Care Home: Wright Homecare

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What the care home does well The staff team have a good understanding of the needs of the people they support and demonstrated a commitment to ensuring that the social needs of individual`s are met whenever possible, which enhances their quality of life. Individual`s communication methods were recorded in the support plans seen and this indicated that each person`s needs are met in a way they prefer. Records such as care plans are regularly reviewed, which ensures the staff team have accurate information on each person`s needs and how they are to be supported to ensure their needs are met. The staffing levels in place ensured that individual`s holistic needs were met. What has improved since the last inspection? This was the services first inspection. What the care home could do better: The temperature of the room were the medication was stored should be recorded. This will ensure that medication is stored at a temperature that is in accordance with the manufacturers instructions. CARE HOME ADULTS 18-65 Wright Homecare 71 Meadow Lane Newhall Swadlincote Derbyshire DE11 0UX Lead Inspector Angela Kennedy Unannounced Inspection 9th March 2009 10:30 09/03/09 Wright Homecare DS0000070056.V374533.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 Wright Homecare DS0000070056.V374533.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. Wright Homecare DS0000070056.V374533.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wright Homecare Address 71 Meadow Lane Newhall Swadlincote Derbyshire DE11 0UX 07949104285 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) Wright Homecare Limited Mrs Sharon Ann Garner Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Wright Homecare DS0000070056.V374533.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered provider may provide the following categories of service only: Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home fall within the following categories: Learning Disability - Code LD The maximum number of service users who can be accommodated is 4. 2. Date of last inspection 23rd October 2007 Brief Description of the Service: Wright Homecare is a care home registered to provide support and accommodation for four adults with a learning disability. The home is located in the residential area of Newhall, which is close to the town centre of Burton upon Trent and Swadlincote. The accommodation consists of a lounge with TV, DVD and music player, kitchen/dining room, utility room and conservatory area on the ground floor. There is also one-bedroom on the ground floor. On the first floor are 3 bedrooms. Two of the bedrooms are en suite and 2 have wash hand basins only. On the first floor is a bathroom with a bath and shower and toilet and a staff bedroom. There is a lawned enclosed area to the rear of the property and ramped access to the front and rear of the home. Parking is available at the front of the property. Fees payable for the service provided are established on an individual basis depending on the level of support required, and are usually paid by a statutory agency. Items and services that are not included in the weekly fees include; • Toiletries and personal items • Clothes • Trips out • Individual purchases such as newspapers, magazines or cigarettes. Further information regarding the home is available in the homes Statement of Purpose and by contacting the Registered Manager. Wright Homecare DS0000070056.V374533.R01.S.doc Version 5.2 Page 5 Wright Homecare DS0000070056.V374533.R01.S.doc Version 5.2 Page 6 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 key inspection was unannounced and took place over one day. This was the first key inspection of the service. Key inspections take into account a wide range of information and commence before the site visit by any information received such as any reported incidents. The site visit is used to see how the service is performing in practice and to meet with the people using the service. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views on the service provided. This process considers the homes capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. An Annual Quality Assurance Assessment (AQAA) had been completed by the service. This is a self-assessment for providers, which is a legal requirement. This assessment gives the provider /registered manager an opportunity to let us know about their service and how well they think they are performing. The information provided in the AQAA is reflected within this report. Surveys were sent out to the people living at the home, their relatives and members of the staff team. An independent advocate from Derbyshire Advocacy Services supported the people living at the home to complete these surveys. The information provided in the surveys is reflected within this report. At this inspection visit two people were case tracked. Case tracking is a method used to track the care of individuals from the assessments undertaken before they are admitted to a service through to the care and support they receive on a daily basis. This includes looking at care plans and other documents relating to that persons care, talking to staff regarding the care they provide and if possible talking to the individual. None of the people living at Wright Homecare were able to verbally express their views of the service and the support it provided. However some of the people spoken with were able to indicate that they liked living at the home through limited verbal communication and facial expression. One member of staff was spoken with at some length. Their views and opinions of the care provided, the support and training given to them is included within this report. The registered manager was on duty on the day of this inspection and provided the relevant information requested. Wright Homecare DS0000070056.V374533.R01.S.doc Version 5.2 Page 7 What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Wright Homecare DS0000070056.V374533.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 Wright Homecare DS0000070056.V374533.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): Standard assessed 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be confident that their needs can be met, as a thorough assessment is undertaken before admission is agreed. EVIDENCE: As stated in the providers self assessment, needs assessments were carried out by individuals care managers before they moved into the home. Records of the needs assessments and assessments that were undertaken by the registered manager was seen in the two peoples files that were looked at. These assessments covered all areas of personal, health and social care support that was required. The records seen demonstrated that family representatives had been involved in these assessments and consulted regarding their son/ daughters move to the home. In the two peoples files that were looked at there was written confirmation from the registered manager to individuals care managers and family representatives, stating that the service was able to meet the assessed needs of the individual. Wright Homecare DS0000070056.V374533.R01.S.doc Version 5.2 Page 10 Within the two peoples files that were looked at there was records of care reviews that had been undertaken to ensure they had settled into the home and that their needs and preferences were being met. The reviews involved the individual, their family representatives and all supporting professionals. Information within one survey confirmed that prior to the move one person had worked with the member of staff who was now their key worker. This had ensured that continuity in this persons support was maintained and provided them with a sense of security and trust during the transition period to their new home. All of the people spoken with indicated that they liked living at Wright Homecare and the rapport between the staff on duty and the people living at the home was relaxed and friendly. Wright Homecare DS0000070056.V374533.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): Standards assessed 6,7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service have a plan of care that reflects their needs and goals and are encouraged to make their own decisions and choices. EVIDENCE: Both of the people case tracked had personal support plans that covered their social, emotional, health and personal care needs. The support plans seen were detailed and clearly instructed the staff team on the level and type of support the individual needed. This included the communication needs of the individual and their preferences on how support was provided. As stated in the providers self assessment, there was evidence in place that demonstrated that support plans were written wit the individual and their family representative and reviewed on a regular basis. Within the two peoples files seen there was a document called, ‘Listen to me workbook’. This document covered individuals preferred routines, what they did and didn’t like such as food and drink, their hobbies and interests, their Wright Homecare DS0000070056.V374533.R01.S.doc Version 5.2 Page 12 circle of support, which looked at the people that were important to them and what staff needed to know about the individual, including the medication they were prescribed and how this was administered. Also included in this document was ‘what people liked and admire’ about the individual. This document provided staff with an individualised picture of the person, which celebrated the individual and their current requirements and aspirations to enable them to support them in a person centred way. As stated above the support plans included the communication needs of the individual and this information was also included in the ‘listen to me workbook’. Discussions took place with the manager regarding the development of a communication profile for each person that would include all of the communication information recorded. This could be developed over time as individuals communication methods developed or changed. This would provide an easily accessible document for staff and others who may not be familiar with the person to communicate effectively with them. Risk assessments were seen and referenced to the appropriate care plans they related to. The risk assessments informed staff of the support each person required to enable them to stay as independent as possible. Risk assessments also included detailed information on the communication methods that were used by individuals. All of the risk assessments seen had been regularly reviewed. The risk assessments demonstrated that risks were managed positively to help individuals maintain their independence and choice as much as possible. During this inspection visit one person was visited by their family. These visitors were spoken with and were very positive about the support that was provided by the staff team. They said that the support provided to their relative was ‘excellent’ and confirmed that the service kept them up to date with any changes in support and involved them in care reviews. The support plans and daily records seen demonstrated that individuals made choices and preferences in their daily lives. This information was seen in individual’s preferred daily routines and in records held regarding activities that individuals chose to or not to participate in. None of the people living at the home were able to verbally express their opinion of the service. However from observations staff were seen providing support in a friendly and positive manner and were able to communicate effectively with individuals. Wright Homecare DS0000070056.V374533.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): Standards assessed 12,13,15,16 and 17. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are treated as individuals’ and the staff team are responsive to their needs, preferences and personal development. EVIDENCE: Most of the people living at the home accessed the local day service during the week, some on a full time and some on a part time basis. As stated in the providers self assessment individuals had maintained their day opportunities as they had done prior to their move to the home. This had ensured that consistency was maintained for them. Individuals interests, preferences and choices were recorded and these records demonstrated that this was done in consultation with the individuals and their family representatives. Wright Homecare DS0000070056.V374533.R01.S.doc Version 5.2 Page 14 This included information about activities and interests that were enjoyed both within the home and within the local community and the level of support that was required to enable the people at the home to live an ordinary and meaningful life. Included with the support plans seen was risk assessments that identified any areas of risk for individuals and the actions that were to be taken to ensure the risks were reduced to a reasonable level. This demonstrated that risks were managed positively to help individuals maintain their independence and choice as much as possible. The types of activities that were undertaken within the community included, going to the cinema, the pub, shopping for food and personal items, walks around the local area and attending church services. The provider’s self-assessment stated that there is a Gateway Club on a Wednesday evening (this is a social club for adults with a learning disability) and everyone is given a choice to attend. It was stated that prior to moving into Wright Homecare, three of the four people were not given the option to attend this club. The support plans seen also demonstrated that individual’s preferred routines when at home were respected by the staff team and that staff supported them in maintaining their privacy and were responsive to individuals changing needs and wishes. Information within the surveys confirmed that people living at the home were able to make decisions about what they did, comments within one survey said, “ I can go out when I want and do what I want each day” The manager confirmed that all of the people had taken an annual holiday last year with staff support. Three people had been on holiday to Filey and one person had been to centre parks. Care plans and daily records indicated that contact with family and friends is promoted and maintained. There are regular visits by family members and a staff member spoken with confirmed that visitors are always welcome. The provider’s self-assessment stated that family and friends are invited to events at the home or on nights out and when visiting are welcome to stay for a meal if they wish. On the day of this inspection one person was visited by their parents. They confirmed that they were always made welcome by the staff team. From observation and discussion it was clear that they had a good relationship with the staff and manager. One person case tracked was supported to retain a personal relationship. Records within this persons support plan demonstrated that this persons close Wright Homecare DS0000070056.V374533.R01.S.doc Version 5.2 Page 15 friend was supported to maintain their relationship and was made welcome at the home. As stated in the provider’s self-assessment individuals were able to decide where they would like to eat their meals. Records were seen that demonstrated this. Menus were in place that ran over a four-week period. They showed that a healthy, varied and nutritious diet was provided. One person spoken with confirmed that they enjoyed the meals at the home. One person case tracked was supported with their meals and the records seen demonstrated that staff gave assistance in a way that was discrete and sensitive to that individual. Records were also in place that confirmed that this individual had been assessed by a speech and language therapist regarding their dietary requirements. As stated above individuals were supported by staff to shop for food and were supported to prepare the table at meal times. This was observed on the day of this inspection visit. Wright Homecare DS0000070056.V374533.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards assessed 18,19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive personal support from staff in a way they prefer and want. The staff team support people to take medication safely. EVIDENCE: Records were in place for individual’s personal care routines, these were detailed and provided the staff with clear instructions on the preferred routines of the individual. These records demonstrated that individual’s preferences were respected and that personal care was provided in private and at a time and pace directed by the person receiving the care. Evidence was seen within support plans that demonstrated that healthcare needs were met. This included records of visits to the doctor, dentist, podiatrist and opticians and well-man and well-woman clinics. Records seen showed that that specialist professionals such as clinical psychologists, occupational therapists, speech and language therapists and physiotherapists and hospital appointments were accessed as necessary. Wright Homecare DS0000070056.V374533.R01.S.doc Version 5.2 Page 17 As stated in the provider’s self-assessment all health checks were up to date and healthcare appointments were kept. This ensured individuals health care was maintained. The medication practices were looked at and the record of administration was seen for the people case tracked. The storage of medicines was organised and the instructions for administration were clear and records show that medicines were administered as prescribed. All medicines audited had the correct quantities of medication as stated on the medication administration record (MAR). Medication profiles were in place for the two people case tracked. This provided information on prescribed medications and an assessment that demonstrated the level of support that the individuals needed in managing their medication. It was noted that the temperature of the room the medicines were stored in was not being monitored; therefore it was not possible to determine that medicines were being stored at the temperature recommended by the manufacturer. No controlled drugs or medicines requiring cold storage were prescribed for individuals living at the home. Records of staff training were seen and certificates were in place to demonstrate that an appropriately trained person had provided medication training. This was further enhanced through a medication competency practical assessment that staff undertook at the home. Wright Homecare DS0000070056.V374533.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): Standards assessed 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The practices and policies in place ensure people’s concerns are listened to and that they are safeguarded from abuse. EVIDENCE: The Complaints Procedure was displayed in the entrance porch of the home. An easy read summary was also seen using symbols and pictures to enable people with learning difficulties to understand it. No complaints have been made or received about the home since it’s opening The provider’s self-assessment stated that information regarding making a complaint was given to everyone living at the home when they moved in and copies were also given to their family representatives. Service user meetings provided people at the home with an opportunity to raise any concerns they had. Independent advocates and parents and carers attended these meetings. Minutes of service user meetings were seen and demonstrated that actions were taken in response to issues that were raised. These issues were not regarding any complaints made about the service but addressed other areas of individual’s lives that were raised. The two visitors that were spoken with on the day of this inspection visit confirmed that they had no complaints regarding the service and said that they would address any issues they had with the manager if they needed to. Wright Homecare DS0000070056.V374533.R01.S.doc Version 5.2 Page 19 Records were seen to demonstrate that staff had undertaken training in Safeguarding Adults and the home Policy regarding Safeguarding Adults was in line with the local authority procedure. This ensured that the correct procedures would be followed if there were any safeguarding concerns at the home. One member of staff that was spoken with confirmed they had undertaken this training and demonstrated a good understanding of the safeguarding adults procedure. Suitable accounting procedures were in place for monies held for people living at the home. The money for the two people case tracked was checked against the records held and was correct. This demonstrates that the practices in place safeguard people from financial abuse. Wright Homecare DS0000070056.V374533.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): Standards assessed 24, 25,26,28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a safe well-maintained environment that is homely, clean and comfortable. EVIDENCE: A tour of the home was undertaken. On the ground floor there is a lounge with TV, DVD and music player, kitchen/dining room, utility room and conservatory. This provided an additional communal area for anyone who wanted some privacy or quiet space. One person’s records seen demonstrated that they used this room when a friend visited to enable them to have some privacy. There is also one bedroom on the ground floor; this room had an ensuite facility. The ensuite and the bedroom had been adapted with the appropriate and adaptations to meet the needs of the person who used that bedroom. On the first floor were the other three bedrooms. One bedroom was en suite and 2 had wash hand basins. All bedroom doors had appropriate locks, and had all necessary furnishing and equipment. Individuals had been encouraged Wright Homecare DS0000070056.V374533.R01.S.doc Version 5.2 Page 21 to bring personal items with them when they moved in, to personalise their rooms. The manager confirmed that when bedrooms were redecorated this would be done in consultation with each individual to ensure it was decorated and refurbished according to their tastes and preferences. This had not been possible at the time of the initial decorating of the home, as the people that now live there had not at that time been identified. On the first floor was a staff bedroom where medication was stored. There was a bathroom on the first floor with a bath and shower and toilet. Water was thermostatically controlled on the taps to ensure people were protected from scalds. All of the radiators seen were covered to protect people from the risk of heat burns. Window restrictors were on windows to ensure the safety of the people living at the home. There were two laundry areas, one was next to the kitchen and one was upstairs. A policy concerning when use of the laundry area next to the kitchen was not appropriate was seen. This ensured that any soiled laundry was handled appropriately to ensure infection control standards were maintained. Automatic fire doors were in place and the entrance of the home was alarmed to ensure staff were alerted to anyone entering or leaving the home. An enclosed lawn was available at the rear of the property; this had ramp access to ensure it was accessible to everyone living at the home. Wright Homecare DS0000070056.V374533.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): Standards assessed 32,33,34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The practices and training provided ensured that the people living at the home were protected and supported by a competent staff team. EVIDENCE: The provider’s self-assessment stated that two members of staff have completed their National Vocational Qualification (NVQ) at level 2 in health and social care and 1 has completed NVQ3. The records seen at this inspection confirmed this and demonstrated that another member of staff had recently completed their learning disability qualification (LDQ). This demonstrates that people are supported by a staff team that have received the right training to ensure their needs can be met. Comments within one staff survey also reflected this, “ the management give me the right support. I have gained NVQ2 level and I have the knowledge and confidence to meet people’s needs” Eight permanent staff, including the manager are employed at the service. The staffing levels provided ensured that the needs of each person could be met. Wright Homecare DS0000070056.V374533.R01.S.doc Version 5.2 Page 23 Two staff was rostered on duty when everyone was at home, although the manager confirmed she was also there each day, so there was usually three staff at the home throughout the day and early evening. One person living at the home received one to one support throughout the day, as they did not access a day service. This ensured they received the support they required to enable their social needs to be met. Interactions observed between the people living at the home and members of staff demonstrated that the staff had built positive relationships with individuals to provide support that was relaxed and enabled people to communicate freely and easily using their preferred communication method. The provider’s self-assessment stated that the recruitment policy was based on equal opportunities and the protection of the people living at the home. This was confirmed in the two staff files looked at. The safety of the people living at the home was maintained as the records seen demonstrated a comprehensive system of recruitment was in place. This met all the requirements of the law. Evidence was seen to demonstrate that people are supported by a staff team who understand and do what is expected of them. Staff training records demonstrated that mandatory training and training specific to the needs of the people at the home was kept up to date. This training included, fire safety, safeguarding adults, food hygiene, first aid, health and safety, infection control mental capacity act training and healthier food. The training provided to new staff included a staff induction checklist and a workbook. This training met the skills for care requirements and ensured that new staff were competent to support the people living at the home. Wright Homecare DS0000070056.V374533.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): Standards assessed 37,39,42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and safety of the people living at the home is safeguarded by an effective management system. The service aims to ensure it is run in the best interest of the people living there. EVIDENCE: The information gathered at this inspection and within the provider’s selfassessment demonstrates that the manager’s enthusiasm for the development of this service has ensured the people living at the home receive a quality service that is managed in their best interests. Comments from staff and visitors indicated that the manager was highly thought of and provided an open and transparent approach to managing the service. Comments included, “ she’s very supportive, excellent always Wright Homecare DS0000070056.V374533.R01.S.doc Version 5.2 Page 25 available” and “ she’s always available to talk to and has been very supportive”. The manager has several years of experience in working with adults with learning disabilities. Her two previous jobs provided her with experience of direct care as well as organising and supervising staff. The manager has achieved an NVQ at level 4 and at the time of this inspection was working towards a management qualification in care. Training records demonstrated that the manager continues to update herself in all mandatory training and other training that is specific to the needs of the people living at the home. As stated earlier in this report minutes of service user meetings provided people at the home with an opportunity to talk about any issues or ideas they had. Independent advocates and parents/carers attended these meetings also. Minutes of service user meetings were seen and demonstrated that actions were taken in response to issues that were raised. Other quality assurance audits included questionnaires that had been sent out to parents/ carers in September 2008. The results of these questionnaires demonstrated that all of the parents/ carers were happy with the service provided and described it as ‘very good’. All of the questionnaires confirmed that parents/ carers were involved in the reviews of their sons/ daughters and that they felt the care provided met the needs of their sons/daughters. Staff surveys had also been sent out to the staff team and these again provided very positive comments regarding the care provided and the training and support they received. The staff surveys we received also demonstrated that staff are supported well. Comments included, “ We have regular staff meetings every month and have supervision with the manager” Questionnaires had also been sent out to the people living at the home following their move. This was to ensure they were happy with their new home and to confirm that they had received enough information about the home before and after moving in. These questionnaires also indicated that everyone living at the home was happy with their home and the support they were given. As stated in the providers self assessment health and safety checks were maintained to ensure everyone at the home was kept safe. A sample of service certificates and weekly fire safety checks was looked at and confirmed this. Wright Homecare DS0000070056.V374533.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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 4 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 2 X 3 X 3 X X 3 X Wright Homecare DS0000070056.V374533.R01.S.doc Version 5.2 Page 27 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA20 Regulation 13 (2) Requirement The temperature of the room were medicines are stored must be monitored and records kept to demonstrate this. This is to ensure that medicines are stored at the temperature recommended by the manufacturer. Timescale for action 09/05/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA6 Good Practice Recommendations A communication profile for each person should be developed to provide an easily accessible document for staff and others to use. This will enable people who may not be familiar with the person to communicate effectively with them. Wright Homecare DS0000070056.V374533.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Wright Homecare DS0000070056.V374533.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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