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Inspection on 04/09/09 for Hindmans Road, 10

Also see our care home review for Hindmans Road, 10 for more information

This is the latest available inspection report for this service, carried out on 4th September 2009.

CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There is a good and welcoming atmosphere in the home and good interaction between staff and residents. The staff help the residents in activities, and provide support for in house and community activities. Staff know residents well and communicate well with them always speaking in a friendly and respectful manner. The home is well decorated and maintained and resident’s rooms are well maintained and reflect their own choices and preference. The manager provides a sensitive and encouraging approach to managing the home, and tries hard to ensure that residents and staff are safe and secure in the home.Hindmans Road, 10DS0000007094.V377574.R01.S.docVersion 5.3

What has improved since the last inspection?

The home has made sure that the care assessment and risk assessments for one service user about the risks of going out in the community has been reviewed to show how this resident can be safely supported. The home now has better information about the cost of the service given to individual residents and is planning to include this information in residents contracts. Person Centred Plans for residents have been completed so that they can get to do things they say they want to. The kitchen has been repaired and updated so that residents all residents can easily use it for learning to prepare food. The home and organisation now always take up a CRBs (police check) for new staff before they start work at the home.

What the care home could do better:

The cost of each residents care needs to be written down for them in their contracts with the home so they or their representatives can understand how they are funded. Care plans and risk assessments for residents must be reviewed every six months instead of every year so that residents will always be safe. The management must find out about concerns that evening staffing levels are not enough to provide residents with opportunities to go out when they want to, and make sure that there are always enough staff to provide for planned activities at that time. The water pressure in the main resident’s bathroom needs to be improved so that residents who want to can have a shower comfortably. More care staff need to get an NVQ 2/3 qualification so that residents are supported by qualifies staff.

Key inspection report CARE HOME ADULTS 18-65 Hindmans Road, 10 London SE22 9NF Lead Inspector Sean Healy Key Unannounced Inspection 4th September 2009 09:00 Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 Page 1 This report is a review of the 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. 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 home adults 18-65 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. Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) 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. www.cqc.org.uk Internet address Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 Page 3 SERVICE INFORMATION Name of service Hindmans Road, 10 Address London SE22 9NF 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) 0208 693 8950 0208 297 1207 PLUS (Providence & Linc United Services) Rose Nellie Abibu Care Home 3 Category(ies) of Learning disability (0) registration, with number of places Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Person may provide the following category 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 are within the following category; 2. Learning Disability - Code LD The maximum number of service users who can be accommodated is: 3 15th September 2008 Date of last inspection Brief Description of the Service: 10 Hindmans Road is a Care Home providing accommodation and personal care to three people with a learning disability, currently all men. Hexagon Housing Association, a voluntary organisation who leases the building to Choice Support, owns the building. The support service is provided by PLUS, (Providence and Linc United Services) a voluntary organisation. The home is located in East Dulwich, close to shops, Peckham Rye Park, pubs, the post office and other amenities. The home consists of a two-storey building, one bedroom downstairs with en-suite facilities, and accessible to wheelchair users. All the home’s bedrooms are single. The home has a garden to the rear. Information about the service provided is made available to current and potential service users in the homes Statement of Purpose and Service Users Guide. The recent Care Quality Commission report is currently kept at the home available to residents and visitors. At 4th September 2009, the homes fees are set at between £36.80- and £78.70 per week for a portion of the cost of accommodation and support. The majority of the cost of support and staffing are met by the referring social services authority, however these costs are not made explicit by the home in Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 Page 5 either resident’s contracts or statements of terms and conditions. There is an additional charge made for food of £29.40 weekly, payable by each resident. Transport is not provided by the home and any costs are payable by each service user. Residents have to pay for other personal expenses such as hairdressing and personal shopping. The provider’s email address is: The home does not have an email address Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 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 that the people who use this service experience good quality outcomes. This inspection site visit took place over one day on the 4th September 2009. The inspection was unannounced, and was facilitated by the Manager, who has now become registered care manager with the Care Quality Commission. During the inspection one resident were observed being helped by staff. Two residents planning files were examined. Three support staff gave their views on the homes management and three staff files were examined to see recruitment, supervision and training records. The inspection included examination of records and policies and procedures, and a tour of the building. All of the seven requirements made at the previous inspection have now been met. Residents seem to be happy at this home, and there has been much improvement in the care and management provided. The atmosphere was relaxed and friendly. The manager and staff involved Residents and spoke with them regularly. What the service does well: There is a good and welcoming atmosphere in the home and good interaction between staff and residents. The staff help the residents in activities, and provide support for in house and community activities. Staff know residents well and communicate well with them always speaking in a friendly and respectful manner. The home is well decorated and maintained and resident’s rooms are well maintained and reflect their own choices and preference. The manager provides a sensitive and encouraging approach to managing the home, and tries hard to ensure that residents and staff are safe and secure in the home. Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 Page 7 What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 Page 8 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. Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 Page 9 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 Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 Page 10 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 5 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents’ are now in possession of all of the information they need to help them to make informed decisions about where they live. Prospective residents’ individual aspirations and needs are being assessed by the home. Residents have contracts or statements of terms and conditions informing them of their rights and responsibilities, however, these documents do not include information on support costs and need to be signed and dated. EVIDENCE: The home provides the information for current and prospective residents, in a Statement of Purpose, which shows services provided, and a range of information about staff experiencing training, the provider organisation, and how residents can complain should they need to. One of the residents has been in the home for many years and has the original complete care needs assessments on file. The second resident has moved in since the last inspection. All care and support needs are clearly recorded in detail covering all areas of health, and social care needs, and these were reviewed in January and April 2009 with the involvement of social services and citizen’s advocacy. Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 Page 11 There was a requirement made at the last inspection to ensure that one residents assessment regarding the need to have two to one support when going out in the community be reviewed with social service. This requirement was met and a review meeting took place in January 2009. This resulted in an agreement for the resident to go out with one to one support. There was a requirement made at the last inspection for the registered provider and manager to raise the issue of lack of specific information about the cost of support with the provider and with social services with a view to being able to provide each resident with this information in their contracts with the home. This requirement was met. The manager has established the full cost of support for all residents in the home and now needs to formalise the individual costs for each resident in their contracts with the provider. At 4th September 2009, the homes fees are set at between £36.80- and £78.70 per week for a portion of the cost of accommodation and support. The majority of the cost of support and staffing are met by the referring social services authority, however these costs are not made explicit by the home in either resident’s contracts or statements of terms and conditions. There is an additional charge made for food of £29.40 weekly, payable by each resident. The registered provider must ensure that written information about the cost of support for each individual residents is made available to them in their contracts with the home, and that reasonable efforts are made to have these contracts read, signed and dated by each resident or by someone independent acting on their behalf. (Refer to Requirement YA5) Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 Page 12 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be sure that all of their assessed needs and personal goals are reflected in their individual plan, and they do get help to make decisions about their lives. They are supported to take assessed risks, which enable them to be more independent. EVIDENCE: There were two recommendations made at the last inspection regarding care planning for residents: 1) to complete the Person Centred Planning documents for both residents 2) to review residents care plans as soon as possible following formal review meetings. Both of these recommendations were met. There was a requirement made at the last inspection for the home to ensure that the behavioural management strategies for one resident be reviewed with input from this resident and from social services to ensure that her rights were Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 Page 13 protected. This was done and a number of important changes were made to her bedroom to make it more homely and less restrictive. This requirement has been met now although there is one remaining issue of attaining formal agreement on the locking of a wardrobe. (See Recommendation Standard 19) I examined two residents care plans and risk assessments. These were well organised and reflected the needs of these residents well. Each of these residents has a personal profile and a personal care plan, which has been regularly updated. There is also a ‘life plan’, which is their personcentred plan. This allows the residents to have a better voice in their care planning. All have had an annual review during the period of January to June 2009 and were attended by the resident, social worker, the resident’s keyworker, the registered manager and the service manager. There was also involvement from relevant GPs and other health care professionals such as psychology and citizens advocacy. The notes taken from these reviews are very detailed and show that previous aims of service users have been reviewed and new aims for achievement or activities have been set. The residents have learning disabilities and have high support needs in personal care and day to day support. None were able to provide comments on the care provided but observations of staff providing support were that they know the residents well and are sensitive and respectful in they way they provide support. They also showed that they communicate with residents well using pictures and prompts where appropriate. There are a range of guidelines for support in place for residents in areas such as personal care, travel in the community and personal care. These are well written and staff said they understood them and that they were helpful. Excellent systems are in place to enable residents to fully make independent decisions about their lives. One resident receives support from the home to safeguard their money, the other resident is relatively independent in managing his money and receives partial support. There are appropriate agreements on file allowing the manager to act on behalf of one resident in financial matters. Care plans are being reviewed every year but must be reviewed at least every six months. (See Requirement YA6 and YA9) There was a requirement made at the last inspection for the home to ensure that the home review the risk assessments regarding one resident needing two to one support in the community and ensure that written guidance is in place for staff to follow. This has now been done and this requirement has been met. This risk assessment was reviewed with input from the community support team challenging needs professional and the resident concerned can now go out with one to one support. The manager identified a need to have two to one support for one resident when swimming and to reduce the support from two Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 Page 14 staff to one staff when sailing. This was done in liaison with social services also. Other risk assessments include sailing, bowling, medication, eating and using the sensory room at a community centre. The home now has adequate risk assessments. These are being reviewed annually but should be reviewed at least every six months. The manager said she would ensure that this happened. Care plans too must be reviewed six monthly. (Refer to Requirement YA6 and YA9) Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 Page 15 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): This is what people staying in this care home experience: 12,13,15,16 and 17 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have appropriate activities and are part of the local community. They have good relationships with family and friends, and their rights are respected and responsibilities are recognised in their daily lives. A healthy diet is provided for and meals are provided at times which suit residents best. EVIDENCE: Examination of residents care activities plans, and records of the activities have taken part in, together with discussion with staff and with the advocacy involved in the home, show that there has been improvement in the level and consistency of activities provided for both residents. Daily records showed that staff do work well and creatively to involve residents in the daily running of the home, in order to foster their abilities as much as possible. Activities plans and Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 Page 16 records for residents show the following activities being provided in weekly basis: bowling, sailing, attending church services, weekly attendance at an aromatherapy workshop and an Irish club for both residents. All residents have some involvement from their families although to a limited degree. All residents have friends they go to visit, and get involved in going to barbecues, birthday parties, and other outings. Discussion with staff, and with the advocate for a number of residents suggest that there has been an improvement too in activities within the local community, such as going to local shops and pubs and cafes. There were previously problems in facilitating some activities due to high support needs of one resident in going out in the community. This has been resolved through improved risk assessments and now staff feel the manager of the home has provided support and encouragement to the enable these activities to happen. However information received suggests strongly that residents evening activities are hampered by restricted availability of additional care staff in the evenings brought about by staff reduction measures. All of the staff were concerned about this situation. The rota showed that regularly there was just one staff one in the evenings after 6pm. The registered provider and manager must investigate staff concerns about this and ensure that residents have access to evening activities on a regular basis. (Refer to Requirement YA13) Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive personal support in the way they prefer and their needs are being met in all other areas. Support with medication is appropriate for the service users’ assessed needs. EVIDENCE: I examined the personal care plans and health and medication records for two residents and found these to be well organised with detailed plans showing the care to be provided in these areas. All Residents’ files examined showed health care needs are well managed with good input from a range of health care professionals. Residents are registered with a GP and regularly attend a dentist and chiropodist. A dietician is also involved in providing advice in the management of diet and weight. There is support provided by psychology and psychiatry in the area of communications and motivation and challenging behaviour. Resident’s files showed pictures and physical prompts are used to help residents understand documentation, and Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 Page 18 also are used in weekly activity plans. Healthcare and medication is being reviewed by the home annually but must be reviewed every six months. (Refer to Requirement Standard YA6 AND 9) The last reviews took place between January and June 2009. Residents have learning disability support needs and need support in washing and dressing. There are also communications support needed for some residents. There are some challenges presented in providing support in the community and in the home and relevant health care professionals are involved in planning the support package. The personal care plans are well written showing what residents need support with and what they should be left to do for themselves. The staff spoken to showed a good knowledge of these areas, and the care plans for residents in how to provide the support needed are very detailed. This enables a very good level of understanding by staff in the support needed. I observed staff providing support for one resident and they were very competent and communicated very well with the resident always reassuring them. The home has a written Medication policy that is clear and up to date. Both residents are using prescribed medication and no controlled medication is being used. Medication is stored in a locked cupboard in a private area, and this is safe and secure. A blister pack is used to administer medication. Records are well maintained with minimal omissions recorded. All of the care staff have been trained in administration and management of medication. No controlled drugs are being used at the home. The manager feels that staff are competent in administering medication and in understanding its effect on residents Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 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 home listens to residents and takes their concerns seriously, and residents are protected by the homes Adult Protection policy. EVIDENCE: The home has a good complaints policy in place that was last reviewed in 2008. There is a good relationship between the staff and residents, and the staff spoken to showed a good awareness of how to deal with complaints. There have been no complaints since the last inspection. All staff have had training on how to deal with complaints. There have been no adult protection issues since the last inspection. Copies of the organisations procedures and social service procedures are available in the home, and these were last reviewed in May 2007. All staff working in the home had received training in relation to safeguarding adults as part of the staff induction and there are regular training updates in relation to this area. Staff showed a good understanding of this policy and their own responsibilities in protecting vulnerable people. Overall safeguarding and protection of residents is well managed. Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27 and 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment is safe, comfortable, homely and clean and resident’s bedrooms are suitable for their needs. EVIDENCE: The home is comfortable and homely and all areas are safe. All residents have their own bedrooms, and one has adapted en-suite facilities. They are well furnished and resident’s bedrooms are personalised. There is one bedroom on the ground floor and two on the first floor, and there is a separate living room/dining room and kitchen. There is a rear garden, which is well maintained and paved for easy wheelchair access. There was a requirement made at the last inspection for the kitchen area to have repairs and upgrades carried out. This requirement was met and the Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 Page 21 kitchen is now in a good state of repair. The rest of the home is generally in a good state of repair also and new sofas have been bought for residents use. Two bedrooms and communal areas have been painted and look homely and bright. Lift equipment has been services although not used at the moment. The water pressure in the bathroom used mainly by residents is very low and needs to be improved as it does not provide adequate pressure for shower use. (Refer to Requirement YA27) The garden area is well maintained and the home generally is very clean and free from hazards. Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Not enough care staff are qualified and there are enough of them to ensure they meet the needs of residents effectively during evening periods. Residents are now protected by the homes recruitment practices. Staff have been trained to ensure that residents individual and joint needs are met, and they receive regular supervision. EVIDENCE: The current staff team consists of a manager and five care staff. This represents a reduction in staffing by one whole time equivalent since the last inspection. At the last inspection there were always at least two care staff on duty during the daytime with additional support provided by the manager at busy times. The staff say that they feel they are able to do their job and get good support from the manager, but they feel that in the evenings after 6pm there are not enough staff to provide for residents to go out should they wish to. The reason given was that the provider has reduced staffing levels due to a resident vacancy and it is not easy to book extra cover in the evenings now to Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 Page 23 facilitate residents going out. (Refer to Requirement Standard YA13 in this report) Changes in staffing since the last inspection has meant that the number of staff qualified to NVQ2/3 has fallen to below 50 and only two of the care staff are qualified. The registered provider must ensure that more staff become qualified to NVQ level 2/3 to meet the required standard for qualified staff of 50 . (Refer to Requirement YA32) There was a requirement made at the last inspection for the home to ensure that there is appropriate staff employment records maintained at the home, and for to ensure that all new staff are CRB checked prior to commencement of employment. Both of these requirements have now been met. Two satisfactory references are now on file for all staff and identification such as copies of passports and birth certificates are also being taken up. Enhanced CRB disclosures are also being taken up before commencement of employment. Staff said that they had been formally interviewed and that they felt they had a good induction and training opportunities were good. The home has good detailed forms available which have largely been completed recording the information about staff recruitment, police and POVA checks, references, and health checks. There are detailed induction schedules completed for each member of staff and held on the file, showing a good and detailed induction has taken place. The staff employment information held that the home has improved significantly and now is of a good standard, and better protects residents. A separate inspection of some staff employment information at the provider’s head office showed that staff records on recruitment and CRB checks is now at a safe level and better protects the interests of residents. Examination of three staff files showed that the good level of training is provided for staff which is appropriate to the needs of the residents. Training in skills teaching, safeguarding adults and visual impairment are now included in the training for all staff. A broad range of “statutory required training” is provided and the home now has a good standard of training provided to all staff which is specific to the needs of the residents. Staff confirmed that they are receiving regular supervision from the homes manager at least every six weeks but usually more often. Examination of staff files showed that this is the case and good detailed supervision note are being maintained which had been agreed by the supervisee. Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents do now benefit from a well run home. Residents are adequately consulted by the management and staff regarding their views but more frequent surveys should be conducted. The health and safety of residents are protected by the homes practices. EVIDENCE: Since the last inspection the manager has registered with the Care Quality Commission. She is NVQ4 qualified in management and has relevant experience in the management of learning disability services. She has now completed the NVQ4 care component of her management qualification and the staff have expressed confidence in her management. She has also completed Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 Page 25 risk assessment training as recommended at the last inspection and has done much to improve the systems for planning in the home and the consistency of staff supervision and training. The staff at the home said that they feel her management support and supervision is very beneficial and that they are now more confident to do their jobs. The care plans for residents, staff recruitment records and staff supervision and training has significantly improved since the current manager took up her post. Monthly visits to the home by the registered provider have also now become consistent and there is also a monthly meting with the service manager to raise any issues for improvement. The home is part of a larger registered charity that also provides support for residents and other homes. At organizational level there is a six monthly conference for residents, with a separate consultation group where resident’s representatives visit homes to ask for residents views on how the organisation is run. There are monthly monitoring visits carried out by senior manager looking at management in care within the home, and the manager has identified a range of areas is in the Care Quality Commissions Annual Quality return (AQAA) which could be entered on a development plan for the home. The manager collects information on the quality of care and staff every three months for the commissioning agent, Southwark Social Services, and this information includes goals set and achieved in residents care and development. This represents a detailed quality assurance audit system and is actively discussed with the commissioner of services for Southwark. It is recommended that in addition to this the home conduct surveys at least annually with relatives of residents or their representatives to gain further insight into their views on the quality of care provided. (Refer to Recommendation YA39) Health and Safety in the home is well managed. The home has an adequate health and safety policy, which includes risk assessment, fire safety, food hygiene, moving and handling, and all of these are included in the staff induction and training programme. Fire equipment checks are being done on a weekly basis and the home has certificates for electrical and gas appliances which are up to date. Appropriate hoists and wheelchairs are in use and are maintained. Risk assessments for residents have been improved but need to be reviewed every six months instead of annually improvement. (Refer to Requirement under Standard 9 of this report) Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 2 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Version 5.3 Page 27 Hindmans Road, 10 DS0000007094.V377574.R01.S.doc 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 YA5 Regulation 5.1 Requirement The registered provider and manager must ensure that residents contracts or statements of terms and conditions include all fees and charges as discussed in this report and reasonable efforts be made to have these agreed and signed by them or their representatives. This is in order to protect their rights. The Registered Provider and manager must ensure that all resident’s care plans and risk assessments are reviewed at least every six months as discussed in this report, Standards 6 and 9. This is to better protect residents and staff. The registered provider and manager must investigate staff concerns about the adequacy of staffing levels at the home in the evening hours to ensure that adequate numbers of staff are available for residents support. This is to ensure that residents social care support needs are DS0000007094.V377574.R01.S.doc Timescale for action 31/03/10 2. YA9 YA6 12.1 & 13.4b 31/03/10 3. YA13 YA33 18.1 (a) 31/03/10 Hindmans Road, 10 Version 5.3 Page 28 met 4. YA27 23 The registered provider and manager must ensure that the water pressure in resident’s bathrooms is maintained at an adequate pressure as discussed in this report under Standard 27. This is to ensure that resident’s bathroom facilities meet their needs. The registered provider and manager must ensure that more staff become qualified to NVQ level 2/3 to meet the required standard for qualified staff of 50 for this home. This is to ensure that residents are consistently supported by qualified staff. 31/03/10 5 YA32 18 30/06/10 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 YA39 Good Practice Recommendations The registered provider and manager should explore ways of conducting surveys of residents and their families views annually to enhance the existing systems for including the residents in the homes development Hindmans Road, 10 DS0000007094.V377574.R01.S.doc Version 5.3 Page 29 Care Quality Commission Care Quality Commission Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: 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. 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