Care Home: Wortley Villa

Similar services:

• 2 Perhaver Park
• The Vicarage
• St George`s
• 5 Seafield Road
• Radfords
• Honeybourne House
• 32 Beaumont Way

What the care home does well Wortley Villa is close to the centre of Nailsworth and people use the town`s shops and facilities on a regular basis. Some people like to go out by themselves the risk of doing this has been individually assessed, which helps to ensure that people keep safe. People receive support so that they can do different things in the local area. One person told us that they enjoyed watching the town`s football team and they had work experience at a nearby farm. Review meetings are being held when people can talk about new things that they would like to do. When we asked in the surveys `What does the home do well?` one person commented `Allows me to have fun and go on fishing trips`. Some people like to have busy lives outside the home and have activities such as attending a college course or going to the organisation`s day centre. Other people prefer to spend more time in the house and they can decide on the day what they would like to do. The bedrooms have been well personalised and they reflect people`s different interests and choice of decor. They are generally spacious, with room for items such as exercise and music equipment. People at the home benefit from members of the staff team who know them well and who provide good continuity of support. Their personal and health care needs are being met and they receive support with managing their medicines safely. Monthly health checks are being carried out, which help to ensure that any changes in health and well-being are identified and followed up. One person in particular continues to receive a lot of support with an on-going medical condition and the appointments that they have needed. The home has worked closely with other agencies and people in connection with this. What has improved since the last inspection? People`s care records have been updated and their personal files reorganised. As a result, the contents are more clearly presented and there is better information about peoples individual needs. People at the home have been given a new `Say no to abuse` booklet, so that they know what to do if they feel that they, or somebody else, are being mistreated. Staff members have received new guidance about abuse and attended safeguarding adults training outside the home. This helps to ensure that any concerns or allegations are followed up correctly and investigated by the appropriate agencies. A training schedule has been produced for the staff team, which shows a more planned approach to staff training. A local college is being used and providing more opportunities for external training. This will help to ensure that people are supported by staff who are developing their skills and knowledge. The home has been looking at how to consult with people and obtain feedback from them about the home. A system of quality assurance is being put into practice and an annual development plan has been produced. We were told in the AQAA that one improvement during the last year had been to develop more `exercise opportunities` for people at the home. This had included providing one person with an exercise bike for their own room. Some improvements have been made to the home environment. A new path has been laid leading up to the front door, which provides a better and safer entrance to the home. Overall, the arrangements in place for monitoring the service are being more consistently applied. This means that people can be more confident about the way in which the home is being managed and how the provider is meeting their statutory responsibilities. What the care home could do better: We have made some recommendations which build on the improvements made since the last inspection. Some of these concern the need for more detail or information in certain policies, records and assessments. This is so that they provide better guidance, or reflect a more person centred approach. The home should continue to look at how best to obtain feedback from people and include this in any development and improvement plans. On occasions, some people spend time in the home without members of staff on the premises. There should be better information about the circumstances in which this takes place, with evidence that it is a safe and well managed practice. The assessments should show that the arrangement is primarily in place to be of benefit to the person, for example because it is part of a planned programme for developing independence. The home`s philosophy and the practical arrangements in relation to the provision of accommodation need to be fully described in the Statement of Purpose. This is to ensure that there is good information about the facilities that people can expect. The staff training plan should be developed to ensure that it reflects people`s diverse needs and covers all areas of training that are appropriate to staff members` roles. The home`s fire risk assessment must be completed in full, to ensure that any hazards are appropriately identified and responded to. Key inspection report Care homes for adults (18-65 years) Name: Address: Wortley Villa Bath Road Nailsworth Glos GL6 0HH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Malcolm Kippax     Date: 2 1 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 36 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 36 Information about the care home Name of care home: Address: Wortley Villa Bath Road Nailsworth Glos GL6 0HH 01453833140 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: admin@ggh.org.ukorjeff@ggh.org.uk Gloucestershire Group Homes care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accomodated is 5 The registered person may provide the following category of service only: Care home only - code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning Disability (Code LD) Date of last inspection Brief description of the care home Wortley Villa is run by Gloucestershire Group Homes, which specialises in the care of people with Aspergers Syndrome. The home is in a central area of Nailsworth, and close to the towns facilities. Wortley Villa is a three storey detached house and there is a garden at the rear of the property. Five people live together at the home and each person has their own room. The people who live at Wortley Villa receive support from a permanent staff team. Gloucestershire Group Homes also employ relief staff who are available to support people at the home when the need arises. Information about the home is available in a Statement of Purpose. Details of current Care Homes for Adults (18-65 years) Page 4 of 36 2 4 0 2 2 0 0 9 5 Over 65 0 Brief description of the care home fee levels, and copies of inspection reports, are available from Gloucestershire Group Homes. Inspection reports can also be seen on the Commissions website at www.cqc.org.uk Care Homes for Adults (18-65 years) Page 5 of 36 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We asked the home to complete an Annual Quality Assurance Assessment, known as the AQAA. This was their own assessment of how they were performing. It also gave us information about the things that have happened during the last year and about their plans for the future. We sent surveys to the home to be given out to the people who use the service and to staff. We received surveys back from two people who use the service and from two staff members. We looked at all the information that we have received about the home since the last key inspection. This helped us to decide what we should focus on during a visit to the home. This visit took place on 21st January 2010. During the visit we met with the people who live at Wortley Villa and with a number of staff members. We spoke to Mr J. Bird, the homes registered manager. We went around the home and looked at some records. Care Homes for Adults (18-65 years) Page 6 of 36 The judgements contained in this report have been made from all the evidence gathered during the inspection, including the visit. The previous inspection of Wortley Villa was on 24th February 2009. Care Homes for Adults (18-65 years) Page 7 of 36 What the care home does well: What has improved since the last inspection? Peoples care records have been updated and their personal files reorganised. As a result, the contents are more clearly presented and there is better information about peoples individual needs. People at the home have been given a new Say no to abuse booklet, so that they know what to do if they feel that they, or somebody else, are being mistreated. Staff members have received new guidance about abuse and attended safeguarding adults training outside the home. This helps to ensure that any concerns or allegations are followed up correctly and investigated by the appropriate agencies. A training schedule has been produced for the staff team, which shows a more planned approach to staff training. A local college is being used and providing more opportunities for external training. This will help to ensure that people are supported by staff who are developing their skills and knowledge. The home has been looking at how to consult with people and obtain feedback from them about the home. A system of quality assurance is being put into practice and an annual development plan has been produced. Care Homes for Adults (18-65 years) Page 8 of 36 We were told in the AQAA that one improvement during the last year had been to develop more exercise opportunities for people at the home. This had included providing one person with an exercise bike for their own room. Some improvements have been made to the home environment. A new path has been laid leading up to the front door, which provides a better and safer entrance to the home. Overall, the arrangements in place for monitoring the service are being more consistently applied. This means that people can be more confident about the way in which the home is being managed and how the provider is meeting their statutory responsibilities. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 36 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 36 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed before they move in, so that a decision can be made about whether the home will be suitable for them. Evidence: The people currently at Wortley Villa had lived at the home for a number of years. There had been no changes in occupancy during the last year. Gloucestershire Group Homes had a policy on new admissions. At the last inspection we had looked at the admission arrangements in relation to one person who had moved into the home. We reported that the home had worked closely with other agencies and with family members to identify the persons needs and how the service could meet these. We were told that the move had been very successful and that the person had settled in well. We had looked at the persons individual file in the home, which had included assessments undertaken by Gloucestershire Group Homes prior to admission, and by the persons funding authority. Other reports had been obtained, including one from the persons previous placement. This had helped to ensure that the home knew the persons needs, and that staff had information to Care Homes for Adults (18-65 years) Page 11 of 36 Evidence: assist them with communication and with establishing a relationship with the person. Following the admission, the persons personal details had been recorded on a Client Information sheet and a Personal Profile was completed. In the homes AQAA, dated 29.12.09, we were told The home continues to operate with a consistent group of service users. There have been no changes since November 2006. Quality assurance questionnaires provide evidence that parents continue to be satisfied with the care provision. Care Homes for Adults (18-65 years) Page 12 of 36 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs and goals are generally well reflected in individual plans. They can make decisions and take risks as part of independent lifestyle. However, the guidance in relation to people spending time unsupported in the home should be improved, to ensure that appropriate arrangements are in place. Evidence: People were doing different things when we arrived at the home. Two people were having home based days and other people were out for the day, or for part of the day. We asked staff members in their surveys whether they were given up to date information about peoples needs, for example in the care plans. One staff member responded Always to this question, and the other Usually. During our visit, staff members told us that some people went out by themselves. For example, one person went on the bus to a nearby town. We heard that another person was able to spend time without staff present when attending a college course. We also Care Homes for Adults (18-65 years) Page 13 of 36 Evidence: heard that some people spent time at the home when staff were not on the premises. People had individual files where information about their daily routines and personal support was recorded. We looked at examples of the files, focusing on three peoples records in particular. Information was recorded on a range of forms, which included Personal Profiles, Client information sheets, Guidelines for Support and Management Plans. The files had been reorganised during the last year to provide a clearer and more concise overview of peoples needs. The guidelines and assessments identified peoples problems and needs, but peoples strengths and abilities were not well highlighted. Each person had a General Risk Assessment on their file. These outlined the hazards and support needed in areas such as road safety, medication, diet and personal care. There was further information recorded in relation to specific risks, including people being out in the community. The assessments took account of peoples individual circumstances, for example in relation to their behaviour and the time of day when they wanted to go out. There was also information about people being left unsupervised at the home. We read that one person could stay alone in the home for up to an hour and there were a number of safety measures in place. It was reported that another person was left alone as infrequently as possible and then only for brief periods. The assessment did not state a maximum length of time that the person could stay in the home unsupervised and the reasons for the home alone arrangement. We had recommended at the last inspection that the assessments show the aims and the potential benefits for the people who use the service, for example whether the arrangement was part of a programme to increase a persons independence. This was to ensure that the policy of home alone was in the best interests of the people who use the service and that risks in relation to people spending time in the home without a staff member present were being appropriately identified and addressed. Review meetings were being held when people could talk about new things that they would like to do. We saw that Annual Review of Assessed Needs forms had been completed in October 2009. Peoples individual files also included Individual Goal Plan forms, which gave information about the personal goals that had been agreed. The goals covered a range of subjects, such as going on day trips and budgeting for holidays. One persons goals included being encouraged to walk or take some other form of exercise on at least four occasions a week. This goal was to be reviewed in January 2010. We talked to Mr Bird about how progress with achieving this goal was being monitored. A separate record exercise record was not being maintained; we Care Homes for Adults (18-65 years) Page 14 of 36 Evidence: thought that this would be useful in giving an overview of the activities that had taken place and the outcome of these. People received support with managing and looking after their personal money. We were told that people could be actively involved, for example by looking after a weekly amount, or saving an amount of money each week for a particular hobby. We saw that individual accounts were being kept of peoples personal money. Records of transactions were being signed by the people involved and receipts obtained when people received support with shopping and other expenditures. Mr Bird said that the financial records were checked regularly as part of the management visits that are made to the home. Care Homes for Adults (18-65 years) Page 15 of 36 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People participate in a range of activities that reflect their interests and abilities. People are part of the local community and receive support, which helps them to maintain their relationships. People have meals that they enjoy, and they are encouraged to participate in the household tasks. Evidence: On the day we visited, one person was doing jobs in the house (referred to as a training day) and spending time on personal tasks such as laundry and room cleaning. Other people had activities outside the home, which included attending the organisations day centre. Staff told us that one person was away from the home for a few days, visiting their family. We met with people at the home and heard about their interests, such as watching the Care Homes for Adults (18-65 years) Page 16 of 36 Evidence: local football team, fishing and using computers. One person did work experience at a local farm. People used facilities in the local community, such as the college and a gym. The home was in a central area of Nailsworth, and well placed for people to be able to get to the towns shops and facilities. Members of staff told us that one person had started a college course during the last year, which they felt was a big step for them. We were told that one person was a regular Churchgoer and that they went independently every Sunday. When we asked in the surveys What does the home do well one? person commented Allows me to have fun and go on fishing trips. In response to the same question, a staff member commented Supports individuals in pursuing their interests - provides a broad range of activities and opportunities. The other staff member told us Supports clients in community. We saw peoples bedrooms, which had been well personalised and reflected their interests and choice of decor. The rooms were generally spacious, with room for items such as exercise and music equipment. We were told in the AQAA that one improvement during the last year had been to develop more exercise opportunities for people at the home. This had included providing one person with an exercise bike for their own room. At the last inspection, we had looked at the arrangements being made for supporting people with activities at the weekends. We had reported that there was normally one staff member working at the weekends, with a second staff member deployed at certain times. The staff members we spoke to had said that it would be beneficial to have more double cover at the weekends, as this would allow for more flexibility in what people could do. During our visit to the home on 21st January 2010, Mr Bird told us that a relief member of staff was now regularly deployed at the weekends to provide some additional support hours. This enabled people at the home to receive more individual support with their weekend activities. We saw that individual timetables had been written, which showed peoples activities during the week. People had a mix of planned activities and unstructured time. There was information in peoples files about their personal backgrounds and relationships. We heard that one person stayed with their family every few weeks. Staff members also told us that another person had visited relatives during the last year, which had been the culmination of a lot of organising. People were encouraged to take an active role in the household tasks, but there was a flexible approach as to how much people did themselves. People could help out with Care Homes for Adults (18-65 years) Page 17 of 36 Evidence: the food shopping and with preparing the meals. At lunchtime, we saw some people having an informal meal together in the homes communal room. The main meal was prepared in the evening. People told us that they like the meals and it was reported in the AQAA that a healthy menu was promoted. We were also told in the AQAA that more flexible mealtimes had been provided for two people who had asked to eat in their rooms as they found group settings stressful. Care Homes for Adults (18-65 years) Page 18 of 36 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and health care needs are being met. People receive the support that they need with managing their medicines safely. Evidence: There was guidance in peoples individual files about their care needs and the way in which they wished to be supported. People managed much of their own personal care, with support being provided in the form of encouragement and prompting. Monthly Health Check forms were being completed by staff. These gave an overview of peoples health and personal care, in areas such as hair and nail cutting. They also provided a summary of the health related matters that had arisen during the month. We reported at the last inspection that one persons file included a lot of information about an on-going medical condition. This condition had necessitated regular hospital admissions, and the close involvement of the homes staff and health professionals. During the last year, the home had continued to support this person with their health appointments and the practical arrangements. We read that a best interests meeting had been held when the options for treatment were considered. Care Homes for Adults (18-65 years) Page 19 of 36 Evidence: Peoples weight was being recorded each month. This helped to identify any changes which might need to be followed up. The Monthly Health Check forms showed when people had had appointments with GPs and other healthcare professionals. The records showed that people had had recent appointments with the podiatrist, dentist and GP. People had seen an optician in 2007, but there was no record of more recent appointments. This was brought to Mr Birds attention, so that it could be followed up. We were given information in the homes AQAA about the arrangements in place for people to receive support from local health services and more specialist services. We were told that the service has a long term and excellent relationship with the local health centre. It was also reported that psychological and psychiatric support was available and during the last year a new referral had been made in relation to one person. Peoples files included a Personal Health Profile that had been written in December 2009. We were told that these were a new development and designed to incorporate all the relevant information and necessary guidance required to support an individual effectively. During our visit, we saw that staff members were respecting peoples privacy and talking to people in a friendly way. Staff recognised that bedrooms were peoples own spaces, in which they could be private and keep as they wished. Some people had their own en-suite facilities. A new facility had been provided for one person who, because of their health condition, could not easily access the homes bathroom. There was guidance in peoples personal records about the impact that their diagnoses had on their daily lives. This was also reflected in the risk assessments. There was information about the medicines that people were prescribed. New forms had been completed which showed the medicines people had been prescribed and the times of day when they needed to be administered. There was a list of homely remedies that had been approved by the GP for administration to people. We also saw that some over the counter eye drops were being used, but these were not included on the list. We looked at the storage and recording of medicines during our visit. Peoples medication came to the home as part of a monitored dosage system, which the pharmacist had prepared. The medicines were then kept in a locked facility. There was no cabinet for the storage of controlled drugs, although we were told that these were not being prescribed at the time. We had recommended at the last inspection that a cupboard that meets the current storage regulations for controlled Care Homes for Adults (18-65 years) Page 20 of 36 Evidence: drugs is installed. This was so that any controlled drugs could be stored safely if they needed to be kept in the home in the future. In the absence of a cupboard for controlled drugs, we talked to Mr Bird about the need for a policy to be produced which sets out the action that will be taken if controlled drugs are prescribed. Records were being kept of the medicines received into the home and of their administration. The records that we saw were up to date and had been completed consistently. We were told in the homes AQAA that members of staff had undertaken accredited medicine training through a local college. It was also reported that medicines were managed safely and appropriately, but that one thing the home needed to do better was to ensure that two people countersigned handwritten entries on medicine records. This was something that we had discussed at the last inspection. Care Homes for Adults (18-65 years) Page 21 of 36 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can express their views and are listened to by members of staff. Staff members receive training and guidance, which helps to ensure that people at the home are protected from harm. Evidence: We were told in the AQAA that the people who live at the home were encouraged to resolve complaints with their key worker in the first instance. Annual review meetings were also seen as a time when people could raise concerns that had not been addressed throughout the year. GGH had produced a procedure that people could use if the complaint was of a more formal nature. We were told that the complaints procedure had been updated during the last year; was easy to understand and had been given to each person living at the home. We saw that the procedure included details for contacting the Commission (CQC), although these were not all correct. The correct telephone number was confirmed with Mr Bird. It was reported in the AQAA that the home had not received any complaints during the last year. In their surveys, the people who use the service told us that knew how to make a complaint and who to speak to if not happy with something. During our visit, people talked openly about the home and the things that they did. Care Homes for Adults (18-65 years) Page 22 of 36 Evidence: We observed staff listening to various issues that people at the home raised, and helping them to make decisions. Since the last inspection, the home has improved awareness about abuse and the guidance that is available to members of staff. Information was displayed in the home about the local procedure for safeguarding adults. There was also Say No to Abuse guidance in the home, which was designed to increase the awareness of the people who use the service. We were told that this new guidance had been given to each person at the home. Staff members had attended safeguarding adults training at a local college during the last year. GGH had a policy about the Disclosure of abuse and bad practice (Whistle blowing). Staff members confirmed in their surveys that they knew what to do if somebody had concerns about the home. There were other polices and procedures, for example in relation to Gifts to staff, Managing peoples money and Equal Opportunities, which helped to ensure that peoples rights and interests were protected. We were told in the AQAA that there had been no incidents involving restraint in the home. It was reported that individuals could display behaviour which challenged the service, and the staff team maintained a low arousal approach in line with the overall philosophy of the service that promotes a safe autism specific environment. Care Homes for Adults (18-65 years) Page 23 of 36 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples individual accommodation and the home environment generally, are meeting their current needs. Evidence: Wortley Villa is in a central area of Nailsworth and close to many of the towns shops and facilities which people used on a regular basis. The property was in keeping with the neighbouring buildings and it did not stand out as being a care home. There was a garden at the rear of the property. We were told in the AQAA that improvements during the last year had included a new pathway to the front door, a new doorway at the rear entrance, and the refurbishment of the downstairs toilet. When we saw the toilet, the floor covering was still in need of attention because it was stained around the WC bowl. The entrance to the home had been much improved following the laying of the new path. We had found at the last inspection that the accommodation had been changed, resulting in the loss of a communal room, but an increase in peoples individual bedroom space and facilities. This was reported on at the time, and we discussed the circumstances in more detail after that inspection. We were concerned that the communal space had reduced to less than is expected for a home of this size, and that Care Homes for Adults (18-65 years) Page 24 of 36 Evidence: people no longer had a choice of communal areas. However we were told that the change had been made in the best interests of the people at the home, who did not make great use of the communal areas and had benefited from better individual accommodation. We have accepted the current arrangements at this time, although the homes philosophy and the practical arrangements in relation to the provision of accommodation had not been fully described in the homes Statement of Purpose. We were shown around the home. The accommodation was on three floors, with bedrooms on each floor. People had personalised their own rooms as they wished. Two people had en-suite areas with a WC and shower. One person with a room on the top floor had their own bathroom. There was no curtain or blind on the bathroom window, which meant that the persons privacy was comprised. We talked to Mr Bird about an appropriate way of dealing with this, including the use of an opaque film which could be used on the window. The communal space consisted of a single lounge/dining room. The room had been refurbished since the last inspection and some cupboards removed which helped to make it feel more spacious. We were told in the AQAA that the homes plans included further redecoration and the fitting of new carpets. The accommodation overall looked clean and tidy at the time of our visit. We were told that a new cleaner had been employed who was previously a support worker and was well known to the people at the home. We were told in the AQAA that staff members were due to receive training in the prevention and control of infection, as part of the homes training plan for 2010. Care Homes for Adults (18-65 years) Page 25 of 36 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by competent staff who are developing their knowledge and skills. There are procedures in place which help to ensure that new staff members are suitable for the work they undertake. Evidence: The AQAA included information about the staffing arrangements for the home. There were four full-time staff members; we were told that each had completed the induction training recommended by Skills for Care, and had achieved NVQ (National Vocational Qualification) at level 2 or above. GGH also had a number of relief staff members who were available to work in the home when additional cover or support was needed. GGH had a policy and procedure for the recruitment of new staff. In their surveys, the staff members confirmed that their employer had carried out checks, such as a CRB (Criminal Records Bureau) disclosure and references, before they started work. No new permanent staff had been appointed since the last inspection, and no staff had left the home. We were told that a new relief staff member had been appointed and Care Homes for Adults (18-65 years) Page 26 of 36 Evidence: worked some shifts at Wortley Villa. We looked at their recruitment file. A Criminal Records Bureau disclosure, references and proof of identity had been obtained before the person started their employment. The AQAA told us about some improvements during the last year. The staff employment application form had been updated. The service had registered with a local college which provided common induction standards training to all new staff. The college was also being used for some external training courses, such as safeguarding adults. We had made recommendations at the last inspection in relation to staff training. These, for the most part, had received attention. During our visit we saw that a new training file had been set up, which included details of training completed and proposed. This provided a much better overview of the arrangements being made for staff training. We looked at a new training and capabilities framework that had been produced for the home. This identified the priorities for training, and the training that was required by staff in different roles, for example support worker and senior support worker. The qualifications and experience expected of a staff member were also listed. We talked to Mr Bird about the range of subjects that were covered in the training framework. This covered a range of relevant subjects, but others such as medicines, were not included. We were however told that staff had attended a course in the safe handling of medicines. Mental capacity and autism were included in the training plan, although equality and diversity, and health related topics such as epilepsy, were not mentioned. We saw that the home had received a flyer from a local college, giving information about a forthcoming course about equality and diversity. The homes senior support worker said that there were no plans for staff to attend this training and we discussed the benefits of staff undertaking such a course. In their surveys, the staff members confirmed that they were being given training which was relevant to their role, helped them to understand and meet peoples individual needs, and kept them up to date with new ways of working. They also said that their induction had covered everything very well. Records in the home showed that staff training during 2009 had included fire safety, medication, deprivation of liberty safeguards and safeguarding adults. Training in first aid, mental capacity, moving and handling and infection control had been planned for the coming months. Care Homes for Adults (18-65 years) Page 27 of 36 Evidence: A plan had been written for staff supervision and appraisals for the year ahead. Records were being kept to show when supervision meetings had taken place. Staff members confirmed in the surveys that they received enough support from their manager. Care Homes for Adults (18-65 years) Page 28 of 36 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Action has been taken during the last year to develop the service and the way in which standards are monitored. This means that people can be more confident about the way the home is being managed and how the provider is meeting their statutory responsibilities. Evidence: Gloucestershire Group Homes has a management structure that includes a General Manager, and two Service Co-ordinators who between them are registered to manage the organisations homes. Mr Bird is the registered manager for three of the organisations homes. He has a Diploma in Social Work, a Certificate in Management Studies and is a Bachelor of Philosophy in Autism Studies. We met with Mr Bird and with the homes senior support worker during our visit. The senior support worker had also completed a degree in Autism studies at Birmingham University. Some management tasks, such as supervision, were being delegated to the senior support worker. Mr Bird spent his time between the homes where he was the manager and had a regular involvement through attending staff meetings at each Care Homes for Adults (18-65 years) Page 29 of 36 Evidence: home. We have talked at previous inspections about the need for visits to be made to the home each month, in accordance with Regulation 26 of the Care Homes Regulations 2001. We saw that these visits were being made consistently and reports of their outcome were being written. The reports have been amended since the last inspection to include an Action Plan section. This helped to ensure that any issues or improvements were identified and followed up. We have also received a Regulation 37 notification, which informed us of a significant event in the home. We had made a requirement at the last inspection about having a system in place for evaluating the quality of services being provided at the home. During our visit we saw that a system had been set up and was being put into practice. There was a Quality Assurance file, which contained an Annual Development plan for the home. The plan had a number of headings, including Health Improvement, Client Protection, and Management of the home. The plan was not dated and it was not clear when all parts of the plan would be implemented. However, we saw that some improvements identified in the plan, for example in relation to staff training, had already been carried out. As part of the Quality Assurance system, surveys had been given to the people who use the service. Letters with questionnaires had also been sent to relatives. The improvements which were mentioned in the plan were of direct or indirect benefit to the people who live at the home. However it was not clear how peoples views had been reflected in the plan. We also talked to Mr Bird about ways, other than through written surveys, in which feedback could be obtained from people on an on-going basis. Mr Bird has told us that GGH was considering using an accredited system of quality assurance, in addition to the current arrangements. GGH had produced policies in relation to health and safety, including the Control of Substances Hazardous to Health (C.O.S.H.H.), Infection control, Food safety, Emergencies and Fire safety. We were told in the AQAA that the heating, electrical and fire precaution systems had last been serviced in July 2009. Portable electrical equipment was being tested to ensure that it was safe for use. We looked at records in relation to fire precautions. The fire alarm system and emergency lighting were being checked regularly. A fire risk assessment had been completed in September 2009. It was reported that drills were taking place and members of staff underwent regular fire training. The main part of the fire risk assessment consisted of a number of questions in relation to the home. It was reported that the home only had fixed radiators and a question about the guarding of the radiators had not been responded to. When going around the home we saw one radiator type heater, which was not fixed and covers had not been fitted to the fixed Care Homes for Adults (18-65 years) Page 30 of 36 Evidence: radiators. Another question about whether the furniture in the home was up to current standard had also not been responded to. Care Homes for Adults (18-65 years) Page 31 of 36 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 32 of 36 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 42 13 The fire risk assessment must be completed in full. This is to ensure that any hazards are correctly identified and responded to. Appropriate action must then be taken, as indicated by the outcome of the assessment. This is to ensure that any hazards are correctly identified and responded to. Appropriate action must then be taken, as indicated by the outcome of the assessment. 31/03/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 6 That, when a goal includes specific activities on a regular basis, a record is kept to show when these have taken place and the outcome. This is so that good information is available when the goal is being reviewed. Page 33 of 36 Care Homes for Adults (18-65 years) Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 2 6 That the personal profiles and assessments include more information about peoples abilities and positive attributes. This is so that there is a person centred approach, which will provide a more balanced view of peoples strengths and needs. That the assessment records for people spending time alone in the home show the aims and the potential benefits for the people who use the service, and the practical circumstances, such as the maximum length of time and frequency. This is to ensure that the policy of home alone is in the best interests of the people who use the service and that any risks in relation to people spending time in the home without a staff member present have been appropriately identified and addressed. 3 9 4 5 20 20 The list of homely remedies should be reviewed to ensure that it is up to date. When a persons medicine is altered or new information recorded, the record should include the name of the person who made the alteration (including a witness when this is possible), the date, and on whose authority. These details are needed in order to show that any changes have been appropriately made and are accurate. A cupboard that meets the current storage regulations for controlled drugs, the Misuse of Drugs (Safe custody) (Amendment) Regulations 2007 should be installed. This is so that any controlled drugs that are prescribed can be stored safely if they need to be kept in the home in the future. (Recommendation from the previous inspection). When an appropriate cupboard has not been installed, a policy needs to be produced which sets out the action that will be taken if controlled drugs are prescribed to people. The policy will need to ensure that the storage of controlled drugs will meet with current regulations at the time when they are received into the home. 6 20 7 24 That the provision of communal space is kept under review to ensure that it continues to meet peoples needs, and the needs of people who may move into the home in the future. (The homes philosophy and the practical arrangements in relation to the provision of accommodation Page 34 of 36 Care Homes for Adults (18-65 years) Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations need to be fully described in the Statement of Purpose; this is to ensure that there is good information about the facilities that people can expect). 8 35 That the range of subjects which are included within the homes training plan is reviewed. This is to ensure that the plan covers all relevant areas, including statutory requirements, and reflects the individual and diverse needs of the people who use the service. That consideration is given to ways, other than through written surveys, in which feedback could be obtained as part of quality assurance from the people who use the service. When feedback has been obtained, the homes Annual Development plan should clearly show how this has been taken into account and acted on. 9 39 Care Homes for Adults (18-65 years) Page 35 of 36 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 36 of 36 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!