DOMICILIARY CARE AGENCY Anchor Trust Integrated Housing Fairfield Court Fairfield Road Droylsden, Manchester M35 6AN Lead Inspector JANET RANSON Announced 11 th & 12 th April 2005
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 Inspection Report Author CSCI Audience General Public Further copies from 0870 240 7535 (telephone order line) Copyright 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 Internet address www.csci.org.uk
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 agency are those for Domiciliary Care. 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. Anchor Trust Integrated Housing Version 1.10 Page 3
SERVICE INFORMATION Name of service Anchor Trust Integrated Housing and Care Address Fairfield Court, Fairfield Road, Droylsden, Manchester, M35 6AN Telephone number 0161 3701914 Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration Anchor Trust 1st Floor, 408 Strand, London, WC2R ONE Miss Michelle Jane Jones DCA Domiciliary Care Agencies No. of places registered (if applicable) 0 Category(ies) of registration, with number of places Anchor Trust Integrated Housing Version 1.10 Page 4
SERVICE INFORMATION Conditions of registration: A Manager must be in place at all times who has the qualifications, skills and experience necessary for managing the service and registered with the Commission for Social Care. 13 th February 2004 The minimum age of service users must be eighteen years old. 13 February 2004 Date of last inspection 22 nd April 2004 Brief Description of the Service: Anchor Integrated Care and Housing provides a domiciliary service to the tenants of Fairfield Court. The tenants can be assessed as requiring personal or domestic care which can include cleaning and shopping. The service also includes monitoring of service users physical and mental wellbeing. A luncheon club is provided twice a week within the building and there is twenty-four hour on-site emergency response cover. The overall aim is to provide support for service users in order that they can remain independent with support in their own home. The scheme was purpose built in 1998. It is well situated for shops and other community resources. Anchor Trust Integrated Housing Version 1.10 Page 5
SUMMARY This is an overview of what the inspector found during the inspection. This was the agency s annual visit, which took place over one and half days. Part of the inspection involved examination of certain records, policies and procedures and talking with the scheme manager. A total of five tenants and one relative spoke with the inspector. Three tenants spoke with the inspector in their own properties. Three carers were interviewed and the inspector sat in on two informal staff meetings during the lunch period. Six (out of ten) questionnaires sent to the tenants were returned. With one exception they contained no adverse comments. Ten care workers surveys were posted to the individual addresses and six returned. They referred to a good working atmosphere with teamwork and support from the management. What the service does well: The domiciliary care agency provides an excellent level of support to the tenants of Fairfield Court. The staff are managed in teams enabling them to respond in a consistent and flexible manner to the changing needs of the tenants. The tenants of Fairfield Court benefit from care consistently delivered by confident carers. One tenant stated in the survey (the staff) are always on hand when needed if you are ill you get well looked after, and one other tenant said moving into Fairfield Court was the best move she had ever made. The tenants stated they felt safe and secure in their accommodation. What has improved since the last inspection? Improvements have been made in the application and administration of medications. Changes had occurred in the pharmacist and a new monitored dosage system had enabled a tenant to take her own medication. The carers were confident in their abilities. What they could do better: At the time of the inspection a service user was observed to open the front door in response to a person knocking on the window. This is patently unsafe for all the tenants particularly as the staff do not have identity badges. This situation must be addressed by the organisation. Anchor Trust Integrated Housing Version 1.10 Page 6
Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Anchor Trust Integrated Housing Version 1.10 Page 7
DETAILS OF INSPECTOR FINDINGS CONTENTS User Focused Services (Standards 1 6) Personal Care (Standards 7-10) Protection (Standards 11-16) Managers and Staff (Standards 17-21) Organisation and Running of the business (Standards 22-27) Scoring of Standards Statutory Requirements Identified During the Inspection Anchor Trust Integrated Housing Version 1.10 Page 8
User Focused Services The intended outcomes for Standards 1 6 are: 1. Current and potential service users and their relatives have access to comprehensive information, so that they can make informed decisions on whether the agency is able to meet their specific care needs. 2. The care needs requirements of service users and their personal or family carers when appropriate, are individually assessed before they are offered a personal domiciliary care service. 3. Service users, their relatives and representatives know that the agency providing their care service has the skills and competence required to meet their care needs. 4. Each service user has a written individual service contract or equivalent for the provision of care, with the agency, except employment agencies solely introducing workers. 5. Service users and their relatives or representatives know that their personal information is handled appropriately and that their personal confidences are respected. In the case of standards 5.2 and 5.3, these do not apply to employment agencies solely introducing workers. 6. Service users receive a flexible, consistent and reliable personal care service. In the case of standards 6.3 and 6.4 these do not apply to employment agencies solely introducing workers. The Commission considers Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT we looked at outcomes for standard(s) 2 3 6 The tenant s care needs had been appropriately assessed before they had been offered the domiciliary service. Carers are well trained and have access to training opportunities provided by the organisation. The service is flexible, reliable and responsive to the tenants needs. EVIDENCE: The provision of the individual needs assessment results in the scheme manager being able to provide the appropriate resources to the tenants. This ensures that the tenant s needs are fully met within their own accommodation. The carers training profiles were submitted with the pre inspection questionnaire. They give evidence of training at National Vocational Qualification level 2 and other courses that have been provided in response to Anchor Trust Integrated Housing Version 1.10 Page 9
the tenants specialist needs. During discussions with the carers they were able to confirm their training and were justifiable proud of their achievements. The National Vocational Qualification certificates were displayed in the main entrance hall confirming the level of training achieved by staff. The record of carer s visits to the tenants demonstrated that the times they visited and the length they stayed was consistent with the individual care needs assessment. The carers stated that they were able to respond to the tenants call bells immediately, and this was observed to be the case. The tenants stated that they felt secure in the knowledge that the call bells are responded to very quickly and this applied both day and night time. Anchor Trust Integrated Housing Version 1.10 Page 10
Personal Care The intended outcomes for Standard 7 10 are: 7. The care needs, wishes, preferences and personal goals for each individual service user are recorded in their personal service user plan, except for employment agencies solely introducing workers. 8. Service users feel that they are treated with respect and valued as a person, and their right to privacy is upheld. 9. Service users are assisted to make their own decisions and control their own lives and are supported in maintaining their independence. 10. The agency s policy and procedures on medication and health related activities protect service users and assists them to maintain responsibility for their own medication and to remain in their own home, even if they are unable to administer their medication themselves. In the case of standards 10.8 and 10.9, these do not apply to employment agencies solely introducing workers. The Commission considers Standards 8 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT we looked at outcomes for standard(s) 7 8 10 The care planning system is clear and concise. The tenants are treated with respect and their personal care needs are carried out within the privacy of their own accommodation. The policy and procedure for the administration of medications enabled tenants to manage their own medications. EVIDENCE: Three care plans were examined they contained information and the action required to be taken by the carers in order that the appropriate care needs may be met. A tenant described how during a recent illness, the carers quickly responded to her changing needs and also involved other healthcare professionals. The tenants care plan described the changes and the required action to be taken by the carers. Anchor Trust Integrated Housing Version 1.10 Page 11
Three tenants described their various packages of care being delivered within their own property, and carers confirmed this to be the case. A new policy and procedure for the administration of medication had been devised. In response to the requirements from the previous inspection the scheme manager had change the community pharmacist and the type of monitored dosage system to good effect. One tenant stated this change had enabled her to self medicate and one other confirmed that it was important to take her tablets when the carer offered them to her. Judging from the scheme manager s comments in the pre inspection questionnaire and in discussion there remains a level of anxiety concerning accountability and the administration of medications. This was not reflected in the comments from the carers. The scheme manager was advised to ensure that carers sign the medication record sheet and not tick the box, as is the present case. Anchor Trust Integrated Housing Version 1.10 Page 12
Protection The intended outcomes for Standards 11-16 are: 11. The health, safety and welfare of service users and care and support staff is promoted and protected, except for employment agencies solely introducing workers. 12. The risk of accidents and harm happening to Service Users and staff in the provision of the personal care, is minimised, except for employment agencies solely introducing workers. 13. The money and property of service users is protected at all times whilst providing the care service, except for employment agencies solely introducing workers. 14. Service users are protected from abuse, neglect and self-harm, except for employment agencies solely introducing workers. 15. Service users are protected and are safe in their home, except for employment agencies solely introducing workers. 16. The health, rights and best interests of service users are safeguarded by maintaining a record of key events and activities undertaken in the home in relation to the provision of personal care, except for employment agencies solely introducing workers. The Commission considers Standards 11, 12 and 14 the key standards to be inspected at least once during a 12 month period. JUDGEMENT we looked at outcomes for standard(s) 11 12 14.15 There are systems in place to ensure the organisation complies with the Health and Safety at Work Act, and to ensure the tenants are protected from all types of abuse. EVIDENCE: Systems and policies are in place to maintain the environment in a safe condition. The scheme manager has received health and safety training and as such is the responsible person. The interviewed carers demonstrated their understanding of health and safety responsibilities. Three tenants who were interviewed stated they felt safe and secure within the property. The carers had received abuse awareness training and the concept of abuse had been discussed at a tenants meeting. Anchor Trust Integrated Housing Version 1.10 Page 13
Entrance to the communal areas of the property is via a digital door lock and intercom to the individual flats. During the inspection a tenant with special needs was observed opening the door to a visitor who had knocked on the window to get her attention. The scheme manager is aware of this security problem and the potential risk to the tenants from strangers entering the property uninvited. The carers do not have identity badges although this is in hand. A new tenant commented that she thought that the carers should wear their identity badges at all times, as she was not always sure of who the carers were. Anchor Trust Integrated Housing Version 1.10 Page 14
Managers and Staff The intended outcomes for Standards 17-21 are: 17. The well-being, health and security of services users is protected by the agency s policies and procedures on recruitment and selection of staff. 18. Service users benefit from clarity of staff roles and responsibilities, except for employment agencies solely introducing workers. 19. Service users know that staff are appropriately trained to meet their personal care needs, except for employment agencies solely introducing workers. 20. The personal care of service users is provided by qualified and competent staff, except for employment agencies solely introducing workers. 21. Service users know and benefit from having staff who are supervised and whose performance is appraised regularly, except for employment agencies solely introducing workers. The Commission considers Standards 17, 19 and 21 the key standards to be inspected at least once during a 12 month period. JUDGEMENT we looked at outcomes for standard(s) 17 19 21 Robust recruitment policies are in place resulting in a group of staff who have been appropriately vetted. The tenants receive a consistent service from carers who have been vetted, well trained and formally supervised. EVIDENCE: According to the pre inspection questionnaire and the care workers survey all staff have been appropriately vetted prior to taking up post. There has been no change in staff since the previous inspection (April 2004). Three carers who spoke with the inspector confirmed they enjoyed working at Fairfield Court it was felt they were a good team. Staff sickness was minimal. The tenants stated the carers would do any thing for them and were good girls. The staff benefit from regular formal supervision and staff meetings. Anchor Trust Integrated Housing Version 1.10 Page 15
Organisation and Running of the Business The intended outcomes for Standards 22 27 are: 22. Service users receive a consistent, well managed and planned service. 23. The continuity of the service provided to service users is safeguarded by the accounting and financial procedures of the agency. 24. The rights and best interests of service users are safeguarded by the agency keeping accurate and up-to-date records. 25. The service user s rights, health, and best interests are safeguarded by robust policies and procedures which are consistently implemented and constantly monitored by the agency. 26. Service users and their relatives or representatives are confident that their complaints will be listened to, taken seriously and acted upon. 27. The service is run in the best interests of its service users. The Commission considers Standards 22 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT we looked at outcomes for standard(s) 22 26 The agency is consistently managed resulting in a high standard of service for the tenants. The tenants were confident that the scheme manager would directly address any complaints they made to her. EVIDENCE: The scheme manager has been in post since the scheme was built. She has adopted an open and informal management style. Both the tenants and carers said the scheme manager was always available to listen to them. The tenants benefit from a team of carers who are skilled and able to recognise changing needs. The lines of communication both formal and informal ensure the changes are correctly assessed and addressed. According to the service users survey the complaints procedure was available to the tenants. Copies were held in the tenant s property and were on the notice board in the communal areas. In discussion they were confident that if they made a complaint to the scheme manager she would deal with it. Anchor Trust Integrated Housing Version 1.10 Page 16
SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Domiciliary Care have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 4 Standard Exceeded (Commendable) 3 Standard Met (No Shortfalls) 2 Standard Almost Met (Minor Shortfalls) 1 Standard Not Met (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 User Focused Services Managers and Staff Standard Score Standard Score Number Number 1 x 17 3 2 3 18 x 3 3 19 3 4 x 20 x 5 x 21 3 6 3 Personal Care Organisation and running of the business Score Standard Score Number 7 3 22 3 8 x 23 x 9 x 24 x 10 3 25 x Standard Number Protection Standard Score Number 11 3 12 2 13 x 14 3 15 2 16 x 26 3 27 x Anchor Trust Integrated Housing Version 1.10 Page 17
Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Domiciliary Care Regulations 2003 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 1. 2. 15 18 The registered person must ensure the staff are provided with identity badges that are worn at all times whilst on duty. 01/07/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations Standard 1. 10 The registered person should ensure the carers initial the medication record sheet. Anchor Trust Integrated Housing Version 1.10 Page 18
Commission for Social Care Inspection 2 nd Floor Heritage Wharf Portland Place Ashton under Lyne, OL7 0QD National Enquiry Line: 0845 015 0120 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 Anchor Trust Integrated Housing Version 1.10 Page 19