Care Home: Wolverton Court

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What the care home does well People who have decided to live at Wolverton Court can be sure that a full assessment of their needs will be done thoroughly. There is a stable group of staff that know the residents well. Staff spoken to have a knowledge and understanding of the residents. The care staff on duty talked and interacted with the residents in a respectful and caring way. The residents are encouraged and supported to do as much as possible for themselves. The care staff know the service users well enough to anticipate and interpret a lot of their needs and are able to communicate through body language, behaviours and sounds. There was seen to be an understanding between the residents and staff. The needs of the resident are anticipated and dealt with appropriately. The service provides an active and fulfilling life style for the residents. People`s goals and aspirations are identified and staff support the residents to achieve these. The home does meet the physical and healthcare needs of the people who live there. There is input from specialists and local GP`s. Any complaints or concerns are taken seriously and acted on. Each of the residents has their own rooms, which are personalised and reflect their individual tastes and choices. People living at the home can be sure that their views will be taken into consideration and acted on. What has improved since the last inspection? The home has started to introduced person centred planning to ensure individuals have meaningful plans, which wherever possible they have been involved in. They are working towards completing some short and longer term goals for the residents. The service now makes sure there are sufficient staff on duty with approved first aid training. CARE HOME ADULTS 18-65 Wolverton Court Alkham Valley Road Alkham Dover Kent CT15 7DS Lead Inspector Mary Cochrane Key Unannounced Inspection 10th March 2008 10:00 Wolverton Court DS0000023630.V358370.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 Wolverton Court DS0000023630.V358370.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. Wolverton Court DS0000023630.V358370.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wolverton Court Address Alkham Valley Road Alkham Dover Kent CT15 7DS 01304 825544 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) High Quality Lifestyles Ltd Post vacant Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Wolverton Court DS0000023630.V358370.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th March 2007 Brief Description of the Service: Wolverton Court is a home for people with learning disabilities and communication difficulties who present challenging behaviour at times. The home is owned by the private company: High Quality Lifestyles. The companys philosophy is to support people who have displayed behaviour that has caused them and others difficulty and has limited ordinary/usual kinds of life opportunities, by positive guidance and a specialised environment. Wolverton Court is registered to provide accommodation for up to 8 people. At present 5 people live in the home and need a high level of support. It is the companys intention for a maximum of 5 people to live in the home in order to provide a high quality level of support to each individual. The home is a detached property in large grounds situated in the Alkham Valley, which is between Dover and Folkestone. It is a semi rural area and the home provides transport to ensure the residents are able to access facilities in Dover or Folkestone and pursue a variety of activities. The local bus route is on the main road opposite the home. All the bedrooms are single and situated on the ground and first floor and are decorated to suit individual needs and preferences. Communal rooms are spacious. The current fees for the service at the time of the visit range from £1885.00 to £3110.00. Information on the home’s services and the CSCI reports for prospective service users will be detailed in the Statement of Purpose and Service User Guide. The e-mail address for the home is wolvertoncourt@hqls.org.uk. Wolverton Court DS0000023630.V358370.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. This visit to the service was an unannounced “Key Inspection” which took place over one day. All the core standards were looked at during the visit. This visit forms part of the key inspection. The manager was available to assist during the site visit. The people living at the home and the staff on duty were helpful and cooperative throughout. The following methods of inspection and information gathering were used: At the time of the site visit there was one-to-one communication with people who use the service, care staff and management. Staff interactions with residents, care interventions and activities were observed. Individual support plans risk assessments were looked at and discussed. Selected policies, medication charts, training matrix and training programmes and financial arrangements were looked at. A partial tour of the building was undertaken. The service had completed an annual service assurance assessment (AQAA) from the commission. Information received from the home since the last inspection is used in the report. We also looked at information sent to us about concerns and complaints and how these have been managed. We also took into account the things that have happened in the service, these are called ‘notifications’ and are a legal requirement. In February 2008 a safeguarding adults alert was raised at the home. The local adult protection team investigated this and the alert has now been closed. What the service does well: People who have decided to live at Wolverton Court can be sure that a full assessment of their needs will be done thoroughly. There is a stable group of staff that know the residents well. Staff spoken to have a knowledge and understanding of the residents. The care staff on duty talked and interacted with the residents in a respectful and caring way. The Wolverton Court DS0000023630.V358370.R01.S.doc Version 5.2 Page 6 residents are encouraged and supported to do as much as possible for themselves. The care staff know the service users well enough to anticipate and interpret a lot of their needs and are able to communicate through body language, behaviours and sounds. There was seen to be an understanding between the residents and staff. The needs of the resident are anticipated and dealt with appropriately. The service provides an active and fulfilling life style for the residents. People’s goals and aspirations are identified and staff support the residents to achieve these. The home does meet the physical and healthcare needs of the people who live there. There is input from specialists and local GP’s. Any complaints or concerns are taken seriously and acted on. Each of the residents has their own rooms, which are personalised and reflect their individual tastes and choices. People living at the home can be sure that their views will be taken into consideration and acted on. What has improved since the last inspection? What they could do better: The service needs to expand and develop the information in the AQAA to give a better picture on how the service is progressing. They need to tell us more about their shortfalls and how these are going to be addressed. They need to tell us their plans for the future and how they are improving the service for the people who live at Wolverton Court. At the last inspection it was reported the home was working on developing communication aids. Photos had been taken of relevant activities, objects and places and laminated to assist with residents’ understanding and to help make choices. There was no evidence to show that this been developed and continued. The home needs to keep a record of consultations with the consultant psychiatrist and the out comes of these meetings. Wolverton Court DS0000023630.V358370.R01.S.doc Version 5.2 Page 7 The home also needs to make sure that medication is stored in a cabinet that meets the requirements in the Royal Pharmaceutical Society guidance. The service has not acted on the requirements and one of the recommendations made at the last inspection. There has been discussions with various representatives of High Quality Lifestyles about developing quality assurance systems to make sure the service is supporting residents and what is happening in the home is fully meeting everyone’s needs and wishes. A requirement was made at the previous inspections but there is still no evidence in place to show this had been progressed. The service needs to make sure the different levels of staff have received the necessary training to demonstrate they have the competency and skills to undertake their role effectively and improve the standard of support and care given to the residents. There is no evidence on staff files to show that POVA 1st clearance has been obtained prior to people coming to work at the home. This means that residents may not be fully protected. This was identified as a shortfall at the last inspection. As identified in the last report The Skills for Care general induction elements need to be incorporated into the induction training. There was no evidence to show this had been done. 50 of staff still need to obtain NVQ level 2. The manager of the home needs to register with the commission. 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. Wolverton Court DS0000023630.V358370.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 Wolverton Court DS0000023630.V358370.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): 1, 2 and 5 People who use the service experience good outcomes in this area. People can access information about the home to help them make an informed decision as to whether it’s the right place for them to live. Individuals will have an assessment prior to coming to live at the home to make sure the service can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a statement of purpose and there is a service users guide in each of the residents care files. These documents have information about the facilities and services the home has to offer. The service users guide is well written and informative. It includes how to make a complaint. The people living at the home would benefit from having easier access to the guide. It could be developed into different formats so it is more understandable for the people who use the service. No new people have recently come to live at the home. The present residents have been there for some time. The service does have all the necessary tools in place to undertake a good assessment. At the time of the visit the manager said there are no plans to have anyone else living at Wolverton Court. Wolverton Court DS0000023630.V358370.R01.S.doc Version 5.2 Page 10 The manager did tell us that all the residents do have contracts/terms and conditions in place, which says how much people are paying and what they are paying for. However this information is not available at the home but is kept at head office. Contracts terms/conditions need to available for residents/representatives/ advocates. This will ensure people are getting what they pay for and will ensure their places are protected. Wolverton Court DS0000023630.V358370.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 and 9. People who use the service experience good outcomes in this area. Residents have individual care and support plans that ensure their needs are identified and met. They are supported to take assessed risks as part of an independent lifestyle and to make decisions in their lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each of the people living at the home has a care plan. 3 care plans were looked at in detail. The manager of the home is in the process of transferring the care plans on to a more person centred format. One of these was done to a good standard. The manager said he will complete the rest to the same standard in the near future. The plans do contain all the necessary information on the action that is required to ensure that needs are met. They contain information on likes and dislikes, how to manage behaviours and the reasons that infringements are in place. There are also plans on, eating and drinking Wolverton Court DS0000023630.V358370.R01.S.doc Version 5.2 Page 12 needs, personal hygiene care, medical and specialist needs, and individual management. The home tries to organise 6 monthly multi-disciplinary reviews for all the people living at the home. The home also carries out its own inhouse reviews on a regular basis. Daily records are person centred and contain good and relevant information to show how the residents have made choices and decisions. It was possible to cross reference information to show that care plans and risk assessments are being used to provide the necessary care and input on a daily basis. Through observation, talking to residents and staff and from looking at the documentation there was evidence to support that people are involved in making decisions on how they live their life’s. Any limitations and restrictions are recorded in the individuals care plan. It was seen that staff know the residents very well and are able to interpret what they need through behaviours, facial expressions and body language. Some of these are also recorded in the care plans. The service told us that the residents do have access to advocacy services. The manager is keen to develop the involvement of advocacy for people living at the home. Risk assessments are in place and incorporated into the care/ support plans. Some of the risk assessments need to contain more direction and guidance on how to manage risks while enabling the residents to live a safe and independent life. It was identified at the visit the kitchen and a bathroom are kept locked unless in use due to them being risk areas for some of the residents. This was discussed with the manager who is going to consider other ways of managing the risk situations without the infringement and restriction on access to these areas. Wolverton Court DS0000023630.V358370.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16 and 17 People who use the service experience good outcomes in this area. People living at the home are able to maintain and develop an appropriate and fulfilling life-style both in-side and out-side the home. The residents are offered involvement and choice in a varied and healthy diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each of the residents has an activities programme in place which is tailored to meet individual needs. 3 of these programmes were looked at and crossreferenced with the daily records. It was seen planned activities happen on a regular basis for the residents. Goals and aspirations are identified and met or worked towards with support from the staff team. At the last inspection the home had been working on some new communication aids. Using photographs which was to give people more opportunity in Wolverton Court DS0000023630.V358370.R01.S.doc Version 5.2 Page 14 exercising choices. At this inspection there was no evidence to show these are being used. Staff reported that they would like more training in developing the way they communicate with the residents. All the people living at the home had a holiday last year and there are pans for everyone to go away this year. Residents are encouraged to maintain contact with their family and friends. Contact details are kept and family are encouraged to be involved in support and care planning and are encouraged to be involved as much as they wish. Relatives can visit the home when they want to and residents are supported and encouraged to visit and stay with their families. Staff help with transport and support the residents. The manager and staff keep relatives informed of what is happening and support residents to keep in touch. All residents have one-to-one support and can access all areas of the home except other people’s bedrooms with support. Areas like the kitchen have been risk assessed and are locked when not in use. The manager is reviewing this restriction. All the bedrooms have locks that provide privacy whilst still enabling people to get out without restriction. Members of staff were observed demonstrating good body language and communication skills when interacting with the residents. They were seen to talk and interact in a positive way and involved and included residents in conversations. The home told us they have a planned menu but this is flexible. They said that choices are given and likes and dislikes are taken into consideration. Residents often go out for meals. Mealtimes at the home are flexible. Residents have the opportunity to assist with some of the food preparation. Residents do go into the kitchen but are always supervised staff. A record is kept of the meals eaten so any problems can be identified quickly and acted on. Residents were observed to be supported appropriately and sensitively whilst making snacks and having drinks. Wolverton Court DS0000023630.V358370.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. People who use the service experience good outcomes in this area. The service ensures that residents benefit from having their physical and emotional and health needs met. They are given personal support in a way that they prefer and require. Residents are protected by the home’s medication policies and procedures for dealing with medicines. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Personal care needs and how they are to be met are detailed in individual residents plans. Staff said that residents are encouraged and supported to do as much as possible for themselves. The home operates a key worker system to provide sensitive and individual support to residents. Each resident has oneto-one support and this level of support increases when out in the community. Staff know individuals and are able to judge by responses and behaviour to work out how people are feeling and what they want. At the time of the visit Wolverton Court DS0000023630.V358370.R01.S.doc Version 5.2 Page 16 there was evidence in place to demonstrate that residents are given a choice about who supports them. Staff were seen supporting individuals in a different ways depending on what they needed. Personal care, life skills and dignity are promoted. Personal care is delivered in a way that is flexible reliable and person centred. The staff were seen to respect the privacy and dignity of the residents allowing them control over their own life. The residents are encouraged to choose their own clothes and are supported to shop. There is a flexible approach to daily living activities e.g. getting up, bed, bath and mealtimes. Staff were seen to approach the residents in a caring and nurturing manner. The service makes sure that the residents have access to all the healthcare facilities. Routine checks and monitoring are carried out at the necessary intervals. A member of staff accompanies residents when they are attending appointments and visits from healthcare professionals are conducted in private. Health care is monitored and there was evidence to show dental, chiropody, G.P. and other health care appointments. It was reported by the staff that the challenging behaviours of some residents has improved significantly. There was a lot evidence to show that staff are pro-active in seeking support when it is needed and do everything possible to make sure the complex needs of the residents are met. The company has arranged for a private psychiatrist to review and monitor the residents at regular intervals. However there are no reports kept about these reviews. The psychiatrist keeps his own notes, which he takes away with him and the home, do not keep any record of what has happened. Sometimes blood checks are done to monitor therapeutic levels of medication but here is no evidence to show the frequency or the outcomes of these tests. What is discussed in these reviews is not recorded unless there is a change in medication. This part of individuals care is missing from their plans and daily records. All the residents have seen a G.P in the past 12months and have been reviewed. The home uses a Monitored Dosage System (MDS) from Boots and all staff that administer medication have received appropriate training. A list of staff competent to administer medication is kept. Sample signatures are also available. The medication is stored in a locked cupboard and the keys to this are kept on the person who is in charge of the shift. MDS were crossreferenced with drug dispensing sheets and at the time of the visit these tallied. Medication is reviewed regularly. The cupboard in which the medication is stored needs to line with those recommended by the Royal Pharmaceutical Society. Wolverton Court DS0000023630.V358370.R01.S.doc Version 5.2 Page 17 The service does need to develop clear written protocols and guidance in relation to medication to be administered as and when required. This will give staff direction and guidelines on when administer ‘as required’ medication. Wolverton Court DS0000023630.V358370.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use the service experience good outcomes in this area. The home has a satisfactory complaints system. The homes policies and procedures are used to protect residents from harm and abuse This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a complaints procedure in place, which meets all relevant requirements. There is a copy on display in the office and it as also included in the statement of purpose/service. This has not been developed into a format for residents who have learning disabilities and communication difficulties. The staff said they are able to judge from the resident’s responses and behaviour if they are unhappy about something. They said they would take action. The home understands the procedures for safe guarding adults and has been pro-active in the past in highlighting adult protection concerns. The service has reported one safe guarding adults alert to the local adult protection team in February of this year. As soon as the service became aware of the issue they immediately took the appropriate steps to deal with the situation. The adult protection team and the police have investigated. The outcome is it has been handed back to the company to resolve the issue and reach an outcome that is right for the residents of the home. The home has an adult protection and whistle blowing policy. Some staff have received safe guarding vulnerable adults training. Staff spoken are aware of their responsibilities and are aware Wolverton Court DS0000023630.V358370.R01.S.doc Version 5.2 Page 19 of the adult protection procedure and what constitutes abuse. Staff competency needs to be regularly tested in this area. The service has evidence to demonstrate that the resident’s finances are managed appropriately and safe guarded. The home has developed systems of managing resident’s personal monies, which protects them from abuse. Wolverton Court DS0000023630.V358370.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,26,27 and 30. People who use the service experience adequate outcomes in this area. The standard of the homes environment needs to be improved through maintenance and future planning so as to provide the residents with a pleasant, homely and well-maintained place to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A partial tour of the premises was undertaken. The house has a lot of potential to develop into a good place for people to live in. The companies own visits to the home (Regulation26 visits) have identified for a long time that up grading and redecoration works needs to be done to improve the environment. The company needs to ensure that general maintenance re-furbishing and decoration is undertaken. The home needs to have an on-going maintenance plan with timescales to ensure that the necessary work is identified, prioritised and completed within reasonable time scales. Wolverton Court DS0000023630.V358370.R01.S.doc Version 5.2 Page 21 The manager told us they are presently waiting for new dining room furniture. But at the time of the visit it had not arrived. Some curtains had been successfully hung in the living room but this had not been extended to other areas of the house. Some new settees had been bought for the lounge but there was one large settee that was passed its best. The staff said they thought the house needed redecoration. Toilets and bathrooms although serviceable are shabby, stained and in need of up grading. The tiles and grouting are stained and staff say they never get them to look clean. The toilets or bathrooms could not be locked. This infringes on the privacy and dignity of the residents. The house could be made more homely and inviting. One of the bedrooms was seen. This was decorated and furnished according to the resident’s personal preferences. The manager said that all the bedrooms are personalised and residents have choices about what they have in their rooms and how they are decorated. The home is kept hygienically clean and there are no unpleasant odours. Residents are encouraged to clean their own rooms with assistance and support from staff and are also encouraged and supported to assist with their own laundry. The laundry room contains all the necessary equipment for residents to do their washing but the room itself is in need of up grading. The walls are cracked and the paint is peeling. The flooring is old and in need of replacing. Wolverton Court DS0000023630.V358370.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34 35 and 36 People who use the service experience adequate outcomes in this area. The staff have a good understanding and commitment, which allows residents to develop social, emotional, communication, and independent living skills. Present recruitment procedures potentially leave residents at risk. The staff receive a range of training. This needs to be updated and on going to make sure the needs of the residents are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff reported they have developed good relationships with the residents and are able to anticipate and meet the individual needs of the client group. The residents responded positively and openly to staff. It was observed that the staff are accessible and approachable. It was evidenced the staff on duty put the needs of the residents first. Some of the staff have worked at the home for a reasonable length of time and have a good knowledge and understanding of the residents. It was observed that the residents like the staff and get on well with them. Wolverton Court DS0000023630.V358370.R01.S.doc Version 5.2 Page 23 From looking at the duty rota and records and speaking to the staff it was evident that there are enough staff on duty to meet the needs of the people using the service. The staffing structure is based around delivering outcomes for the residents. The home employs 19 care staff 7 of these have obtained a care NVQ2 or above and 3 more are working towards this qualification. The service does have a record of training completed by the staff group. At the time of the visit shortfalls were identified in staff training. In some cases there was no evidence to show that new staff had received induction training. Induction training should be in line with Skills for Care. This was a recommendation at the last inspection and has not been actioned. Other staff are not up to date with mandatory training. All staff that cook need to have up receive food hygiene training. Senior staff and those staff members in charge of shifts need to have more in depth training in line with their responsibilities. Staff also said that they would like to receive more specialist training especially in communication skills. The mangement needs to develop ways to check staff competencies after they have received training. The files of the 3 most recent staff employed by the home were looked at. Application forms are in place and completed. They did include a full employment history however there was no evidence in place to show that staff had been asked about the gaps at interview. CRBs had been requested for all staff including an application for a POVA check but POVA clearance had not been obtained prior to new staff starting work. It was seen in some cases that staff had been working for over 2 months before notification of CRB clearance had come through to the home. This procedure needs to be reviewed by the company as it potentially leaves residents at risk. The manager said he will address this issue. It is the company’s policy to directly supervise and shadow new staff until the CRB disclosures have been returned but this needs to occur after POVA clearance. At the last inspection a requirement was made with regards the homes procedures for obtaining safety checks on new staff. This requirement remains outstanding. All staff files need to contain an up to date photographs. The service told us that regular staff meetings are held. However due to an open door policy, issues are usually discussed as they occur. All staff have regular supervisions and appraisals. Wolverton Court DS0000023630.V358370.R01.S.doc Version 5.2 Page 24 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 and 42 People who use the service experience good outcomes in this area. Resident’s benefit from a well run home. Development of the quality assurance monitoring system would determine whether the service being provided is what residents want and is meeting their needs. This would provide the basis for the development plan for the home. The home has a good record of meeting health and safety requirements. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Wolverton Court DS0000023630.V358370.R01.S.doc Version 5.2 Page 25 The manager of the home has only been in this position for a few months. He has several years experience in working with people with a learning disability and previously he was a senior worker at the home so he knows the residents, staff and service. Staff reported they feel confident in the manager. They said he listens and acts on any issues that are highlighted. He has a clear understanding of the key principles and focus of the service and is aware of the shortfalls within the home. He has the vision and plans on how these will be addressed. He understands the importance of person centred care and actively promotes and leads the staff team. At the time of the visit he demonstrated a commitment to improving the lives of the people who live at Wolverton Court. The manager has an NVQ level3 and has started a degree course to provide him with specialist skills and knowledge to support people with learning disabilities. He plans to commence his NVQ4/RMA as soon as possible. The company has not yet developed the quality assurance system to identify the strengths and weakness of the service and how they plan to improve outcomes for the people who live at the home. The service told us that management staff have been employed to design and implement this. The manager did tell us that questionnaires were sent to relatives and others stakeholders last year. These were sent to head office but here has been no feedback. The service does need to further develop and use in-house audits to ensure that the home is meeting its aims and objectives and to identify any shortfalls in practises of the home. The majority of the policies and procedures used by the home have not been reviewed and up-dated since 2004. The manager needs to address this. We did receive Annual Quality Assurance Assessment (AQAA) from the home however the information was scant and did not tell all we need to know about the service. The requirements and recommendations made at the previous inspection were not addressed. The next AQAA needs to contain more relevant information so we can do a better assessment of the service. The home provides a safe environment for people to live in and staff to work in. Good working practices ensure the home is free of hazards. The home has informed us that maintenance checks are up to date. They have reviewed fire safety and fire risk assessments are in place. The required checks are done. Water temperatures are monitored regularly. All staff need to be up to date with mandatory training. Training needs to be up dated and on- going. Wolverton Court DS0000023630.V358370.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 3 3 X 4 X 5 2 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 2 25 X 26 3 27 2 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 3 34 2 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 3 3 1 X X 3 X Wolverton Court DS0000023630.V358370.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? YES 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 YA24 Regulation 23(2)(b)(d) Requirement The home needs to have an on-going maintenance plan with timescales to ensure that the necessary work is identified, prioritised and completed within a reasonable time scales. Especially with regards to the refurbishment of the toilets/bathrooms. Make sure there has been POVA clearance prior to new staff working in the home and to review the effectiveness of the shadowing procedure whilst staff are waiting for CRB clearance. (Outstanding requirement from the previous inspection. Timescale 29/03/07 not met) The service needs to make sure that all levels of staff have received the necessary training to demonstrate they have the competency and knowledge to do their job DS0000023630.V358370.R01.S.doc Timescale for action 31/05/08 2. YA34 19(4)(c) 29/03/08 3. YA35 18(1)(a) 30/06/08 Wolverton Court Version 5.2 Page 28 4. YA39 effectively. This includes • Induction training. Linked to Skills for Care. (Recommendation made at last inspection). • Mandatory training • Specialist training • NVQ training. 24 To set up a quality assurance (1)(a)(b)(2)(3) audit system within the company to measure success in achieving aims and statement of purpose of the home based on views of residents and their representatives. System structure and planned implementation to be completed by timescale. This includes updating policies and procedures. (Outstanding requirement from the previous 2 inspections. Time scale of 29/06/07 not met) 30/06/08 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. 2 Refer to Standard YA5 YA19 Good Practice Recommendations The contracts/terms and conditions of residency need to be kept at the home. The manager needs to make sure that individual care plans are updated and records kept following reviews with the consultant psychiatrist. This will ensure that the appropriate action is taken and outcomes can be trailed and monitored. Continue to provide NVQ training and work towards DS0000023630.V358370.R01.S.doc Version 5.2 Page 29 3. YA32 Wolverton Court achieving 50 of the workforce having NVQ 2 or above. 4. 5. OP34 YA37 Gaps in employment need to be explored at interview and evidence kept. Staff files need to contain an up to date photograph. The manager needs register with the commission. Wolverton Court DS0000023630.V358370.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Wolverton Court DS0000023630.V358370.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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