CARE HOME ADULTS 18-65
Medina Road (28) 28 Medina Road Grays Essex RM17 6AQ Lead Inspector
Claire Brookes - Nandara Unannounced Inspection 26th October 2005 12:40 Medina Road (28) DS0000018084.V261704.R01.S.doc Version 5.0 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.V261704.R01.S.doc Version 5.0 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.V261704.R01.S.doc Version 5.0 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.V261704.R01.S.doc Version 5.0 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. 1st March 2005 Date of last inspection Brief Description of the Service: The home is situated in a quiet residential cul-de-sac in Grays. The building is well decorated and homely. The lounge is large with plenty of comfortable seating for the residents, and has patio doors that open out on to an extensive 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.V261704.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. On the inspector’s arrival at the home, there were four residents and three staff members present. The inspection included time spent talking to staff, and a complete tour of the house and garden took place. What the service does well: What has improved since the last inspection?
On the day of the inspection, the home was in the process of being redecorated. The stairs and hallway were being painted, and the home is currently working on modernising the huge fireplace in the lounge. Medina Road (28) DS0000018084.V261704.R01.S.doc Version 5.0 Page 6 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.V261704.R01.S.doc Version 5.0 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.V261704.R01.S.doc Version 5.0 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 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: The support plans list the residents’ individual difficulties and needs. These 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. Resident likes and dislikes are documented in detail. The individual support plans also document the residents’ progress towards achieving their goals, and any positive changes that occur in their lives as a result. Medina Road (28) DS0000018084.V261704.R01.S.doc Version 5.0 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 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. However, the residents’ care and support plans are not being kept tidy and in good condition. The files are poorly maintained and not orderly. EVIDENCE: The residents have a series of Care Needs Assessments made, which are contained within their individual Support 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
Medina Road (28) DS0000018084.V261704.R01.S.doc Version 5.0 Page 10 as independent as possible with the support from the staff. Each day, the residents are given the opportunity to make decisions within their daily 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. The residents’ paperwork is contained within lever arch files. inspected were untidy and in need of reorganising. The files Medina Road (28) DS0000018084.V261704.R01.S.doc Version 5.0 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. 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 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. 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
Medina Road (28) DS0000018084.V261704.R01.S.doc Version 5.0 Page 12 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. Food intake is currently recorded on menu sheets, but is too brief, and lacks sufficient details of what the residents are consuming at each mealtime. Medina Road (28) DS0000018084.V261704.R01.S.doc Version 5.0 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 The residents’ all receive good quality care, and the home always aims to meet the residents’ physical and emotional needs. 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. Medina Road (28) DS0000018084.V261704.R01.S.doc Version 5.0 Page 14 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): These standards were not inspected on this occasion. EVIDENCE: Medina Road (28) DS0000018084.V261704.R01.S.doc Version 5.0 Page 15 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 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.V261704.R01.S.doc Version 5.0 Page 16 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): 34 & 35 The home offers its staff a comprehensive training package and operates efficient recruitment practices. EVIDENCE: The home has a comprehensive range of policies and procedures in place, which are updated on an annual basis. All staff members sign to confirm that they have read and understood these policies, and the home also offers its staff a wide range of mandatory and supplementary training courses throughout the year. Medina Road (28) DS0000018084.V261704.R01.S.doc Version 5.0 Page 17 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): These standards were not inspected on this occasion. EVIDENCE: Medina Road (28) DS0000018084.V261704.R01.S.doc Version 5.0 Page 18 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 3 3 3 X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Medina Road (28) Score 3 3 X x Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000018084.V261704.R01.S.doc Version 5.0 Page 19 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. 1 2 Refer to Standard YA 17 YA 6 Good Practice Recommendations It is recommended that the home find a better means of recording the residents’ nutritional intake, which allows more details to be clearly recorded. It is recommended that the home keep its residents’ paperwork tidy and orderly. Medina Road (28) DS0000018084.V261704.R01.S.doc Version 5.0 Page 20 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
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