The Richmond Fellowship Scotland Todhill Country Centre Care Home Service

Transcription

1 The Richmond Fellowship Scotland Todhill Country Centre Care Home Service Dubbs Road Stevenston KA20 3DB Telephone: Type of inspection: Unannounced Inspection completed on: 15 August 2016 Service provided by: The Richmond Fellowship Scotland Limited Service provider number: SP Care service number: CS

2 About the service Todhill Country Centre is located on the outskirts of the town of Stevenson in North Ayrshire and provides a care home service for up to ten adults with learning disabilities. The Service is managed by the Richmond Fellowship Scotland. The stated aims of the service are "We aim to support all our service users to further develop their life skills, achieve greater independence and confidence and become valued and respected members of the community". At the time of this inspection there were nine people staying at the service. What people told us During our inspection visit we spoke with six of the people living at the service who were generally happy with the service being provided however commented on some of the restrictions at the service which were not person centred. Some people we spoke with indicated that they were keen to move on from the service to their own tenancy and felt that this would increase their independence. We spoke with one relative who, whilst positive and praised the service, also expressed a concern that we shared in respect of ensuring that nutritional needs were being met. Self assessment We received a fully completed and detailed self assessment which helped to inform the inspection process. The provider identified what it thought the service did well and graded itself accordingly, we did not concur that these grades realistically reflected our findings. From this inspection we graded this service as: Quality of care and support Quality of environment Quality of staffing Quality of management and leadership 4 - Good 3 - Adequate 4 - Good 4 - Good Quality of care and support Findings from the inspection Support plans we looked at gave a sense of the individual, their likes and dislikes and assets and needs and reviews of the support being provided were taking place regularly. Relevant stakeholders were being invited to reviews, this included family members and care managers. Guided conversation training that staff had received enabled them to have good conversations with people helping them determine the things they wanted to achieve. There was evidence that personal outcomes were being identified and achieved however we felt that care plans could better evidence how the service was supporting people to achieve outcomes in respect of the promotion of life skills. page 2 of 9

3 Staff had received training to help them to be more effective within their role and have a greater understanding of the needs of the people whom they were supporting. Having a long standing staff team had advantages including that staff knew some of the people living at the service very well. Residents received a weekly food allowance and were supported to prepare meals. Whilst this enables residents to have choice over the things that they eat and promotes independence, we were concerned that people may not have been receiving a balanced diet. We felt that there was a need to develop more flexible working practices, this will help the service to work within a more person centred approach. Whilst we saw good evidence that people were supported to manage health issues we thought that there was opportunity to further develop staff champion roles at the service to help progress specific areas including oral care and nutrition. We would like to see more effective use of behaviour support plans to help manage some of the challenging behaviours that were referred to in the risk assessments that we sampled. We suggested that, as best practice, the service introduce the guardian checklist, available within the Mental Welfare Commission publication Working with the Adults with Incapacity (Scotland) Act. This will enable staff to be conversant with the decisions that a guardian can make in respect of people subject to such an order. We noted that people using the service had access to independent advocacy, this is a valuable resource for people with learning or physical disabilities who may struggle to be listened to and have their wishes understood. Whilst we found that health and safety processes were well managed, we made a suggestion about how these could be further improved. Requirements Number of requirements: 0 page 3 of 9

4 Recommendations Number of recommendations: 2 1. The management team should evaluate that current approaches at the service are sufficiently ensuring that nutritional needs are being met for the people being supported. National Care Standards - Care Homes for People with Learning Disabilities Standard Number 13: Eating Well. 2. The management team should ensure that a personal emergency evacuation plan is completed for each person being supported by the service. National Care Standards - Care Homes for people with Learning Disabilities Standard Number 9: Feeling Safe and Secure. Grade: 4 - good Quality of environment Findings from the inspection We discussed the providers plans to develop the service and took this into account when considering areas for improvement needing to be addressed in the property currently being used. During the time we spent at the service we found that good standards of cleanliness were being maintained. The communal areas were bright however there was a lack of a homely feel. Whilst there was evidence of ongoing maintenance and improvements, some of the furnishings and flooring were in need of upgrading. Whilst most people living at the service had microwaves and fridges in their rooms, others had no cooking or food storage facilities. This meant that some people were at a disadvantage and had to prepare and store their food in the training kitchen. The service is situated in a rural setting with access via a road that had no pedestrian path, people using the service expressed that due to the high volume of traffic at particular times it made the approach to the service quite dangerous. As this is a cycle path, we understand that there are plans by the local authority to address this in the near future. We noted that people are able to move about the service freely and have a key to their rooms however some people said that they would like to be able to stay out later in the evening and having to return to the service by 9.30 pm was limiting the potential for some wishing to engage in evening activities. We felt that having such restrictions were not person centred and were contrary to the aims and objectives of the service. Whilst people using the service are able to comment on aspects of the service in a number of ways, we would like to see more clearly how this feedback effects changes at the service. page 4 of 9

5 Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 3 - adequate Quality of staffing Findings from the inspection Training records that we looked at illustrated that staff had access to a range of training to meet the needs of people being supported and to help progress positive outcomes. Supervision and team meetings were opportunities for staff monitoring and development and staff indicated that they were encouraged to contribute at team meetings and felt that their views were valued. Whilst staff were aware of the Keys to Life, reflecting on how the Scottish Governments ten year strategy to address health inequalities in people with learning disabilities was informing the approaches and practices of individual staff could contribute further to workforce development. We noted that there were some champion roles for staff at the service and discussed how these could be further developed in areas including health promotion and social activity. We observed that staff interactions with people using the service were respectful and it was evident that staff had developed positive relationships with the people whom they support. Staff were able to articulate some of the things that they felt were impacting negatively on people using the service and were keen to see the proposals to develop the service progressed by The Richmond Fellowship Scotland. We felt that expectations about service developments had been raised and were now needing to be managed to maintain the morale of staff and confidence of people using the service. Staff we spoke with felt that they were part of a team that worked well together and had the best interests of people using the service at heart. Whilst staff appeared committed and motivated to helping people improve the quality of their lives we would like to see the service work in a more risk enabling way. page 5 of 9

6 Requirements Number of requirements: 0 Recommendations Number of recommendations: 1 1. The managers in conjunction with the staff team should further develop staff champion roles that will enhance the experience of people using the service, this could include health promotion, nutrition and social activity and exercise. National Care Standards - Care Homes for People with Learning Disabilities: Care Standard Number 14: Keeping well - Healthcare Grade: 4 - good Quality of management and leadership Findings from the inspection The service had systems in place to monitor staff competency and performance and plans to introduce observational monitoring were being rolled out. Staff training was up to date and relevant to the needs of people using the service and staff said that they could request training as required. There were opportunities for people using the service and stakeholders to contribute their views about the service in a variety of ways and activities were evaluated and provided useful information. Our sampling of key performance indicators, including a range of audits suggested that the service was good at ensuring that its activities were up to date. Positive views of the management team were expressed by the staff we spoke with and people using the service indicated that managers were approachable. We found that the way the service was managing resources was not always person led and restrictions were impinging on offering a person centred service and could be impacting on people reaching their potential. The managers and staff team should evaluate the use of their resources to address this and plans to develop the service should be progressed. When we looked at accident and incident records we noted that there were some that should have been reported to the care inspectorate. Requirements Number of requirements: 0 page 6 of 9

7 Recommendations Number of recommendations: 1 1. The management team should ensure that notifications are submitted to the Care Inspectorate in line with 'Records that all registered services (except childminders) must keep and guidance on notification reporting' (February 2012, Care Inspectorate). National Care Standards: Care Homes for People with Learning Disabilities: Care Standard number 5 - Management and staffing arrangements. Grade: 4 - good What the service has done to meet any requirements we made at or since the last inspection Previous requirements There are no outstanding requirements. What the service has done to meet any recommendations we made at or since the last inspection Previous recommendations There are no outstanding recommendations. Complaints There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at page 7 of 9

8 Enforcement No enforcement action has been taken against this care service since the last inspection. Inspection and grading history This service does not have any prior inspection history or grades. page 8 of 9

9 To find out more This inspection report is published by the Care Inspectorate. You can download this report and others from our website. Care services in Scotland cannot operate unless they are registered with the Care Inspectorate. We inspect, award grades and help services to improve. We also investigate complaints about care services and can take action when things aren't good enough. Please get in touch with us if you would like more information or have any concerns about a care service. You can also read more about our work online at Contact us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY enquiries@careinspectorate.com Find us on Facebook Other languages and formats This report is available in other languages and formats on request. Tha am foillseachadh seo ri fhaighinn ann an cruthannan is cànain eile ma nithear iarrtas. page 9 of 9