Inspection on 25/11/08 for 2 Mundania Road

This inspection was carried out on 25th November 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

2 Mundania Road 29/11/06

2 Mundania Road 20/10/05

2 Mundania Road 14/07/05

2 Mundania Road 01/02/05

2 Mundania Road 02/11/04

2 Mundania Road 13/03/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 2 Mundania Road 2 Mundania Road London SE22 0NG The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Claire Taylor Date: 0 3 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 32 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: 2 Mundania Road 2 Mundania Road London SE22 0NG 02086931983 02086939276 Mundania@saffronland.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Saffronland Homes Name of registered manager (if applicable) Albert Kudzai Mutasa Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 6 0 care home 6 learning disability Additional conditions: The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Eiither whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of service users who can be accommodatis: 6 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 32 A bit about the care home Mundania Road is registered to provide accommodation and care to six people who have learning disabilities. The house is a large Victorian style 3 storeydetached building in a side street close to many local shops, community services and transport links. There is a large communal dining area and lounge with a communal kitchen on the lower ground floor. There is a garden with patio at the back of the house. There is no lift and the house is not wheelchair accessible. The fees range from between £1750 and £2000 depending on a persons needs. This account was correct at the time of this inspection. Care Homes for Adults (18-65 years) Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 32 How we did our inspection: This is what the inspector did when they were at the care home This was an unannounced inspection, which took place over two days. We met with all five people living in the home, several staff, the manager and two relatives who were visiting during our second day. We also met with the responsible indivual for the service. The home is owned by Saffronland homes who have several other residential services throughout the country. We looked at various records in relation to peoples care, staffing and the way the home was being run. Some people living in the home do not have the capacity to fully share their views regarding their care. In order to make judgements about the care that individuals receive, we observed care practices; interactions with staff and tracked records of care. We also looked around the building and viewed some of the bedrooms with peoples permission. Prior to our visit, the manager returned a fully completed AQAA (Annual Quality Assurance Assessment) when we asked for it. The AQAA gives us details about the home and includes service improvements over the past twelve months and proposals for development during the coming year. Some of the information is included in the report. Feedback from the written comment cards returned by the five people living in the home and two staff also informed this inspection. We told the manager what we found at the end of Care Homes for Adults (18-65 years) Page 7 of 32 our visit. We would like to thank all those who took part for their time and contribution to this inspection. What the care home does well The home focuses strongly on peoples choice and independence and uses imaginative ways for ensuring that peoples views are taken into account and that their personal wishes or goals are being met. Individuals are central to the planning of their care and staff have good information on how to meet each persons needs. When needs change, the home is good at making sure the appropriate action is taken and involves other relevant healthcare professionals where necessary. Any changes in individual needs are acted upon and adjustments to their care and support are put in place. People that live in the home have busy lives and are supported to do the activities they want, including going to college and getting a job. People have their health needs fully met and they are encouraged to manage their own health appointments. The home ensures people are safe by managing any risks appropriately whilst encouraging independence. The staff work hard to ensure that they understand the needs of the people they support and encourage individuals to achieve their personal ambitions. The staff group are skilled in communicating with people, and for those individuals with limited speech, great efforts have been made to document and to interpret their Care Homes for Adults (18-65 years) Page 8 of 32 moods, gestures and expressions. The home also provides useful information for people in ways that they can understand. People are encouraged to see the home as their own and bedrooms reflect their individual personality and lifestyle in a unique way. The manager and staff show commitment and enthusiasm to run the home in the best interests of the people who live there. Good training and supervision systems support staff to do their jobs well. The staff have worked at the home for some time and know each persons needs well. For what the home does well, staff comments included, one on one support. Sensitive to service user and family needs and concerns. Another wrote, promoting individual choices, preferences, independence in different areas. What has got better from the last inspection All areas that needed attention from the last inspection in November 2006 have been addressed. Information about the home has been updated so that people have the necessary details about the home and the services it offers. Plans of care were more individualised and had been reviewed with the full involvement of the person. The home has started to adapt its information for people in ways that they can understand. Quality assurance systems have improved since we last visited. A detailed annual plan has Care Homes for Adults (18-65 years) Page 9 of 32 been developed that outlines the expected aims and outcomes for improving the services for the people in the home. People have been given questionnaires to seek their views about the home as well as their relatives and other people with an interest in the service. People have been provided with a bedside light and an extra chair in their rooms where needed. The home has set up a contract with the local council for the disposal of clinical waste. What the care home could do better Some areas of the home are in need of redecoration or repair. Although there are plans to upgrade areas that need attention, this needs to be recorded with timescales for completion. A planned maintenance and redecoration programme is therefore needed. Some of the bathroom facilities are in need of attention so that they are more homely and accessible to people living in the home. When medication is not given the reason must be recorded clearly on the administration chart. This will enhance accuracy and maximise safe practice. All staff now need to update their training on managing challenging behaviour, as it is specific to the needs of some people living in the home. This will ensure that staff have the specialist knowledge and skills to meet individual needs in a safe and competent manner. Care Homes for Adults (18-65 years) Page 10 of 32 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Claire Taylor 33 Greycoat Street London SW1P 2QF 02079792000 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 11 of 32 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 12 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Good information is available about the home to help people make a choice about whether to live there. People are confident that the care home can support them. This is because good arrangements are in place for assessing peoples needs so that staff are aware of how to support them. Evidence: We looked at an updated Statement of Purpose and Service User Guide. They both contain lots of useful information and are written in a way that is meaningful and specific to the individual home and the group of people who live there. The home aims to care for people who have specialist needs such as autism and other complex needs where their behaviour may challenge the service.The home has used photographs, pictures and simple language to help people understand what rights they have at the home and what they can expect while living there. The owning organisation has clear procedures in place for admissions and assessments. These ensure that any prospective person is central to the process and the service considers the needs assessment and the capacity of the home to meet a persons needs. The manager advised that the home would also carry out its own needs assessment. We looked at the care records for three people and each file Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: contained a needs assessment that was undertaken through care management arrangements in the local authority of Southwark. The assessment focuses on achieving positive outcomes for people and covers all aspects of a persons life, including individual strengths, hobbies, social needs, dietary preferences, health and personal care needs. For the newest person, they were offered introductory visits including staying for meals and joining in with activities. A review meeting was then held after six weeks to discuss whether the person was happy in the home and that it was suitable for them. Care Homes for Adults (18-65 years) Page 14 of 32 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Peoples needs and goals are met as the home has a plan of care that the person, or someone close to them, has been involved in making. Individuals are consulted and given opportunities to influence how the home is run. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. Evidence: We looked at care records for three people which were very person centred and showed well planned, individualised care. Each plan clearly outlined the persons assessed needs and how these will be met by the service. Areas included peoples religious and cultural beliefs, their personal care, preferred leisure activities, relationships, behaviour, healthcare needs and ways of communication. The plans also emphasise the individuality of each person and reflect their qualities and personality. Plans included a section called things that make me happy. For one individual it said,music, dancing and going on a bus ride to places of interest. Plans showed evidence of regular internal review and there was also records of annual reviews by the local authority. Monthly reviews are carried out by keyworkers to evaluate whether Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: goals and objectives are being met for each person. As we required at the last inspection, plans had been reviewed with the individual and other relevant people such as family. Things that were important to the person, raised at reviews, had been followed up by the home. For example, one person hopes to move into their own flat in the future and there were various support plans in place to help the person achieve their goal such as to improve budgeting skills and independent living skills.Progress was being closely monitored with the person with additional support through an Occupational Therapist. The manager wrote on the AQAA that plans for the next twelve months are, More accessible documentation. We saw that regular meetings are held at the home for people to give their views on activities, the way the home is run and any other issues. Minutes of the most recent meeting were not available and the last one was held in May 2008. We therefore suggest that the home ensures there is a clear record of discussions held to form an audit trail of decision making and how these are being followed up. The home shows a positive approach to managing risk for people who use the service. Individual assessments covered the full range of assessed risks and varied appropriately according to the needs of each person.Plans show that action should be taken to lessen risk, whilst encouraging independence for people. A risk assessment also tells the staff how to make sure that each person is kept safe from anything that might harm them. Examples seen included safety in the home, travelling in the community and money management. Observation and records showed that where an individuals behaviour could potentially present risks this is wellmanaged with staff continuing to promote the persons independence at home and in the community. Any specialist guidelines were clearly recorded to enable staff to support the person appropriately. Guidelines had been frequently reviewed or as changes occur together with associated risk assessments. Care Homes for Adults (18-65 years) Page 16 of 32 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People lead fulfilling lives as they are supported in the lifestyle they choose and have good links with the local community. Relationships with family and friends are well supported and daily routines ensure that peoples dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. Evidence: We looked at records relating to peoples lifestyle. The activities they do are individual to them and are based on things they say they enjoy as well as new things they would like to try. Each person has something planned every day. The activities are a mixture of educational activities, daily routine activities and leisure. Examples include college, shopping,eating out, going to the pub, walks, church, cinema, social clubs, farm visits and leisure day trips. One person has part time job at a local football ground and a second person was being supported to seek employment. Timetabled planners are used each week that include pictures to help individuals recognise their daily activities. Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: One person uses pictures or Talking mats to help them make more choices and promote decision making. This was implemented with the help of speech and language therapy. During both visits, staff spoke respectfully with individuals and supported them with their day-to-day routines. We saw each person being supported with their regular activities. I.e. people went out with their respective key worker staff, two attended their day centre or college and one person went to their regular bowling session. There is a range of indoor entertainment including a widescreen television, computer with internet access, music system, table top football and various games and craft activities. People who live in the home have their own leisure equipment within their private rooms. This includes TVs, videos/DVD players and computer games. We received surveys from all five people using the service. Four ticked that there were good activities in the home. Three people responded that they were involved in decision making in the home and two ticked sometimes. Care records included details about each persons social network and who is important in their lives. Families are involved and the staff support people to visit and to keep contact with those that are close to them. Care plans and daily diaries confirmed that people who live in the home maintain links with their families and that this process is supported by staff at Mundania. People are able to eat at flexible times according to their routines and social lives and are actively involved in cooking and meal preparation. We spoke to two individuals who confirmed this. All five people ticked that they liked the food in the home.We saw records to show that people are asked what they want to eat and that their food choices were included on the planned weekly menus. For how the home has improved the AQAA stated, Increased opportunites for family gatherings at home. Increased Service user participation and skills development in a healthy cooking and eating regime based on known preferences incorporating allergies etc. Care Homes for Adults (18-65 years) Page 18 of 32 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. The homes medication systems are generally well managed although improvements to record keeping will ensure safer practice. Evidence: Peoples preferences about how they receive personal care were recorded in their care plans.Some individuals have specific goal plans to help them manage their personal care and increase independence. Records and observations showed that staff respect peoples choices and know their preferred routines. Times for getting up and going to bed are flexible, as are mealtimes.Four out of five people who responded to our survey told us that staff treated them well and one ticked sometimes. Care plans seen gave good information about how individuals are supported with their health care needs. Staff closely monitor the health and wellbeing of the people living in the home and each person has their own health action plan. This also outlines the support the person may need for health check-ups and health screening. Individual records show involvement with a number of healthcare professionals including, GP, Consultant, optician, dietician and dentist. Staff keep a detailed record of all appointments, outcomes and any follow up action required. These systems showed us that individual Care Homes for Adults (18-65 years) Page 19 of 32 Evidence: healthcare needs are being monitored reliably in the home and that staff act upon any changes to ensure that peoples care and support needs are met. Plans on the AQAA stated, Encourage the development of Health Action plans by GPs. Continue with staff development and training programmes.The policy and procedure for the safe management of medication was clear and up to date. Records showed that all staff have received medication training through the organisation. We looked at a selection of medication charts and the medicine cupboard. When we asked, staff showed a good knowledge of the medicines that people were prescribed and what they were used for. The home uses a monitored dosage system, with most medication being delivered in blister packs by the dispensing pharmacist. A list of homely remedies were in place for each person which included instructions for use, dosage instructions and precautions. Lists had been signed by the individuals general practitioner.Records were accurate for the receipt and disposal of medication. Overall, sampled administration charts were signed and accounted for. For one individual, there were several instances where a prescribed antibiotic medication had been omitted or administered but not signed for. Although there were acceptable explanations for this, these had not been fully recorded. In all cases where medication is not given as prescribed, staff must ensure that they record the reason for this. This is to ensure safe practice and to provide a complete audit trail. Care Homes for Adults (18-65 years) Page 20 of 32 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . If people have concerns with their care, they or those close to them, know how to complain. Their concern is looked into and action taken to put things right. Arrangements for protection from abuse are well managed and help ensure that people living in the home are safe. Evidence: The home has a clear complaints procedure that is also available in an easy read format with pictures and symbols to support the written text. We have recieved no direct complaints about the service and the home has had one complaint since our last inspection. Records showed that it was investigated in line with the organisations policy and that the provider takes peoples views seriously.Surveys received from the five people using the service indicated that each person knew who to speak to if they were unhappy and how to complain. We saw policies and procedures for safeguarding adults that give clear, specific guidance to staff working at the service. A local authority procedure for reporting any safeguarding concerns was also available. This helps staff know when incidents need external input and who to refer the incident to. Records showed that all staff had received in house training on safeguarding and abuse awareness. We suggest that the home looks to secure some external training in this area in order to ensure that training is updated in line with revised guidance and local authority procedures, namely Southwark. The manager confirmed that there have been no safeguarding adults referrals or investigations at the home since the last inspection. The two staff surveys confirmed that Criminal Record Bureau checks had been carried out at recruitment and that staff understood what to do if a concern was Care Homes for Adults (18-65 years) Page 21 of 32 Evidence: raised. The five people using the service responded on their surveys that they felt safe in the home. Appropriate documentation was in place with regard to income/expenditure made on peoples behalf as well as policies to safeguard their personal interests. We saw that accurate records are kept of all financial transactions and daily checks are made to ensure that these are correct. Personal expenditure sheets were sampled and balanced correctly with cash amounts held in the home. These systems help to ensure that peoples financial interests are safeguarded. Care Homes for Adults (18-65 years) Page 22 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Overall the home is comfortably decorated and furnished although some redecoration work is needed so that people live in more welcoming and homely surroundings. People living in the home have spacious bedrooms that are designed and furnished to meet their needs and reflect their individuality. Facilities are clean, safe and homely although two of the bathrooms would benefit from some maintenance work. Evidence: The home provides good access to local community facilities, services and transport links. We had a look around the house and in three of the bedrooms with peoples permission. Each one clearly reflected the persons individuality, interests, leisure needs and preferences. People are supported to make the room their own with personal possessions that are meaningful to them. There were pictures and models of cars for one person who has a particular interest in them. Another person has a hobby collecting model characters and DVDs. All the rooms we saw were comfortably furnished and decorated and the people we spoke to said they were happy with their rooms. In response to our last inspection, people have now been offered two chairs and a bedside light for their room. Records confirmed that people are supported to join in with housekeeping tasks to promote their independence.There is a large lounge which is very comfortably furnished with television, music system, leather furniture, tables and modern prints on the wall. There is a second lounge / dining area which is also used as an activities room. The Care Homes for Adults (18-65 years) Page 23 of 32 Evidence: communal space for people is very good and gives many different choices for people to relax and enjoy quieter areas of the home. There was one vacant bedroom at the time of our inspection which was temporarily being used by staff for sleeping in duty. Facilities are clean and generally safe for people to use although some improvements are needed in two of the bathrooms. The first floor bathroom is now in need of general redecoration. There were some cracked tiles, a rusty radiator and several damaged areas of paintwork. In the second floor bathroom, the shower hose attachment was missing and the light fitting was not secured to the ceiling. Although we acknowledge that the company has plans to refurbish parts of the home, Saffronland homes need to write an annual plan for the redecoration and maintenance programme with scheduled timescales for completion. This will show how the home monitors the upkeep of the premises and makes improvements where necessary. We saw records to show that staff make a monthly check around the home to identify if any repairs or improvements are needed. Staff use a repairs/ maintenance report form to highlight any areas within the premises that need attention. We also suggest that the empty boxes, unused equipment and various records in the top floor office are either removed or tidied as it was difficult for people to access the area. This was also highlighted during a recent monthly visit by the registered provider. The home was clean and tidy with good hygiene practices in place and suitable hand washing facilities available. As required at our last inspection, the home has set up a contract with the local council to ensure that clinical waste is disposed of on a weekly basis. We saw that the local fire authority carried out an inspection of the property in October of this year. The fire safety report confirmed that the premises were satisfactory. Similarly, the home also had a satisfactory food hygiene inspection by the Environmental Health Department in June 2007. Care Homes for Adults (18-65 years) Page 24 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Peoples needs are met and they are supported because staff get the right training, supervision and support they need from their manager. Some refresher training is needed however that is specific to the assessed needs of individuals. Evidence: We looked at the staff duty rotas. Allocation allows for a minimum of five staff on each day shift with one waking staff at night and additional sleep in. The manager confirmed that people using this service are provided with one to one staff support during the day. Regular staff team meetings are held; minutes were clear and focused on peoples needs as well as the day-to-day running of the home. Six of the seven permanent staff have completed their NVQ level 2 in care and some have achieved the level 3 qualification. This exceeds the minimum requirement for which the home is commended. We checked recruitment practices on day two of our inspection. Procedures were detailed and focus on ensuring that staff are recruited correctly. Main recruitment records are held at the organisations head office. We saw three staff files; a checklist showed that each had a satisfactory CRB (Criminal Record Bureau) disclosure and POVA (Protection of Vulnerable Adults) check prior to commencing employment. Two staff responded on their surveys that such checks were completed before they started work. All other legal checks had been verified such as proof of identity, a full previous work history, two references and health declaration. The AQAA stated that only one staff had left in the last 12 months. At this inspection, the Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: manager confirmed that there were 3 vacant staff posts which included one for a part time worker. The low turnover of staff shows that people benefit from a stable staff team and consistent care. The manager had completed a training schedule to show what courses staff have done, when they did them and when they must refresh. Most of the training is provided by an external company and covers a variety of topics that are relevant to the aims of the service. We looked at training certificates for two staff. Certificates included courses on medication, food hygiene, fire safety, safeguarding vulnerable adults; moving and handling and person centred approaches. There is a culture of training in this home, not only in care but in diverse areas needed to support those who live in the home. One staff had begun a course on Italian for beginnersso that they could learn the language and improve communication with the indivual that they were keyworker to. Records showed that staff completed training on management of challenging behaviour some years ago. As the home aims to provide a service to people with autism, complex and challenging needs, arrangements must now be made for staff to update this specialist training. This will ensure that staff keep their knowledge and skills updated in line with current good practice and that they can support individuals with such specific needs in a safe way. We also suggest that the home explores other sources of training to ensure that they are accessing the most appropriate courses to meet peoples needs such as autism. The manager carries out regular supervision and yearly appraisal with staff to monitor job performance and identify any training needs. Records were up to date and thorough. We received two staff surveys; one responded that they regularly met with their manager and the other said,often. Care Homes for Adults (18-65 years) Page 26 of 32 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The manager has relevant qualifications and a good leadership approach to run the home in the best interests of the people who live there. Peoples opinions are central to how the home develops and reviews its practice and there and good arrangements in place for monitoring the quality of care provided. The environment is safe for people and staff because health and safety practices are carried out. Evidence: Mr Albert Mutasa continues to manage the home and successfully registered with us in December 2006. He has acquired the relevant NVQ4 qualification and advised that he is due to complete the NVQ Assessors award. He has also attended training periodically to keep his knowledge and skills up to date. Recent courses have included the Mental capacity Act, various mandatory updates and a workshop on accessible communication run by Southwark local authority. Discussions and observation confirmed that the manager is knowledgeable about each persons unique needs and understands the importance of person centred care. Staff gave positive views about his leadership qualities. The manager also works some shifts in the home and therefore has a hands on approach as part of the staff team. In response to our last inspection in November 2006, we saw that there have been significant improvements with the Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: homes quality assurance systems. Saffronland homes have written an annual plan which describes in good detail how the quality of the service is monitored. The home provided surveys to people who use the service, their family or representatives and other professionals who have involvement with the home in August 2008. We sampled some of these questionnaires which confirmed a high percentage of positive feedback. From their findings, the home has developed an action plan to address any issues raised. The responsible individual visits the home once a month and completes an audit of the service. Reports were detailed and showed that the owners make sure the conduct of the home is closely monitored. Records showed that most areas that need attention are acted upon in a timely manner. We do suggest however that visits are unannounced whenever possible. The home has good systems in place that aim to promote the health, safety and welfare of the people using the service, staff and visitors. In addition, there is policy guidance for staff to follow regarding a range of health and safety activities. Mandatory training is provided by the owning organisation and records showed that staff training is planned ahead so that they can update their skills and knowledge when needed. This includes training in health and safety, first aid; fire; moving and handling and infection control. Records are maintained of all accidents and incidents at the home. Fire drills are organised and fire alarms and equipment had been checked at regular intervals. Detailed risk assessments were in place concerning the premises and safe working practices. These aim to safeguard the welfare of all people living and working in the home. As required by law, the service keeps us informed of any reportable events. We looked at some of the servicing and maintenance records for the home. We identified one concern in that the electrical safety certificate for the building had expired several years ago. We therefore asked the home to put this right within a week and the manager arranged for a check on the premises to be carried out. We saw a copy of the new certificate at our follow up visit. Care Homes for Adults (18-65 years) Page 28 of 32 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 29 of 32 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 20 13 When medication is not given 28/02/2009 the reason must be recorded clearly on the administration chart. This will enhance accuracy and maximise safe practice. 2 24 23 A maintenance and redecoration programme is needed that identifies planned timescales for completion. 31/03/2009 To show how the premises are kept in a good state of repair and where any necessary and planned improvements are made to the upkeep of the building. 3 27 23 Repairs and redecoration work are completed in the first and second floor bathroom as outlined in this report. 31/03/2009 Care Homes for Adults (18-65 years) Page 30 of 32 So that people are provided with homely and accessible bathroom facilities that are in good working order. 4 35 18 All staff need to update their 03/06/2009 training on managing challenging behaviour, as it is specific to the needs of some people living in the home. This will ensure that staff have the specialist knowledge and skills to meet individual needs in a safe and competent manner. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 That there is a clear record of discussions held of house meetings. This is to form an audit trail of decision making and show how these are being followed up for people who use the service. That the home looks to secure some external training on safeguarding vulnerable adults. This is to ensure that training is updated in line with revised guidance and local authority procedures, namely Southwark. The empty boxes, unused equipment and various records in the top floor office are either removed or tidied as it was difficult for people to access the area. The home explores other sources of training to ensure that they are accessing the most appropriate courses to meet peoples needs such as autism. 2 23 3 24 4 35 Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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. 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