDENCE: It was previously confirmed that appropriate information is provided about the service, including a statement of purpose, a service users’ guide and a terms and conditions of residence. Relevant documents are also available in a format with symbols and photographs so they should be easier for people who have learning disabilities to understand. Residents have all been given the guide. No one has moved into Weir End House for three years. The assessment and admission processes that the home would follow for prospective residents were therefore reaffirmed with the manager. Staff would always potential residents to fully assess their care needs, wishes and goals, having first received a copy of a community care assessment made by their funding authority. Visits to the home, overnight stays and a trial stay would then be arranged to ensure they fit in with existing residents and that their needs could be met. A review would be held after the trial period involving staff, the prospective resident and their representatives to decide if the placement is suitable and if they stay there. Weir End House DS0000024745.V372076.R02.S.doc Version 5.2 Page 9 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 & 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. Residents have care plans that they and/or their representatives are involved in making and reviewing. Plans show their needs and goals and how they can be met. Risks are also assessed so they can be reduced. People make choices and decisions about their lives and staff promote their rights and individuality. EVIDENCE: Two residents’ care records were looked at. They include their photograph, background information, a pen picture and a map showing all the people who are important to them. Each person also has a care plan that is based on their assessed needs and shows the support or guidance they need. Plans cover all relevant areas in their lives and include their individual skills, likes and dislikes, preferred daily routines and goals. They specify the action and support needed to meet their identified goals with progress evaluated regularly and outcomes. The home has an appropriately “person centred” approach to care planning, which means that residents are fully involved in planning their own care. Plans Weir End House DS0000024745.V372076.R02.S.doc Version 5.2 Page 10 are written in plain language with pictures, photographs and symbols so that they can understand them better and if able to they sign them. Staff focus on individuals’ needs and one relative says “it is a very “homely” home and very personal with individuals’ needs respected”. Residents have an allocated person from the staff team called a keyworker who can spend some individual time with them. Keyworkers are also involved in care planning and help to ensure their needs and goals are reviewed regularly. Significant other people such as families are also involved in reviews if people want them to be. It is evident that residents are also involved in making decisions about the home, their own lives and the day-to-day running of the household. Residents’ meetings are held monthly when they are all encouraged to discuss their everyday experiences and make choices about activities, holidays, menus etc. Relevant risk assessments are carried out as part of care planning to ensure that necessary action is taken to minimise any possible risks to an individual’s health, safety and welfare. Risk assessments also focus on residents’ rights to be independent and to lead a normal lifestyle and they include such as people managing their own personal allowance, going out alone and having their own bedroom key. Consent forms are also signed by, or on behalf of, people who need support to manage their own finances and medication. The manager and staff are also aware of the implications of the Mental Capacity Act when people may not be able to give informed consent in respect of important matters or in situations when their choices or freedom may need to be limited. Weir End House DS0000024745.V372076.R02.S.doc Version 5.2 Page 11 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, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are enabled to take part in a wide range of appropriate activities, which meet their personal interests and involve them in the local community. Their independence and chosen lifestyles are also encouraged and their dignity and rights respected in their daily lives. They are being supported to maintain links with their families, friends and representatives. Food provided by the home is healthy, with meals that residents enjoy and are involved in choosing. EVIDENCE: The home supports residents to lead full and interesting lives and to develop their social and independent living skills. The AQAA also says they encourage those people who are capable, and have the motivation and self-confidence, to move on to a more independent form of living. Residents are involved in the community and some have become members of various groups and clubs such as self-advocacy, a gym, Leisure Link, drama and swimming. They are now invited to local activities and their opinions sought by people in the community. Weir End House DS0000024745.V372076.R02.S.doc Version 5.2 Page 12 The service is clearly committed to community integration and staff comment in their surveys that “people are well supported and able to express opinions and make decisions on things they want to do, places to go and food” and “the home promotes community based activities”. The home plans to seek more opportunities in the employment area and to explore every avenue to ensure that work related day care is possible. They will also be continuing to support people in seeking more community-based activities. Each resident’s plan reflects their interests and social and developmental needs and they all have an activity plan and social interaction records. Those people able to can attend college courses and/or have work placements. Community based activities include a woman’s group, beauty therapy, massage and health awareness sessions. People also regularly go out to the cinema, into town, to local pubs etc and they also have opportunities for individual shopping trips, outings and holidays with their keyworkers. Residents confirm that they can always make decisions about what they do every day and at the weekends. Residents are fully involved in the domestic routines of the home. They have a variety of household tasks allocated to them and are also expected to keep their own bedrooms tidy, do their laundry etc with staff support when needed. This is risk assessed for some individuals if for example it involves then using equipment. As already discussed they are also involved in menu planning, as well as preparing meals, drawing up shopping lists and provisions shopping. Staff support people to keep in touch with their families and to maintain their friendships. Residents talked about their regular calls to them from the home and visits to family with their keyworker. Families confirm they are kept up to date and informed about their relatives’ care and made welcome at the home. Regarding food provided by the home weekly menus are drawn up with the residents and there are comment sheets they complete showing their views of all meals to assist in future planning. The AQAA also states they are supported in healthy living skills and are encouraged to eat healthily. Everyone has had a nutritional assessment and any special dietary requirements are known to staff and managed appropriately. The manager and staff confirm that they promote healthy eating and meals are home cooked using fresh meat and vegetables and that fresh fruit, yoghurts etc are always available. Menus are displayed and show a good variety of wholesome meals such as pasta, fish and rice etc. Weir End House DS0000024745.V372076.R02.S.doc Version 5.2 Page 13 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 & 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents receive personal care from staff in the ways they need and prefer. Their physical and emotional health care needs are met because the home has procedures in place that staff follow. If residents take medicines that they are not able to manage themselves then staff manage them safely on their behalf. EVIDENCE: Residents’ plans show the support and/or guidance they each need with their personal care and to promote their self-care. Any individual preferences, such as receiving support from a same gender carer and daily routines are included. People were seen to be well presented and appropriately dressed for their age, activities etc. and confirm that they can choose and shop for their own clothes, which they do with support from their keyworkers. Relatives comment on the good personal care offered, saying “X is always well dressed and chooses her clothes on shopping trips” and “X is always clean, well groomed and smart”. Care records include information about residents’ physical and mental health and their plans specify any support need in relation to their health. Particular health conditions are detailed with information about their medical history and Weir End House DS0000024745.V372076.R02.S.doc Version 5.2 Page 14 diagnosis etc. Staff have received instruction from relevant specialists, such as the Diabetes nurse and a Dietician, and there is also written guidance to help them support any of the residents with their specialist needs. It is good that each resident now also has a “health action plan” that covers all aspects of their health and welfare and is in a suitable format. The home is making progress to enable people to be more involved in managing their own health by them making and attending their health care appointments. Also to encourage healthier lifestyles through a good diet, massage, exercise, fitness sessions and going to a gym. Health action plans include records of annual health screening checks and of all routine, preventative and specialist health care input, which has been sought and received and appointments attended. Staff also carry out physical checks that individuals may need to monitor their health with records kept, for example weight, blood sugar and blood pressure. Regarding management of residents’ medication the home has an assessment tool used to establish if people are able to self-administer their own medicines safely and a consent form is signed when staff need to do so on their behalf. Policies and procedures are in place for safe management of medicines and the home has individual protocols for homely remedies and for when medicines can be taken as and when required. Medication is suitably stored in the home and the managers hold keys securely. Administration records are maintained appropriately and staff designated to administer receive relevant in-house and external accredited training on safe handling of medicines. The home keeps a reference book and all the patient information leaflets for staff to access and individual records show the medicines each person is prescribed and for what reason. Medication ordered, received and managed by the home is audited regularly both internally and by the provider, when an assessment is made of the home’s competence in respect of supply, storage and administration. Weir End House DS0000024745.V372076.R02.S.doc Version 5.2 Page 15 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 good. This judgement has been made using available evidence including this visit to the service. If residents have concerns about the service they and/or their representatives know how to complain and can be confident they will be listened to and dealt with. The home safeguards residents from abuse, neglect and self-harm. EVIDENCE: The home provides a written complaints procedure that is also available in a suitable format for the people living there. Copies of this procedure have been given to each resident and are displayed in the home. Residents say they can always talk to the manager and their keyworker and they like them and all the staff and are very happy living at the home. They confirm they know who to speak to if they are not happy, how to make a complaint and that staff always treat them well and listen and act on what they say. Their relatives also know how to make a complaint about the service and staff would know what to do if any concerns are raised with them. The home or Commission has not received any complaints and no issues have been raised about the service, which would adversely affect the health, safety and welfare of the people living there. Residents also have the opportunity to raise issues in their house meetings and are involved in the “Your Voice” project set up by the provider. Weir End House has representatives who attend the Your Voice monthly meetings and yearly conferences when they can express their views and influence the policies and procedures that relate to the organisation’s care services. Weir End House DS0000024745.V372076.R02.S.doc Version 5.2 Page 16 There are also policies and procedures provided relating to abuse, safeguarding adults and whistle blowing. The manager and staff know where and how to refer concerns relating to residents’ protection and inter-agency safeguarding procedures. Staff all receive instruction about complaints and safeguarding as part of their induction, and through NVQ (National Vocational Training) and ongoing training. They are clearly aware of their responsibility to safeguard residents and would take any necessary steps to do so, although feel that the practice and climate within the home ensures that such issues would not arise. Weir End House DS0000024745.V372076.R02.S.doc Version 5.2 Page 17 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 good. This judgement has been made using available evidence including this visit to the service. People living at Weir End House have a safe and well-maintained home that is homely, very comfortable, clean, pleasant and hygienic. EVIDENCE: Weir End House is located just off a busy main road but also has a rural aspect and lovely, extensive, secluded grounds. It is about a mile from Ross-on-Wye town centre and for those residents not able to walk to access local services and facilities the home has three vehicles. Staff are deployed flexibly to offer transport when needed for them to go to town, college, outings etc. A relative says “Its lovely to see residents wander around freely in the lovely gardens”. The home is spacious, homely and comfortable and although a relatively large group of younger adults live at there, three residents have their bedrooms in a separate annexe. The communal rooms are very pleasant and all areas seen were found to be clean, tidy and fresh and are well decorated, furnished and equipped to a high standard. Some areas have been redecorated since the last Weir End House DS0000024745.V372076.R02.S.doc Version 5.2 Page 18 inspection and there is an efficient system in place for ongoing maintenance and upgrading of the building, equipment and furniture etc. Residents are involved in choosing the home’s decor and furnishings and have well personalised their bedrooms. They use their own rooms as their personal space if they want to and have the keys to them and many routinely lock their doors. Although two of the bedrooms are shared this has been a long-term arrangement and the occupants know each other well and are happy to do so. Residents say in surveys that the home is always clean and fresh. It is evident that due attention is paid to ensure that good general health and safety and food hygiene are maintained in the home. There are policies and procedures in place relating to all relevant aspects, which staff follow, and staff are trained in all the mandatory topics. Protective gloves etc are provided, there are suitable laundry facilities and arrangements are made for disposal of soiled waste. Weir End House DS0000024745.V372076.R02.S.doc Version 5.2 Page 19 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, 33, 34 & 35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. Residents receive appropriate support and their needs are met because there are sufficient, competent and well-trained staff. People can also be confident in staff because checks have been carried out to make sure they are suitable. EVIDENCE: Staffing levels are appropriate to meet all residents’ personal and social needs. There is also a very stable staff team, which is good for consistency of care and it is apparent that staff and residents know each other and get on very well. The approach of the staff team reflects their commitment to the needs of residents as individuals and they are clear about their role as keyworkers in providing person centred care and identifying the needs and goals of residents. Regarding recruitment it is confirmed that Craegmoor have robust procedures in place. Although there has not been any new staff appointed since the last inspection the AQAA, staff surveys and the manager confirm that all necessary checks had been, and would be, taken up before new staff start working at the home. It is good they are introducing residents to the interview process and are working with them to give them the skills to be able to take an active role Weir End House DS0000024745.V372076.R02.S.doc Version 5.2 Page 20 There is a comprehensive induction programme that all new care staff must complete. Each staff member also has a training and development file, which includes all the core training they are required to undertake during their threemonth probationary period and ongoing. Each care worker also has a Personal Performance Agreement, which includes regular individual supervision, work performance appraisals and a training/development plan. New staff will also complete an LDQ (Learning Disabilities Qualification), an accredited induction programme that is especially for staff working with people who have learning disabilities. Staff confirmed in surveys that their induction covered everything very well. They feel they have good relevant training and meet their manager regularly for support and to let them know how they are doing their job. The evidence obtained shows that the whole staff team have completed all the mandatory health and safety training with refreshers arranged when needed. Other relevant training they have all undertaken includes managing medicines, safeguarding, person centred planning, autism awareness and mental health disorders. Staff confirm that they have opportunities to develop their skills and knowledge and to have training to help them meet residents’ particular needs. Another three staff had achieved an NVQ (National Vocational Qualification) since the last inspection and another three are working towards NVQ There is good and open communication within the staff team and it is apparent that they work well together, for the benefit of people living at the home. Staff meetings are held regularly and they say their views and any issues raised are listened to and acted upon. Care staff receive regular individual supervision and they feel they are well supported by each other and management. Weir End House DS0000024745.V372076.R02.S.doc Version 5.2 Page 21 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 & 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including this visit to the service. People living at the home can have confidence in the service because it is run and managed appropriately. Residents’ views are central to how the service reviews and develops their practice and the home has ways to continue to make sure it is getting things right. The environment is safe for people living there and the staff because good health and safety practices are carried out. EVIDENCE: The registered manager (Mrs Ann Fletcher) also manages Woodpecker Lodge and is supported by a deputy manager. Mrs Fletcher has had many years experience working with people with learning disabilities. She has achieved an NVQ level 4 in care and management and continues to undertake appropriate training to update her knowledge and skills and to make sure that she and the staff team keep abreast of current practice guidelines and legislation. Weir End House DS0000024745.V372076.R02.S.doc Version 5.2 Page 22 Management arrangements for the home are suitable with administrative, supervisory tasks and responsibilities being delegated to the deputy, two team leaders and some aspects to other care staff, such as general and fire safety. It is evident from this inspection that the home continues to be very well run, and there is an open and positive management approach. The leadership style is effective, with clear lines of accountability. There is an appropriately person centred approach to care provision by the service, which focuses on the individuality and rights of residents. Their families also recognise this and their comments include that the home is “Well organised and allows independence” and that “Weir End House is run with dignity and respect for residents”. The provider has a comprehensive Quality Assurance (QA) system, which the home operates. Part of this process includes regular unannounced external audits of relevant aspects of the service and the required monthly visits to the home from a representative of the provider. The manager received training on this QA system and is also required to complete internal audits on aspects that are appropriately based on the National Minimum Standards. An important element of the QA process is a service user involvement project called “Your Voice” and there is guidance for managers that include principles for involving service users and significant other people. Monthly meetings are held at the home (with an agenda and records kept) and some residents also represent the home at meetings for “Your Voice” and are involved in policy development etc for the organisation. Residents, their relatives and other stakeholders are also sent questionnaires about the service. Their feedback is included in annual plans, with action points, to continually develop and improve the service. The home’s AQAA was completed in detail and gives good information, with evidence, about what the service does well and how this has resulted in good outcomes for people living there there. The manager clearly also recognises the importance of continual development of the service, which is based on what residents want and/or for their benefit. Regarding the promotion of good health and safety in the home staff had all undertaken training in the mandatory topics including first aid, food hygiene, infection control, fire safety and moving and handling with regular refreshers. The information in the AQAA confirms that all required safety and electrical checks are carried out and there is routine in-house and external maintenance and/or servicing of services and equipment are arranged and that relevant risk assessments are in place. There were no safety hazards identified during this visit and evidence indicates overall that staff and residents are aware of how important it is to maintain safety in the home and that their practices seek to promote safety in the home and minimise any identified risks. Weir End House DS0000024745.V372076.R02.S.doc Version 5.2 Page 23 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 4 34 X 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 4 X 3 X X 3 X Weir End House DS0000024745.V372076.R02.S.doc Version 5.2 Page 24 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. 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. Refer to Standard Good Practice Recommendations Weir End House DS0000024745.V372076.R02.S.doc Version 5.2 Page 25 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Weir End House DS0000024745.V372076.R02.S.doc Version 5.2 Page 26 - 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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