Inspection on 19/06/08 for Brighton Road (851)

This inspection was carried out on 19th June 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Brighton Road (851) 07/01/08

Brighton Road (851) 01/08/06

Brighton Road (851) 12/07/05

Brighton Road (851) 07/12/04

Brighton Road (851) 20/05/04

Similar services:

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Delrose House Ltd

Clovelly House Residential Home Ltd

Abbey Road [53]

Cherry Tree House

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOME ADULTS 18-65 Brighton Road (851) 851 Brighton Road Purley Surrey CR8 2BL Lead Inspector Michael Williams Key Unannounced Inspection 19th June 2008 10:00 Brighton Road (851) DS0000028529.V366010.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 Brighton Road (851) DS0000028529.V366010.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. Brighton Road (851) DS0000028529.V366010.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brighton Road (851) Address 851 Brighton Road Purley Surrey CR8 2BL 020 8763 0062 NONE 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) Ms Alice Manteaw-Dankyi Iris Naa A Asiedu-Addo Care Home 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (8) of places Brighton Road (851) DS0000028529.V366010.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Mental Disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 8 7th January 2008 Date of last inspection Brief Description of the Service: 851 Brighton Road is registered with the Commission as a care home for adults 18 to 65 years of age. The registration category is for up to 8 people with past or present mental health problems. The home is situated on the Brighton Road (Purley) and is therefore on bus routes and within walking distance of shops and other local community resources. The premises comprise six single and one double bedroom (currently used as a single). The home has a lounge, dining room and several conservatories plus the usual facilities comprising kitchen, laundry, toilets, bathroom and a small office. There is limited off-street parking to the front of the home and a small, landscaped garden to the rear. Fees are from £550 to £905 per week with any additional charges by negotiation with the purchasing authority. Brighton Road (851) DS0000028529.V366010.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection included a 2 visits to the home, on 7th January and 19th June 2008. In addition to these visits, which latest approximately 6 hours, a number of questionnaires were distributed to interested parties including residents, relatives/friends, professional visitors and to staff working in the home. In compiling this inspection report the Commission also noted information we receive and this can include details of any complaints, untoward incidents and general correspondence. During the course of the inspection visit in June we met with the people who use the service; in this care home they are referred to as residents, we also met staff on site at the time. In order to cross-check information we toured premises and checked documentation, including records such as case files, staff records, fire safety records plus the money and complaints records. We also took account of the information provided in the AQAA, (the home’s annual quality assessment). What the service does well: What has improved since the last inspection? A number of requirements were made in January and these have all been addressed including staffing matters, care planning and environmental matters. Brighton Road (851) DS0000028529.V366010.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Brighton Road (851) DS0000028529.V366010.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 Brighton Road (851) DS0000028529.V366010.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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 2: People using this service experience good quality outcome in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs of people who use this service, (here they are called residents), are being appropriately assessed at or before the time of admission so residents know their needs are understood from the outset. EVIDENCE: Each resident has a case file, samples of which were examined during the inspection; we also interviewed residents and spoke to the manager about the admission process. The residents confirmed that they have contributed to the compilation of these documents and usually sign their care plans. In previous inspections the home’s manager was not clear about the legal status of some service – particularly when they had been subject to the provisions of the Mental Health Act but information is now much clearer. Staff have since had guidance during supervision are much clearer about these mental health issues. Another problem previously requiring attention was the information supplied to resident; when we visited in January 2008 there was not a contract or agreement to provide information about fees payable, how they would be paid and changes to the original agreements for example a resident that moved from one home to another (within the Alice group of homes) and nor were changes to the level of support and charges made clear to the resident in the form of revised contracts or addenda. This has now been attended and we Brighton Road (851) DS0000028529.V366010.R01.S.doc Version 5.2 Page 9 were able to check the documentation that gives this important information to each resident. As some residents wish to move into the new service being developed next door so we had the opportunity to discuss with residents what preparations had been made for this and they told us that they had been consulted as to whether or not they might move, what rehabilitation plans are in place for them and practical matters such as which bedroom might be allocated to them. Areas of strength include the collation of information prior to admission and in general the information now available to residents including contracts, the opportunity for visits and a trial stay. No further matters requiring improvement arise and this section, about choice, is assessed as good. Brighton Road (851) DS0000028529.V366010.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 6, 7 and 9: People using this service experience good quality outcome in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are used to ensure the home knows and can deliver an individual care package to each resident. EVIDENCE: This care home recognises the right of individuals to take control of their lives and to make their own decisions and choices and there is some evidence that individuals are involved in some decision making about the home, such as day to day living and social activities. In January we identified that in some areas the ability for individual residents to effect change was limited because management decisions were centralised; decisions are often made by the proprietor rather than the local, on site manager. We discussed this matter at some length and conclude that the home’s manager has sufficient control over the day to day running of the service that residents are not prevented from rehabilitation and learning skills for daily living. Each individual has a care plan. The plan includes basic information necessary to deliver the resident’s care and where before it was not detailed as to how additional, one-to-one, support was to be given and recorded was to be given Brighton Road (851) DS0000028529.V366010.R01.S.doc Version 5.2 Page 11 this is now in place and it is now much clearer what additional support is being provided to residents. Care plans are reviewed and updated as required by the Standards and the manager advised us that this was an ongoing process to keep the care plans alive and relevant for residents. For example they were reviewed in within the last four weeks by the manager. The homes procedures describe the arrangements for providing ‘Key Workers’ to support individual residents. Sufficient staff are now being employed to enable them to put into practice the plans of care and this is commended. Risk assessments are completed, these are basic and mainly focus on keeping residents safe. Where limitations are in place, there is some evidence that decisions are agreed with the individual, for example when leaving the premises with or without staff support. There is basic information available to inform individuals of their rights for example in respect of mental health ‘sections’ as they might apply, most commonly ‘after care’. The manager advised us that they have supported residents in using advocacy services of agencies such as MIND (a specialist mental health charity). The home consults with residents on their satisfaction with the service they are receiving, usually during the course of residents’ meetings which the residents have told us about. Areas of strength include the general care-planning process and consultation and discussion with residents which is now acceptable. This section, about need and choices, is assessed as good. Brighton Road (851) DS0000028529.V366010.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 11 to 17: People using this service experience good quality outcome in this area. We have made this judgement using a range of evidence, including a visit to this service. This home is becoming increasingly skilled in supporting residents and developing skills for living so they can be assured the home can provide a rehabilitation programme to meet their needs. EVIDENCE: Staff are aware of the need to support residents to develop their skills, including social, emotional, communication, and independent living skills. Residents are consulted or listened to regarding the choice of daily activity. The home is generally able to provide the facilities for some personal development but the laundry is very small indeed and inhibits staff working together with residents; the kitchen is of an adequate, domestic size in layout and equipment. As food was bought centrally (by the proprietor) the scope for personal development in catering had been somewhat limited to helping peel vegetable and washing-up plus some shopping but this does not amount to the best form preparation for independent living and taking part in ‘life in the community’ as standards 11, 13 and 16 indicate. Brighton Road (851) DS0000028529.V366010.R01.S.doc Version 5.2 Page 13 On this occasion the manager advises us that residents are not being inhibited in their progress by the proprietor’s frequent contact with the service. So for example, we noted during our visit that residents have control over their own money, can come and go as they wish or need to, they can shop as the need arises, they can visit friends and look for work or education. So it appears that a realistic rehabilitation programme is now possible in this service. Educational, and where appropriate employment opportunities are explored and encouraged, residents are supported to lead a lifestyle that enables them to become part of the local community but progress is very slow; this maybe because staffing levels are very low so that one member of staff is expected to ‘support’ residents in cooking cleaning and laundry tasks each day. With this poor staffing arrangement there is little time or scope for individualised training for each resident – not even those that pay for one-to-one support each day. So, where appropriate some residents are more involved in preparation for ‘independent living’ or ‘supported living’. We are advised that the proprietor plans to develop two residential units next to each other in Brighton Road and this one, at No. 851, will provide a higher level of skills and independence training. Greater emphasis on individual work with residents will be needed to achieve that aim – requiring a higher staff ratio not a lower one. Residents enjoy shopping in the local High Street and some have plans to take up further (adult) education. Residents told us that they keeping touch with family and friends and if residents have young children the home support residents to keeping touch where this is appropriate. Residents have commended the home for the meals and one comment summarises the general opinion of residents, “The food is excellent”. Opportunities are available for residents to be involved in food shopping, the preparation of meals and menu planning. We make on recommendation that as staffing has improved and support can now be more clearly directed to working with residents to achieve their care plan goals it is suggested that the daily notes identify which goals are being worked upon – for example personal hygiene, social skills, continence and so for; this will help identify what progress is being made when plans are reviewed. Areas of strength include the residents’ appreciation of the support given by staff, and the good meals. Whilst there is atmosphere of independence and choice in fact progress towards residents playing a full part in community life is often very slow. Improvements that have been made include improved plans of care and more staff on duty each day to support residents to be independent; to move from communal activity to individualised support and to move away from centralised purchasing to home-based shopping so residents have greater opportunity to learn life skills. This section, about lifestyle, is now assessed as good. Brighton Road (851) DS0000028529.V366010.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 18 to 20: People using this service experience good quality outcome in this area. We have made this judgement using a range of evidence, including a visit to this service. Suitable health and social care is being provided so residents can be assured their care needs can be met. EVIDENCE: Residents have access to health care services both within the home and in the local community. The residents are able to choose their GP and attend local dentists, opticians and other community services from local options available to them. Health needs are monitored and appropriate action and intervention taken, for example if a resident’s mental health deteriorates then the manager consults the appropriate mental health team. There is evidence in the Care Plan of health care treatment and intervention, and a record of general health care information. There were some gaps in information, for example the staff duty roster does not indicate when one-toone care is being provided but this is now in place. Each resident has a care plan that outlines the care required including support for personal hygiene and support to undertake daily activities. Staff encourage individuals to be independent and to take responsibility for their own personal hygiene and this was confirmed by residents who responded to our questionnaire by telling us, “You are encouraged to live Brighton Road (851) DS0000028529.V366010.R01.S.doc Version 5.2 Page 15 independently”. The views of residents are sought in the way personal care is delivered, this is reflected in the way that the care plan is drafted with reference to this specific point, and in most instances person care is delivered in a private and dignified. The home has a medication policy which is accessible to staff, medication records were on this occasion up to date for each resident and medicines received, administered and disposed of are recorded. A new medication administration chart is in use to avoid the problems (failing to sign for medication given) identified in previous inspections. There is no evidence of any residents administering their own medication safely at present and it is surprising that none of the residents is being supported to do so in a unit offering rehabilitation – some level of self-medicating might be expected even if only on a daily basis. Residents are happy with the way that staff deliver their care and respect their dignity and have commended the staff for their “considerate and compassionate support”. Areas of strength include the support given to residents to maintain their mental health and to keep in touch with the mental health team providing psychiatric support; residents are supported in maintaining their medication regime and are encouraged to lead an active life and not to linger endlessly in the lounge smoking or watching television. No matters requiring improvement arise on this occasion. This section, about personal care and health, is therefore assessed as good. Brighton Road (851) DS0000028529.V366010.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 22 and 23: People using this service experience good quality outcome in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a clear and simple procedure for dealing with complaints so residents’ are confident their concerns will be dealt with promptly and effectively but not all service have copy of the procedures as required. To ensure vulnerable residents are safeguarded from abuse the home has written policies and procedures about the protection of residents and their property; this includes procedures for passing on concerns to the relevant authorities including the local authority care management team and the Commission. EVIDENCE: There have been no changes in this area and it remains fully met as before. The record of complaints remains empty and no new complaints have been recorded for several years. However the home has taken up the suggestion of comments and concerns book which is now readily accessible to all residents and their visitors in the lounge – this too is empty. It is also noted that staff hold resident meetings from time to time, and of course staff meet with residents regularly both informally throughout the day and more formally for individual support sessions. This contact enables residents to make known their concerns without using the formalised compliant procedures. Nevertheless they must be given a written copy of the procedures as required by regulation and the manager is planning to do so by including it in a ‘welcome pack’ and the manager confirmed that this is happening. The Commission will continue to monitor the complaints procedures to ensure the home is demonstrating in a tangible way that it will listen to residents’ views without reprisal or recrimination. The residents themselves made no Brighton Road (851) DS0000028529.V366010.R01.S.doc Version 5.2 Page 17 complaints about the service, on the contrary they commended the home and staff. The manager is familiar with both the complaints and the safeguarding procedures and has confirmed her understanding that these procedures must be referred to, and followed, if allegations of abuse in any form arise. No such allegations arose during the course of this inspection. Areas of strength are the positive way in which residents are supported to make known their concerns and the procedures that are in place to safeguard residents from abuse; whilst a matter still requiring improvement is for each resident to have a written copy of the complaint procedures. Despite this shortcoming this section, about complaints and protection, remains assessed as good. Brighton Road (851) DS0000028529.V366010.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 24 and 30: People using this service experience adequate quality outcome in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a safe, well-maintained and comfortable environment. This care home is an adapted family home and therefore very homely. It is well maintained. It was clean and tidy on the day of inspection but on a very hot day some areas such as the conservatories can be a little too hot and winter a little too cool, but otherwise residents are assured they will live in a safe and comfortable setting. EVIDENCE: Communal areas are pleasantly decorated and individual rooms are reasonably spacious and comfortably furnished. No bedrooms (except the one in the annexe) have ensuite facilities but each bedroom has a wash hand basin and each has a range of suitable bedroom furniture and fittings. Some areas of damage in the kitchen, a work surface near the sink was damaged and again needs repair or replacement. We note that all the kitchen units have recently been replaced so it was unfortunate that one area was damaged with days of being installed. Some bedroom doors were being wedged open and magnetic holding devices are needed; we also note that a door closing device was faulty. Brighton Road (851) DS0000028529.V366010.R01.S.doc Version 5.2 Page 19 The Commission is confident these are matters that will be addressed by the manager or owner but a requirement is made to deal with them without further delay. The manager also needs to get the fire extinguishers checked as this is now overdue. The garden is very attractive and makes a pleasant location for residents to relax and meet visitors. The new entry-phone and camera adds to residents safety and is a welcome new feature. Areas of strength are the very comfortable surroundings in which residents live and the good standards of hygiene maintained in the home. Matters requiring improvement are need to repair or replace broken equipment in the kitchen and attend to doors that residents prefer to hold open during the day. Fire fighting equipment needs to be serviced. Since these are important hygiene and safety matters this section, about the environment, is assessed as adequate whilst noting overall this is a very well maintained care home. Brighton Road (851) DS0000028529.V366010.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 32, 34 and 35: People using this service experience good quality outcome in this area. We have made this judgement using a range of evidence, including a visit to this service. The number of staff employed and their skill mix is now appropriate to the assessed needs of the current residents in this home – so this will reassure residents that their needs can be met. EVIDENCE: Recruitment practices were found to be not safe when the home was inspected in 2005 in so far as two staff were being employed and neither the person in charge nor the proprietor could confirm that all necessary checks have been completed prior to their appointment. In 2006 this matter had been resolved and suitable recruitment procedures were put in place. From the checks we made, and judged by the statement made by the manager, no staff are being employed without suitable safety checks including the police [CRB] checks taking place before employment starts. As identified in earlier reports, the staff team is a well established and loyal team of carers; they do reflect the gender of the resident group, that is, all resident are female and so are the staff. The manager is provider regular supervision and this includes in-house training, for example in relation to mental health and medicines used in mental health. Brighton Road (851) DS0000028529.V366010.R01.S.doc Version 5.2 Page 21 As to numbers of staff on duty each day, there is no longer any nationally agreed formula for staffing numbers; it is for the registered person, having regard to the size and layout of the home, the number of residents and their needs, to demonstrate that enough staff are on duty to meet residents’ needs. In 2004 we identified that the home can provide care for up to 8 residents (in fact usually 7) including residents who are periodically removed to hospital under the provisions of the Mental Health Act and then discharged back to the home on leave. In these circumstances the CSCI requires that, unless the home can demonstrate that the safety and care needs of residents can be met, then there must be a minimum of two staff must be on duty for the safety and protection of staff and residents and to ensure the care needs of residents are fully met. The manager must also ensure that she has sufficient hours to provide supervision, training, administration and management duties in addition to any direct care she may provide. 20 Hours management time for the manager each week is advised. On this occasion we found that there are three care staff of duty in the middle of the day; so now one person comes on duty early in the day and two more arrive a little later so the whole day is adequately covered (including the oneto-one care needed for one of the residents). These staffing levels appear to be meeting the needs of the current resident group and this improvement to staffing levels is commended. This section about staffing is assessed as good. Brighton Road (851) DS0000028529.V366010.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 37, 39 and 42: People using this service experience good quality outcome in this area. We have made this judgement using a range of evidence, including a visit to this service. This is a well run home and there is little doubt that the home’s aims and objectives benefit the residents. Residents can be assured that their best interests are being safeguarded. EVIDENCE: The manager is qualified and has the necessary experience to run the Home and she is aware of and works to the basic processes set out in the National Minimum Standards. 851 Brighton Road is one of a small number of care homes owned by Mrs Dankyi. She has been advised by the commission in the past, for example in 2004 to develop are clearer managerial structure for her organisation and to that end she now employs an area manager who oversees the running of the care homes. The manager is aware of the need to keep up to date with practice and continuously develop management skills and uses here initiative to keep up to date with changes in the law - for example the new Mental Capacity Act. Brighton Road (851) DS0000028529.V366010.R01.S.doc Version 5.2 Page 23 The manager trains and develops staff who are generally competent and knowledgeable to care for the residents the service, but not all staff have had training in mental health and this is particularly important for staff who have no previous experience of mental illnesses, as was the case when we visited the service in January. The service is planned to be user focused, to take account of equality and diversity issues, and generally works in partnership with families of residents the service and professionals. A good example of this is the admission of residents who first language is not English, the home has sought out family members who can supply information about the residents. The home has a Statement of Purpose that sets out the aims and objectives of the service. The proprietor is improving and developing systems that monitor practice and compliance with the care plans, policies and procedures of the home by employing an area manager who will monitor and supervise the care homes under his authority. The manager is aware of the need to promote safeguarding and has developed a health and safety policy that generally meets health and safety requirements and legislation. Staffing levels have been outlined under the staffing section of this report and are now more realistic in being able to meet residents’ care needs and offer a greater degree of safety for both staff and residents. In addition to the minimum staffing levels the proprietor has contracted to provide one-to-one care for a specified resident and this is now being provided. Checks show that records are generally up to date. The manager has given a commitment to ensuring recruitment practices will be safe, for example by ensuring application forms are fully completed and in detail without gaps that are, or were, being overlooked by the manager. Other records such as the complaints record are in place and so was the record fire safety checks and drills. Residents case files were acceptable but would benefit by clearer subdivision. Areas of strength include improved staffing arrangements including supervision of staff; good administration as exemplified by the re-arranged office, and by the good reports coming from residents themselves. This section about management is assed as good. Brighton Road (851) DS0000028529.V366010.R01.S.doc Version 5.2 Page 24 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: Good Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES: Good Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Good Standard No Score 22 3 23 3 ENVIRONMENT Adequate Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING: Good Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME: Good Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES: Good Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT: Good Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 x Brighton Road (851) DS0000028529.V366010.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard 1 YA24 Regulation 23 Requirement Timescale for action 30/08/08 2 YA24 23 Fire safety: fire extinguishers must be maintained in good working order and regularly services so all people on the premises know fire equipment is in good working order. Fire safety: fire doors must be 30/08/08 maintained in good working order and suitable door holders fitted so residents have a choice about keeping then open in the daytime. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA24 Good Practice Recommendations Hygiene: The kitchen work surfaces should be maintained in good condition so as to reduce the likelihood of contamination and spread of infection. It is noted that the units were replaced but have again been damaged. Care Plans and daily notes: it is suggested that reference is made to care plans when compiling the daily notes and summaries so that it is clear when and how they are being acted upon. DS0000028529.V366010.R01.S.doc Version 5.2 Page 26 2 YA6 Brighton Road (851) Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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