Inspection on 02/08/06 for 28 Medina Road

This inspection was carried out on 2nd August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

28 Medina Road 01/08/07

28 Medina Road 02/02/06

28 Medina Road 26/10/05

28 Medina Road 01/03/05

28 Medina Road 26/10/04

28 Medina Road 26/03/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Medina Road (28) 28 Medina Road Grays Essex RM17 6AQ Lead Inspector Claire Brookes - Nandara Key Unannounced Inspection 2nd August 2006 15:55 Medina Road (28) DS0000018084.V296099.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Medina Road (28) DS0000018084.V296099.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Medina Road (28) DS0000018084.V296099.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Medina Road (28) Address 28 Medina Road Grays Essex RM17 6AQ 01375 380366 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) Mosaic Essex Manager post vacant Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Medina Road (28) DS0000018084.V296099.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Personal care may be provided for up to 4 service users of either sex who are aged between 18-65 years of age. Personal care and accommodation may be provided for no more than 4 service users who have a learning disability. 2nd February 2006 Date of last inspection Brief Description of the Service: The home is situated in a quiet residential cul-de-sac in Grays. The service currently caters for four gentlemen with learning disabilities. The property is a converted bungalow and is well decorated and homely. The residents each have bedrooms that are clean, tastefully designed and suit their individual needs. The lounge area is large with comfortable seating, and has patio doors that open out on to a picturesque plot of land - which the residents themselves take great pride in maintaining as their garden. The home is walking distance from local amenities, and a short bus journey away from the main town. Medina Road (28) DS0000018084.V296099.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place during an afternoon at the beginning of August. On the inspector’s arrival to the home, there were three residents and two staff members present. The inspection included assessments of the residents’ care plans, the homes’ health and safety records, training, activities and a complete tour of the house took place. The home makes information about the service available via their Statement of Purpose and the Service User Guide. A copy of the homes’ most recent inspection report is kept in the office. The current weekly fee payable for a placement in this home is £1451.00, with the residents contributing £63.25. Some statements included in this document are similar to those recorded in previous inspection reports for this home. This is due to no changes having occurred in some outcome areas. What the service does well: 28 Medina Road works closely with the residents in order to meet their needs. Clear aims and objectives are set out in each individuals support plan, and comprehensive notes are kept to assess a person’s progress whilst working towards their goals. The residents are encouraged and fully supported by staff to be as independent as possible. As the residents cannot clearly verbally communicate, staff do their best to ensure that the residents needs are positively responded to, and always taken into account within their everyday lives. One of the homes’ main objectives has been to help the residents integrate into the local area, and to make more use of the public leisure facilities available. The staff here have championed for the residents to be accepted by people in their community, and they now feel that the quality of life that they can offer the residents has greatly improved because of this. The home is keen to respond to any areas highlighted for change in inspection reports. Since the last inspection all requirements and recommendations have been met. Medina Road (28) DS0000018084.V296099.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Medina Road (28) DS0000018084.V296099.R01.S.doc Version 5.2 Page 7 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 Medina Road (28) DS0000018084.V296099.R01.S.doc Version 5.2 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ needs and aspirations are valued, and the home assesses these in the most effective way possible. The residents are not able to clearly communicate verbally, so staff have developed close and trusting relationships with the residents in order to properly assess their needs and opinions. EVIDENCE: Support plans are colour co-ordinated with the residents’ individual care plans – to make it easy to cross reference information between the persons two files. The support plans contain the residents’ personal details, a contact list, personality profile, personal history, medical history, a list of community professionals involved in their care, a community professionals contact sheet, assessment of abilities – including bedtime routine, mobility, personal care, independence skills, aids required, spiritual & emotional needs and preferred activities. The support file also lists the likes and dislikes of the individual – including foods, drinks, social situations / interaction and temperature preferences. Individual needs are assessed and reviewed on at least a monthly basis. The home has aims and objectives designed, for the staff to support the residents’ in their everyday lives. Medina Road (28) DS0000018084.V296099.R01.S.doc Version 5.2 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 28 Medina Road takes great care in ensuring that the residents know that their assessed and changing needs are reflected in their support plan. The residents are supported to make decisions about all aspects of their lives, and comprehensive risk assessments are put in place as necessary, which maximise the residents’ independence. EVIDENCE: The residents have a series of Care Needs Assessments made, which are contained within their individual Care Plan. Each assessment consists of an aim, short and long term goal for the individual, details of support required, how staff will enable the resident to achieve their goal and a date for which the assessment should be reviewed. Reviews for each of the residents’ needs assessments happen on a monthly basis, where it can be decided whether the need has changed, been met, or whether continued support is required. Along with the Care Needs Assessments, residents are also encouraged to be as independent as possible with the support from the staff. Each day, the residents are given the opportunity to make decisions within their daily Medina Road (28) DS0000018084.V296099.R01.S.doc Version 5.2 Page 10 routines. For example, the residents are offered a series of choices, which the staff can facilitate. E.g. would they like a bath or shower when they get up in the morning? What would they prefer to eat for dinner? Pictorial aids are used to assist the residents when making their choices. The residents at this home are supported to take risks, in order for them to maintain an independent lifestyle. The home has Risk Assessments documented for each resident - for any potentially hazardous activity that they may undertake in their daily routines. Risk assessments are put in place for all aspects of the residents’ lives as appropriate. Medina Road (28) DS0000018084.V296099.R01.S.doc Version 5.2 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offers its residents’ a wide variety of activities. The residents are offered a good range of wholesome and healthy meals, and mealtimes are shared with staff, to create a warm and homely environment. EVIDENCE: The home has an activity resource kept in the office, which contains details of places of interest to visit – printed from the Internet or from leaflets and correspondence. Photos of residents on outings are included, along with information regarding wildlife parks, trips to London, fetes, boat tours, railway trips, theme parks, hotels, art galleries and farms. The residents’ each have an “Annual Diary” kept in their care plan, which lists all of the activities that the individual has participated in. Activities are arranged according to individual preference, as well as activities for the whole group and activities arranged jointly between several other local homes. Medina Road (28) DS0000018084.V296099.R01.S.doc Version 5.2 Page 12 The residents are invited to evening meals and parties with their friends at the other homes. They also attend appointments in the community with hairdressers and chiropodists, as well as visiting the local shopping centre, and other places of interest such as near by country parks and the seaside. The relatives and friends of the residents are encouraged to visit the home as often as possible. Adequate seating is provided in each individual’s room, and quiet space is made available as necessary for any guests who may visit. Staff will also facilitate family contact outside of the home on request. The care plan has a list of each individual’s “Weekly Opportunities”, which is a daily record of the residents’ every day activities inside and outside of the home. Onsite activities such as relaxing and listening to music in the lounge, or enjoying some time in the garden are also available. The residents are invited to participate in their daily routines where practicable. For example, the more independent residents are encouraged to help at snack time by carrying the empty teacups back to the kitchen. The residents’ weekly menus offer a choice of meals and meal alternatives, which are well nutritionally balanced and healthy. The inspector was present at the residents’ evening meal, and it was noted that a selection of fresh vegetables were served along with the evening’s main dish. Medina Road (28) DS0000018084.V296099.R01.S.doc Version 5.2 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 &20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ all receive good quality care, and the home always aims to meet the residents’ physical and emotional needs. The home has adequate medication policies and procedures in place. EVIDENCE: There are currently four male residents in the home, cared for by a mixed staff team. The residents are all encouraged to be as independent as possible with their personal care, and staff offer minimal intervention whilst supporting the residents’ to meet their healthcare needs. Key workers review the residents’ progress within the home on a monthly basis; a person-centred approach is used. Staff are all familiar with the homes’ medication policies and procedures, and have all received the homes’ mandatory medication training. On completion of this training, the assessor completes an Administering Medication Competency form, which is signed and kept on file. Staff also attend training for the Safe Handling of Medications and Accountability of keeping Administration Records – facilitated by Boots (the chemist). The staff within the home are trained in line Medina Road (28) DS0000018084.V296099.R01.S.doc Version 5.2 Page 14 with the Boots Monitored Dosage System (MDS). The residents’ Medication Administration Records were reviewed and no omissions were found. Each resident’s medication file contains a photo of the individual along with a clear document of PRN protocols – including the generic name for the medication, the date that it was first prescribed, the required dose, route and reason for use. Guidelines from the Royal Pharmaceutical Society of Great Britain were available for inspection. Medina Road (28) DS0000018084.V296099.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has clear guidance and advice contained within its protection and complaints policies and procedures. The home has a very useful compliments and complaints book, which is available for visitors to write their comments in. EVIDENCE: All staff have read the homes’ abuse policy and protection guidelines. The manager has had training for Protection of Vulnerable Adults, and all staff attend Adult Protection training on an annual basis. The complaints policies give clear guidance on the procedures to follow when a resident (and their representative) or a staff member wishes to make a complaint. Both the homes’ protection policy, and complaints guidelines contain details of how to contact the Commission for Social Care Inspection. No complaints have been received by the home since the last inspection. Medina Road (28) DS0000018084.V296099.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27,28 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides its residents with a comfortable and safe environment. The residents’ bedrooms are beautifully maintained, and shared areas are spacious and nicely decorated. EVIDENCE: The individual bedrooms within the home are well decorated and comfortable. The residents have been able to personalise their rooms with their own belongings. Their rooms are suitable for their individual needs and lifestyles, and promote their independence. For example, one of the residents is incontinent. The home has been able to provide him with a comfortable and pleasantly decorated room, whilst incorporating washable materials as part of the décor – which allows the room to be kept thoroughly clean and hygienic. The toilets and bathroom are clean and well maintained, and provide sufficient privacy for the individuals who use them. Shared areas are spacious, clean and well looked after, and complement the residents’ own private rooms. Medina Road (28) DS0000018084.V296099.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home offers its staff an induction and mandatory training package, along with the NVQ level 3. Of the staff training files checked, most showed the need for updates to their core training needs. EVIDENCE: The home has a comprehensive range of policies and procedures in place. All staff members sign to confirm that they have read and understood these policies, and the home is also able to offer its staff a wide range of mandatory and supplementary training courses throughout the year. The service provider (Mosaic Homes) encourages its staff to attain the NVQ Level 3 qualification in Care. At present one staff member has already achieved this qualification, whilst three others are currently studying for it. The acting Manager is on course for the NVQ level 4, and several staff will be joining the new intake in 2006. Medina Road (28) DS0000018084.V296099.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ daily lives are enriched by the benefits of such a well run home. Good methods of quality assurance are used. The monitoring of health and safety practices around the home is now satisfactory. EVIDENCE: Key workers and support staff work with the homes’ acting manager to plan the residents’ activities and appointments. These can be planned for as much as a year in advance or on a daily/ weekly / monthly basis. The home tries to make activities part of residents’ every day routines wherever possible. For example, helping to lay the table for dinner is considered to be an independence activity. Or the residents might be taken to Medina Road (28) DS0000018084.V296099.R01.S.doc Version 5.2 Page 19 the supermarket to help with the homes’ weekly grocery shopping – with a stop off at the park and a café on the way home to make a day of it. The daily routine is shaped to include the residents as much as possible. They are encouraged to take an active role in their own lives. The home does its best to ensure that the residents receive good quality care. The residents each have a twice-annual review, where their social workers and other professionals are invited to attend and share their comments. Regular house meetings are also held, where the residents and their key workers can discuss any issues and suggestions. Staff attend mandatory training to encourage safe working practices within the home. The home has a folder containing a series of risk assessments for around the house. These include; bathing of service users, COSHH, colour coded chopping boards, manual handling, gardening, visitors to the home, fire, radiator covers, window restrictors, general and service user use of the garden swing. A fire logbook kept in the office contains a list of equipment and systems around the building, which might need to be accessed in case of emergency. Fire system checks are up-to-date, with the last inspection on 22/05/06 testing the panels, call points, smoke detectors, heat detectors, alarm bells and emergency lighting. Fire drills are carried out regularly on a monthly basis; with the date, time, evacuation time and people present being recorded by that shifts designated fire officer. Fire risk assessments for the building have been undertaken, and all electrical equipment was checked on 04/04/06 and gas systems have had up-to-date safety checks carried out on 17/07/06. The homes’ water system was checked on 22/05/06, and a test for legionella was carried out. The inspector noted that the main cupboards containing cleaning substances (COSHH materials) are locked at all times in the utility room. Since the last inspection the home has implemented an acceptable system for transporting soiled linen from the sluice to the utility room. Medina Road (28) DS0000018084.V296099.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF 3THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 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 Medina Road (28) DS0000018084.V296099.R01.S.doc Version 5.2 Page 21 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Medina Road (28) DS0000018084.V296099.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Medina Road (28) DS0000018084.V296099.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!