Care Home: William Morris House

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What the care home does well Comments from students about the service provided included: "William Morris House is a good place to live". "I`m happy here". "It`s nice here with all my friends". "I can talk to my house parents or my tutor if I am unhappy". "Living at William Morris House is making me more confident".Comments from relatives about the service provided included: "They respect people treating them as individuals and encouraging them". "They teach people to be independent in a safe and caring environment". "They make a special effort to meet my son`s needs". "They have nurtured my daughter with exceptional love and care and she has blossomed in her first year". "William Morris House provides a constructive and supportive environment for developing life skills and independence". "William Morris House has on the whole been excellent for my daughter". Comments from other professionals about the service include: The service "works in a consistent, person centred way that respects individual wishes, needs and preferences". Talking about staff having the right skills, "My experience is always positive and clear skills and knowledge are in place at the care setting". "My experience of William Morris House has been very positive". What the service does well, "fulfil the aims of providing education and training". "They include students in community activities" Students are able to "test drive" the service before they move in and this enables the staff to gather further information that becomes part of the assessment process. The assessment process is thorough and minimises the risk of someone being admitted to the college whose needs cannot be met. Students are encouraged to be involved in the day to day running of the home and are given responsibilities for chores each day. This enables the students to learn new skills. Students lead active lifestyles that are lead by their needs and interests and staff provide them with the appropriate support where required. Students are able to make complaints if they are unhappy through the homes robust complaints procedure. Students are provided with a good standard of accommodation that is homely and comfortable and meets their current needs. William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 7Staff receive ongoing training to meet the needs of the students. Health and safety practices across the site minimise the potential risks to students while they are living there. What has improved since the last inspection? The activities that students can be involved in continues to grow allowing them a wider choice and better quality of life. Regulation 37 notifications to the CSCI are completed more thoroughly. Communication with other local agencies has improved which has led in turn to safeguarding of vulnerable adults improving. Medication administration minimises potential risks to the students. CARE HOME ADULTS 18-65 William Morris House William Morris House Eastington Stonehouse Glos GL10 3SH Lead Inspector Mr Paul Chapman Key Unannounced Inspection 10 January and 13th February 2007 09:00 th William Morris House DS0000016648.V344713.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 William Morris House DS0000016648.V344713.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. William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service William Morris House Address William Morris House Eastington Stonehouse Glos GL10 3SH 01453 824025 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) William Morris Camphill Community Suzanne Pickering Care Home 35 Category(ies) of Learning disability (35) registration, with number of places William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th February 2007 Brief Description of the Service: William Morris House (WMH) named after the designer, craftsman and author William Morris (1834-1896) is part of the International Camphill Movement, founded in 1940. The Home is one of thirty Camphill Communities in Britain. The movement is inspired by teachings of the late philosopher and teacher Rudolf Steiner. It is dedicated to serving the needs of young people with learning disabilities, aged between sixteen and twenty five years during their transition to adulthood. WMH is also a registered residential care home. It provides education in a residential college setting, which is subject to OFSTED Inspection. The home is situated in Eastington, which is approximately 3 miles from Stroud town centre and is within a few minutes from J13 of the M5. The campus is set in countryside and consists of four households, surrounded by gardens and other workshop buildings. The four houses function as extended families with Students and carers living and socialising together. The first three years have a strong educational element alongside social therapy, where students attend the college on site, for thirty-seven weeks of the year. From nineteen years onwards the student becomes a trainee and the emphasis is on work related skills for a period of forty-three weeks in a year. William Morris House DS0000016648.V344713.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 this service experience good quality outcomes. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. As part of the inspection process the site visit took place in January 2008 and included two visits on the 10th of January and the 13th of February. The registered manager was in attendance throughout the visits. The registered manager completed a CSCI Annual Quality Assurance Assessment (AQAA) prior to this site visit being completed. We received completed questionnaires from 11 students, 16 staff, 5 professional health/care staff and 10 relatives. Time was spent observing the care of students and their interactions with staff. 9 of the students were spoken to as a group, while 2 others were spoken to individually. We spoke to 10 of the co-workers and 3 house parents about the care and support they provide to the students. The care of three students was looked at in depth, this included looking at their needs assessments, care plans, medication and other personal records. Other records examined included staff files, health and safety information and quality assurance records. The service provides potential students with a Service User’s Guide. The fee’s to live at the college range between £12, 083.00 to £22, 943.00 per term. What the service does well: Comments from students about the service provided included: “William Morris House is a good place to live”. “I’m happy here”. “It’s nice here with all my friends”. “I can talk to my house parents or my tutor if I am unhappy”. “Living at William Morris House is making me more confident”. William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 6 Comments from relatives about the service provided included: “They respect people treating them as individuals and encouraging them”. “They teach people to be independent in a safe and caring environment”. “They make a special effort to meet my son’s needs”. “They have nurtured my daughter with exceptional love and care and she has blossomed in her first year”. “William Morris House provides a constructive and supportive environment for developing life skills and independence”. “William Morris House has on the whole been excellent for my daughter”. Comments from other professionals about the service include: The service “works in a consistent, person centred way that respects individual wishes, needs and preferences”. Talking about staff having the right skills, “My experience is always positive and clear skills and knowledge are in place at the care setting”. “My experience of William Morris House has been very positive”. What the service does well, “fulfil the aims of providing education and training”. “They include students in community activities” Students are able to “test drive” the service before they move in and this enables the staff to gather further information that becomes part of the assessment process. The assessment process is thorough and minimises the risk of someone being admitted to the college whose needs cannot be met. Students are encouraged to be involved in the day to day running of the home and are given responsibilities for chores each day. This enables the students to learn new skills. Students lead active lifestyles that are lead by their needs and interests and staff provide them with the appropriate support where required. Students are able to make complaints if they are unhappy through the homes robust complaints procedure. Students are provided with a good standard of accommodation that is homely and comfortable and meets their current needs. William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 7 Staff receive ongoing training to meet the needs of the students. Health and safety practices across the site minimise the potential risks to students while they are living there. 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. William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 8 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 William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 9 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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Prospective students are thoroughly assessed before they are offered a place to minimise the risk of people being admitted to the service whose needs cannot be met. EVIDENCE: Assessments for two of the prospective students were examined in detail and we spoke to the staff member responsible for managing the admission process. They showed that each person completed an application form providing a detailed personal history. This forms the first part of the home’s assessment process. After the initial assessment people are invited to visit William Morris House where the assessment will continue. An educational assessment is completed by the education co-ordinator (in addition to the home being regulated by the CSCI the educational side is overseen by Ofsted). As part of the assessment process all of the tutors who work with the student on that day are asked to give their views from their involvement with the prospective student. This also forms part of the overall assessment. William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 10 To support all assessments completed by William Morris House they receive assessment/reports from social workers or previous educational establishments. In addition to this they will also have reports from other professionals involved in the prospective students care, for example speech and language therapists. Correspondence to the prospective student and their care managers were evident in the student’s files confirming their placement at William Morris House. A recommendation from examining the process would be for the management team to review the filing system/storage of the documents gathered as part of the assessment process. When examining student’s files it was difficult to find all of the information. We spoke to both of the students whose admissions we had examined. Both of the students were positive about the experience, one commented “because I visited William Morris House before I moved here it wasn’t so scary”. One student said that they thought their visit was “very good” and that since they have moved in “it’s been very good and I have made lots of new friends”. The AQAA completed by the manager accurately reflects the process seen by us. The manager identifies that over the past 12 months they have updated the student handbook and college brochure. William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 11 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, 8, 9 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Assessments completed by the House parents allow the students to be supported appropriately to meet their identified needs. Individual learning plans ensure that staff can monitor, review and report on the students progress towards their goals accurately. Current risk assessments are putting students at unnecessary risks. EVIDENCE: The care of 3 students were looked at in depth. This included examining their needs assessments, care plans, risk assessments and activities. House parents complete a skills assessment during a student’s first term. The assessment is very comprehensive and identifies the areas of personal hygiene, eating, health, preparing and cooking food/drinks, laying a table, washing up, looking after a room, public transport, local knowledge, shopping, communication, social conduct and telephone skills. Records seen of these William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 12 assessments showed them to be regularly recorded and allowed the reader to see the progress of a student at a glance. House parents then review these assessments every six months. All of the examples examined showed that the house parents had completed reviews of the skills assessments. Each student has Individual Learning and Care plan assessments that comprise of a student profile, care plan and an individual learning plan. This allows the staff to identify goals with the students and reports and reviews are completed twice during the first two terms. The assessment process is comprehensive and enables the staff to agree targets for skill improvements with the students. Once these targets have been agreed the house parents are responsible for supporting the student to achieve them. On the 2nd day of the site visit we met with a group of the house parents and a discussion took place about developing a more person centred approach to students care (A Person Centred Plan is Commonly known as a PCP, this approach empowers people to make changes in their lives, achieve their goals and ensure that resources are in place to meet their future needs). House parents were enthusiastic that this should happen and it was agreed that this would be a goal for the future. The AQAA completed by the manager states that staff are going to complete training in Person Centred Planning (PCP). On the 2nd day of the site visit we met with 9 of the current students as a group. Various topics were discussed. Students were asked whether friends and family are welcome to come and visit them. All of the students agreed that this was alright and gave examples. In addition to this they spoke about other ways they are able to communicate with others outside. They gave examples of using emails, telephone and writing letters. Talking to students about their lifestyles they gave examples about making decisions about activities in the local community that they like to take part in. All of the students are asked to participate in the day-to-day activities around the home. To varying degrees people will be involved in doing their own laundry, tidying their rooms and the houses, involved in preparing food and cleaning up after meals. All students have “life books”. These are created by the student with the support of staff. They make good use of pictures with descriptions to document the activities students take part in during their time at William Morris House. Risk assessments for each student were examined. In one students file there were no risk assessments. Staff said that this was probably due to their house parents reviewing them. Another file showed that staff had completed a number of risk assessments for the student, but unfortunately these had not been reviewed since November 2006. The 3rd file contained a good range of William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 13 risk assessments to meet the person’s specific needs, again a number of assessments had not been reviewed recently. A shortfall identified with 2 of the 3 files was there were no risk assessments for students attending college. The manager stated that all people should have these assessments. It becomes a requirement of this inspection report that risk assessments are reviewed regularly, and it is recommended that the manager ensures that all students attending the local college have risk assessments in place. All of the students’ documents are stored securely. William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 14 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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Students lead varied and fulfilling lifestyles that meet their needs. Students are supported to maintain contact with family and friends with staff support where it is required. The food served across the site is healthy and nutritious. EVIDENCE: As mentioned earlier in this report we met with a group of 9 students. They gave examples of the various activities they are involved in around the site and in the local community. Some of the activities organised on site each week are a film club, craft evening, men and women’s groups and folk dancing. Activities in the local community included meals out, the cinema, horse riding, hockey, swimming, bowling and shopping. Students were asked whether there was enough to do and whether they enjoyed the activities they were involved in. A range of comments including “there are lots of things for us to do” confirmed that students feel there are enough activities. All of the students were very William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 15 positive stating that they really enjoyed living at the home. One student commented, “I like it here”. Other comments included it was “I enjoy making new friends”, “interesting” and “peaceful”. The home makes good use of facilities in nearby Stroud as well as other towns locally (shopping in Bristol, Cheltenham, Gloucester and Bath). Students attend a “student forum” every other Tuesday where they discuss issues and now publish a student newspaper twice a year called the Sunshine Express. Students all agreed that their parents/relatives and friends are allowed to visit when they wish. Students stated that staff support them to maintain contact with their parents/friends. When speaking to staff they explained that they would help write letters, emails and make phone calls. Students are supported to attend a local church if they wish. Students are involved in bible study groups with their house parents one night each week. Staff explained that as well as these groups’ students are given the opportunity to learn about other religions. As identified earlier William Morris House is an educational college and is inspected by OFSTED regularly. It therefore has an obligation to meet the educational needs of the students. Some of the classes organised on site included gardening, weaving and woodwork. Each student has a lesson book that shows subjects are taught in 3 or 4-week blocks. Staff explained that 1 of these lessons is called the “main lesson”. In these sessions students will learn about specific topics. Recent examples of this have been Orchestras, William Morris, Isambard Kingdom Brunel and astronomy. As well as students attending classes on site they can also attend the local college in Stroud to complete courses. The courses accessed by students include drama, music, computers and cooking. Another course used by the older students is called “out and about” and teaches people skills needed to access the community independently. Talking to staff they confirmed that where required they support students at college. Students were enthusiastic about these courses and spoke about what they were learning. Students are supported by staff in the preparation of food. Meals are eaten together in the respective Houses. There is a central food store, from which the individual Houses replenish their provisions. Food is always fresh and predominantly organic. No meals are pre-packaged. Each of the houses has a dedicated cook that cooks the lunchtime meal. Speaking to 1 of the cooks they commented that it was a nice place to work and that they enjoy supporting the students to do some cooking. Whilst completing a tour of the houses across the site we spoke to staff about the process of enabling people to choose meals. Staff stated that students get a choice in as much as there is a range of different dishes available at each meal. William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 16 We spoke about the need to ensure that students are given a choice about what they are eating. It becomes a recommendation of this inspection report that staff develop a system that ensures all students get a choice about the meals. The menus seen by us confirmed that the students were offered nutritious, varied and balanced meals. Menus showed that the meals were offered three times a day and that there were also a range of snacks available to people. We joined a group of students for lunch during the site visit. Students and staff sit and eat together promoting family/Community. A number of students commented on the food. One student stated that they thought the food was “fantastic”. It was the opinion of all the students spoken with that they thought the food provided on site was really nice, and that they were able to choose what to eat. Each of the houses across the site use “safer food, better business” which was supplied to them by the Environmental Health Department. This provides guidance for staff to follow to minimise the risk to people through food preparation and storage. The AQAA completed by the manager makes it clear that the aim for the coming 12 months is to give more students the opportunity to attend Stroud College, and enable more students to complete OCN (Open College Network) qualifications on site. William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 17 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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Students’ personal care needs are identified by the house parents which enables them to meet those needs. Students’ health needs are addressed by access to a local GP whilst they are at William Morris House. Medication practices ensure that potential risks to the students are minimised. EVIDENCE: The house parents or co-workers deal with any personal care requirements that are identified through their assessments. Each student’s personal care needs are assessed and reviewed regularly. When speaking to house parents they suggested that as part of the person centred approach they wish to implement they will include student’s personal care needs. This becomes a recommendation of this inspection report as it will enable a more thorough assessment of student’s needs in this area. Students’ health needs are met locally with students being registered at a local GP’s surgery. William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 18 Medication administration across the site was examined. It was seen to be being managed correctly by staff and did not put students at unnecessary risks. All staff that administer medication have received training. William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 19 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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has a complaints procedure and students are confident that if they are unhappy they can speak to staff and their issues will be addressed appropriately. EVIDENCE: The home has a complaints procedure and whilst speaking with the students they confirmed that they could make a complaint if they were unhappy about something. Students confirmed that if they made a complaint they felt that it would be dealt with appropriately. In addition to the complaints procedure students explained that if they were unhappy with something they would firstly talk to their house parents or tutors. Students have “helping hands” documents. These are kept in their bedrooms and identify important phone numbers that they should call if they are unhappy. In addition to this students have been given the contact details for advocacy groups and Citizens Advice in Gloucestershire. There have been no complaints made to the home or the CSCI since the previous inspection was completed. The home has a trained member of staff who is responsible for taking the lead in any issues of adult and child protection. Since the previous inspection was completed a new staff member has been given the role as a second protection officer. William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 20 Speaking with the second officer they have not completed any specialist training in this area. It becomes a requirement of this inspection report that both of the of the protection officers complete the local safeguarding adults training that is provided by the Gloucestershire safeguarding adults team. This will ensure that staff are aware of the procedures that need to be followed when an issue of safeguarding an adult is received. All staff receive training in protection and a qualified trainer provides this from Camphill and the trained staff member on site. Speaking to the co-workers they confirmed that as part of their induction they complete training in safeguarding adults. The AQAA completed by the manager states that in addition to providing safeguarding training to staff that over the next 12 months they intend that mental capacity act training will be provided to all staff. William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27, 28, 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The homes across the site appear to meet the needs of the current students, being nicely decorated and personalised with items of students’ artwork. EVIDENCE: Students are not allowed televisions in their bedrooms, and they are made aware of this before they move into the home. There are four houses within the Community campus, Kelmscott, Bridge, Hiram and Merton. A short walk up the lane from the campus is another house named Willow. William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 22 Kelmscott – provides the students with a separate lounge and a dining room. The communal area is a good size and was personalised with the student’s pottery, pictures and carvings. Some students share bedrooms and where this is the case it is documented that the students are happy with this. Bridge – New house parents have started in this house since the previous inspection. Students have a separate lounge and dining room, and as with the previous home this is decorated by students work. As with the previous house some students share bedrooms. Kelmscott and Bridge are both situated in the large “main” building. The manager explained that last summer the cold water system in the main building was renewed. They explained that this summer it is planned that the central heating system and windows will be replaced. A number of shortfalls around decoration and floor coverings were identified in both Bridge and Kelmscott houses. This was brought to the attention of the manager. It was agreed that these areas can be addressed after the central heating has been fitted. Hiram – the home was purpose built twelve years ago. It has high ceilings and large windows that give it a light and airy feeling. The accommodation provides a large lounge/diner personalised by the students. Each student has their own bedroom. It was noted that there was a good use of symbols to support students with communication difficulties. Merton – provides a lounge/diner on the first floor with bedrooms on the ground floor. Willow House - Willow house is a detached property within a short walking distance from the main site. It provides accommodation for up to four students and two staff. Each of the students has their own bedroom and there is a communal dining room and a lounge. The kitchen is well equipped. Students and the staff have made a good job of adding their personal touches, which in turn make it homely and comfortable. At the time of this visit the home was clean and tidy. Kelmscott, Bridge and Hiram houses would be suitable for wheelchair users, Merton because of its design would not be. The property is set back off a quiet country lane. There is a short walk to the nearest bus stop. The home does have its own transport in the form of cars and mini buses. Each house sets out its refurbishment requirements each year and presents these to the main management group. A rolling maintenance programme is then developed. William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 23 All of the student’s bedrooms were personalised with their possessions and decorated to a good standard. Each of the homes takes re-cycling seriously and collects a wide range of items to re-cycle. On the day of this inspection all of the homes across the site were cleaned to a high standard. Since the previous inspection was completed a new art room has been created for use by the students. The AQAA completed by the manager states that over the next 12 months they intend to complete the disabled access to the estates classroom. William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 24 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The recruitment procedures ensure that students are not put at unnecessary risks. Staff receive sufficient training to meet the current needs of the students. EVIDENCE: Speaking to 10 co-workers they explained that when they start at working at William Morris House they complete induction training and that after that training is ongoing. In addition to this training they also complete the LDAF (Learning Disability Award Framework). The majority of the co-workers are students from overseas and the home provides English lessons each week that they attend. Comments from the co-workers were generally positive about working at William Morris House. There was agreement that they feel supported by the house parents that they work with and can talk to them if they have any concerns. All of the co-workers were asked about the lifestyles of the students and were in agreement that they felt people led active lifestyles. The examples they gave supported what students had said. William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 25 Training records that were seen showed that new staff had completed an induction period with the appropriate training being provided. Other training records showed that the majority of the team had completed Health and Safety, Equal Opportunities, Confidentiality, Personal Care, First Aid, Medication, Risk Assessment, Makaton, Protection and Prevention of Abuse. The manager has developed an effective training matrix which identifies the teams training needs. The manager completes an annual audit of training needs for the following 12 months. Six of the house parents have completed NVQ’s (National Vocational Qualification) in health and social care to level 3 or above. The AQAA completed by the manager states that an additional three house parents will complete NVQ’s this year. A sample of recruitment records were examined for staff that have started at the home since the previous inspection. The samples seen contained all of the information required except Criminal Records Bureau (CRB) checks. Speaking to the financial administrator after the site visit they explained that they had completed an audit of all CRB’s. They confirmed that all staff had CRB’s and provided us with the reference numbers for each of the CRB disclosures requested. Where a foreign equivalent to a CRB is supplied staff on site translate them. William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 26 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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Quality assurance procedures are not being followed consistently which make it difficult to assess some of the practice improvements. Health and safety measures across the site minimises potential risks to the students. EVIDENCE: The manager has been in post for a number of years and has completed the registered managers award. As identified in the AQAA completed by the manager they state that quality assurance is a “growing area”. A system for a quality assurance monitoring of documents and policies has been created. Speaking to staff they stated that unfortunately this is not being followed at present. William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 27 It is recommended that the manager review this system, as it may be a useful tool in ensuring that there is a regular review system in place. Another tool used by the home is questionnaires to both the students and their parents. In the past this has provided constructive feedback to the home. The next round of questionnaires will be examined at a future site visit. The home has a comprehensive health and safety action plan that identifies issues across the site and sets timescales for actions required. The issues are identified through regular audits. Completing the walk around the site showed that other checks required by health and safety legislation have been completed. These included: • Portable Appliance Testing (PAT). • Fridge and freezer temperature monitoring. • Use of food probes for cooked meat. • Regular fire appliance safety checks. • A legionella test has been completed and cold-water tanks flushed/disinfected. • A fixed wiring test has been completed. • Landlords gas safety certificate present for this year. A fire risk assessment for the site has been completed. William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 28 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 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 29 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 YA9 Regulation 13(4) b, c Requirement Risk assessments must be regularly reviewed to ensure that students are not being put at unnecessary risks while they are going about their day-to-day lives. The college’s adult protection officers must complete the local safeguarding adults training. A quality assurance procedure must be in place to enable the management team to monitor/measure the outcomes for students whilst they are at the college. Timescale for action 11/04/08 2. YA23 13 (6) 06/06/08 3. YA39 35 01/08/08 William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 30 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 YA2 Good Practice Recommendations The filing/storage system for information gathered as part of the admission process should be reviewed, as it is difficult to find some documents. The home should introduce a more person centred approach to the care provided by the house parents and co-workers. Each of the homes across the site should ensure that there is a good system to enable students to make a choice of what meals are served. 2. 3. YA6 YA17 William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection South West Regional Office 4th Floor, Colston 33 33 Colston Avenue BS1 4UA Bristol 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 William Morris House DS0000016648.V344713.R01.S.doc Version 5.2 Page 32 - 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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