Inspection on 06/10/08 for Care Approach Canonbie Recovery Centre

This inspection was carried out on 6th October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Care Approach Canonbie Recovery... 12/08/09

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Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

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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 29/01/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Care Approach Canonbie Recovery Centre 118 Canonbie Road Forest Hill London SE23 3AG     The quality rating for this care home is:   one star adequate 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: Peter stanley     Date: 0 6 1 0 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. the things that people have said are important to them: They reflect 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. Care Homes for Adults (18-65 years) Page 2 of 33 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI 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 33 Information about the care home Name of care home: Address: Care Approach Canonbie Recovery Centre 118 Canonbie Road Forest Hill London SE23 3AG 08452269903 08452269904 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Adenike Rachel Ogunleye Type of registration: Number of places registered: Jonathan Davids Limited care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The Registered Person may provide the following categories of service only: Care home with Personal Care - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder - Code MD The maximum number of service users who may be accommodated is: 6 Date of last inspection Brief description of the care home 6 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 33 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: one star adequate 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 peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection was conducted over one day and involved discussion with the home’s responsible individual, Mr Ade-Ounlade. The inspection also involved discussion with the acting manager, and the training and quality manager. Views were sought from staff and clients, regarding the home and the support provided. The records of clients and staff were inspected, and the records of a recent admission were casetracked. Records examined included residents’ assessments, risk assessments, care plans, medication records and review minutes. Staff records examined included staff rotas, supervision, and training records. Staff recruitment records, and criminal records checks, were checked for the staff recruited since the transfer of ownership in April 2008. Care Homes for Adults (18-65 years) Page 5 of 33 Care Homes for Adults (18-65 years) Page 6 of 33 What the care home does well: Prospective clients are being provided with all the information they require, and the opportunity to visit, and stay overnight if they wish, before deciding whether the home is likely to meet their needs. The home is able to demonstrate that the range of needs presented by clients are being properly assessed, and appropriately met. Each client is being provided with a contract that details the terms and conditions that apply to their residency at the home. Clients are having their health, personal and social care needs and goals set out in an individual plan of care, and are being involved in the care planning process. Clients are being enabled to participate in daily routines and activities, and are being supported to make decisions that affect them and their day-to-day lives in the home. Clients are being assessed regarding potential risks to their health and safety, and are enabled to take responsible risks wherever possible. Clients are being provided with a range of opportunities for leisure and social activities. Clients are being encouraged to participate in daily routines and activities, and to exercise choice and control in their day-to-day lives. develop their abilities and potential. Clients are being encouraged to maintain contact with their family and friends, and to develop their links and involvement with the local community. Clients’ rights and responsibilities are being respected and recognised in their day-today lives. There is choice and flexibility with meal arrangements. Clear information for raising complaints is made available, and clients and their relatives/friends are encouraged to raise any concerns they may have. The Home’s policies, procedures and practice indicate that clients are being protected from abuse and are living in a safe environment. Generally, clients are living in a safe, hygienic and well-maintained environment with access to appropriate communal facilities. Clients’ rooms are reasonably furnished and decorated, and suited to individual needs. The home has sufficient bathing and toilet facilities, which are generally meeting clients needs. The best interests of clients are being protected through the maintenance of appropriate staffing levels, and by clearly defined staff roles and responsibilities. Care Homes for Adults (18-65 years) Page 7 of 33 The needs of clients are being met by appropriately trained staff. Clients are being protected by the Home’s recruitment practices and procedures. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is 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 8 of 33 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 9 of 33 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective clients are being provided with all the information they require, and the opportunity to visit, and stay overnight if they wish, before deciding whether the home is likely to meet their needs. The home is able to demonstrate that the range of needs presented by clients are being properly assessed, and appropriately met. Each client is being provided with a contract that details the terms and conditions that apply to their residency at the home. Evidence: The home has a Statement of Purpose which sets out the aims, objectives and philosophy of the home, its services and facilities, and the terms and conditions that Care Homes for Adults (18-65 years) Page 10 of 33 Evidence: apply. It includes all the information detailed in Schedule 1 of the Care Homes Regulations. There is also a Service User Guide, which includes information required by Regulation 5 and the National Minimum Standards. This is given to prospective residents, the Homes residents or clients (this being the Homes preferred terminology), their relatives or friends and to care managers/ professionals. The Guide includes comprehensive information relating to the home, and the services, support and facilities provided. The details given for the Commission For Social Care Inspection are, however, out-ofdate and need to be revised, so as to provide contact details for the CSCI London Regional Contact Team, which is based at Caledonia House. A requirement applies, for all the Homes documentation to be updated so as to provide the correct and up-todate details. The Home accepts referrals following a CPA assessment (Care Programme Approach) by the CMHT (Community Mental Health Team) or relevant health care agency. Together with any other information relating to the individuals social background, their health history and their present circumstances. The Home involves the potential client in the initial assessment. This includes a trial visit and overnight stay. Visits provide the opportunity for potential clients to ask questions, view the home, and to meet clients and staff. The Home has developed its assessment processes to include comprehensive written assessment and risk assessment formats. The Home also involves the services of an advocate where required, and provides access to advocacy services where these are requested. The Home currently has six clients, one of whom has moved into the home since the present owner became the Homes registered provider in April 2008. The files of all the Homes clients were examined to check that the relevant assessment documentation was in place. The new owner, Mr Odunlade, advised that all clients have been reassessed since taking over the running of the Home. Referral information, CPAs, CPA reviews, assessments and risk assessments were evidenced, together with daily logs and keyworker summaries. All information required for the recent admission was found to be in place. The home has a contract that is agreed and signed by the client following their admission to the home. Care Homes for Adults (18-65 years) Page 11 of 33 Care Homes for Adults (18-65 years) Page 12 of 33 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Clients are having their health, personal and social care needs and goals set out in an individual plan of care, and are being involved in the care planning process. Clients are being enabled to participate in daily routines and activities, and are being supported to make decisions that affect them and their day-to-day lives in the home. Clients are being assessed regarding potential risks to their health and safety, and are enabled to take responsible risks wherever possible. Evidence: Given that the home has only been operating under its present owner since Aprill 2008, it is a little too early to make any definitive judgement as to how well these Care Homes for Adults (18-65 years) Page 13 of 33 Evidence: standards are presently being met. Progress has, however, been made, in developing the necessary processes and good practice. The home has developed care planning processes, with clients service user plans being based on information available from both CPA and the Homes assessments. These identify clients needs and choices, and risks, and provide detailed information evidencing how residents’ needs are being addressed. Inspection of service user plans indicates that these are providing the necessary information regarding clients needs, choices and risks, and that they are being formally reviewed on at least a 6 monthly basis. Keyworkers are required to review service user plans with their clients from month to month. Service plans are being agreed and signed by residents and are accessible to them at all times. Service user plans should, however, be developed so as to become more personcentred in their structure and content. CPA reviews were also evidenced on files, though one clients review was found to be 3 months overdue. This must be followed up as a priority. A requirement applies. Clients are being consulted in a variety of ways during their stay in the home. This includes service user meetings, and meetings with their key-workers. Questionnaires have also been designed for quality assurance purposes. From the evidence so far available, the indication is that residents are being encouraged to be as independent as possible in their day-to-day living and, with the support of their key workers, to be consulted and involved in making decisions relating to their daily recreation and activities. Clients are encouraged to be as independent as possible in their day-to-day living and, with the support of their key workers, to be fully involved in making decisions relating to their daily recreation and activities. We spoke with a number of clients during the inspection. This indicated that clients are generally feeling settled and well-supported living in the Home, and that they are being encouraged to pursue their interests and to develop their independent living skills. The Home has developed its links with the wider community, and is encouraging clients to access local leisure, occupational and educational resources. The inspector was advised that one client has recently been able to make the transition into supported accomodation following a period of residency at the Home. There is evidence that residents are supported to take risks in developing independent Care Homes for Adults (18-65 years) Page 14 of 33 Evidence: skills and abilities. The home aims to enable residents to take responsible risks wherever possible. Prior to their admission prospective residents are thoroughly assessed regarding potential risks relating to their day-to-day living inside and outside of the home. Inspection of clients service user plans and daily logs evidences that individuals are being encouraged and assisted to participate fully in daily routines and activities. This includes using public transport, and accessing local recreational and shopping facilities. Residents are also encouraged to look after their own monies and to collect their own benefits. Risk assessments are completed by the Home, with any specific areas of risk being identified, together with the actions required to address and minimise these. Care Homes for Adults (18-65 years) Page 15 of 33 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Clients are being provided with a range of opportunities for leisure and social activities. Clients are being encouraged to participate in daily routines and activities, and to exercise choice and control in their day-to-day lives. develop their abilities and potential. Clients are being encouraged to maintain contact with their family and friends, and to develop their links and involvement with the local community. Clients’ rights and responsibilities are being respected and recognised in their day-today lives. There is choice and flexibility with meal arrangements. Care Homes for Adults (18-65 years) Page 16 of 33 Evidence: Given that the home has only been operating under its present owner since Aprill 2008, it is a little too early to make any definitive judgement as to how well these standards are presently being met. Progress has, however, been made, in developing an appropriate range of opportunities for activities and personal development. These need to be sustained and developed further, and evidenced over a longer period of time. The ethos of the home is very much orientated towards promoting independence and maximising individual choice and opportunities. Staff at the home work with residents with the aim of increasing their motivation and confidence, and developing their independent living skills. Residents are encouraged to take responsibility for undertaking daily tasks such as tidying their rooms, and preparing drinks, food and snacks. Discussion with a number of clients during the inspection indicated that the daily routines of the home are flexible and accommodating of individual needs and preferences, and that clients feel able to exercise choice in their day to day activities. Clients are supported to develop their independence by obtaining freedom passes for public transport, and making use of local resources, and by encouraging clients to vote in local elections. Clients are able to access activities at the Speedwell Mental Health Day Centre in Deptford, with two clients currently attending. The home has a weekly activity programme, and individual activities, a copy of which was available. Clients are assisted to access community resources such as the local library, leisure centre, cinema, Horniman museum and local shops and restaurants. Each client is provided with a key to their room, and are able to receive visits from friends and relatives. The Home organises an occasional barbeque to which friends and relatives are invited. Care Homes for Adults (18-65 years) Page 17 of 33 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The personal support, health care, and emotional health needs of clients are being addressed. It is, however, too early to make a clear assessment as to how well these needs are being met Generally, clients are being protected by the home’s medication policy, procedures and training. However all staff must undertake accredited medication training for sufficient protection to be in place. Evidence: The Home has developed good links with a local GP practice, and clients are supported in attending their appointments. There are also good links with the local CMHT (community Mental Health Team), based at the Speedwell Centre in Deptford, with support being provided by a team of CPNs, care coordinators and psychiatric Care Homes for Adults (18-65 years) Page 18 of 33 Evidence: consultants. The inspection of residents’ files indicates that there is regular contact with health care professionals, and that personal support and healthcare needs are generally being addressed. The person’s mental and physical health needs are monitored in daily logs and keyworkers summaries, with individuals being reminded to receive visits and attend appointments as and when these are required. The home has a medication policy and procedures in place which, together with internal training in medication procedures, is generally protecting the Homes clients. Safe and secure storage arrangements are in place, with a separate medication cabinet for each client. A sample of medication records were inspected. These indicated that appropriate recording is taking place. The Home does, however, need to ensure that all staff receive accredited medication training so as to ensure that clients are fully protected. A requirement applies. Care Homes for Adults (18-65 years) Page 19 of 33 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clear information for raising complaints is made available, and clients and their relatives/friends are encouraged to raise any concerns they may have. The Home’s policies, procedures and practice indicate that clients are being protected from abuse and are living in a safe environment. Evidence: The Home has an appropriate Complaints Policy and Procedure in place. The contact details for CSCI do, however, need to be updated to those for the Regional Contact Team at Caledonia House. Each client is provided with a copy of the Complaints Procedure. The Home maintains a record of complaints. To date, no complaints have been recorded. The service has a policy and procedures on adult protection, which is based on statutory guidelines. This is complemented by a copy of Lewisham multi-agency POVA (Protection of Vulnerable Adults) policy and procedures. All staff are familiarised with Care Homes for Adults (18-65 years) Page 20 of 33 Evidence: these procedures, and receive POVA training from a qualified trainer. The training is based on Lewishams statutory policy and guidelines. A number of clients were present during the inspection. Views expressed indicated that clients feel safe and secure living in the Home. No concerns were expressed. No allegations of abuse have been recorded. Care Homes for Adults (18-65 years) Page 21 of 33 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. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Generally, clients are living in a safe, hygienic and well-maintained environment with access to appropriate communal facilities. Clients’ rooms are reasonably furnished and decorated, and are suited to individual needs. The home has sufficient bathing and toilet facilities, which are generally meeting clients needs. Evidence: Canonbie Recovery Unit is situated in a quiet residential road in Forest Hill, close to bus and rail connections. The Home provides accomodation for up to six clients over 3 floors of an old Victorian house.There is a communal lounge (with widescreen television), dining area, and kitchen. There is a garden at the front and rear of the property. Care Homes for Adults (18-65 years) Page 22 of 33 Evidence: Each client has their own room, with access to bathroom and toilet facilities on each floor. Each client is provided with a key to his/her room, and has lockable storage for money and valuables. The home is housed in an old, spacious building which is not ideally suited to its present use. The owner indicated that he has plans to move to another property which he feels will provide a more user friendly and modern environment. Inspection of the premises indicated that the Home is reasonably well furnished, carpeted and decorated throughout. A programme of maintenance and repair is in place, and the property presents as being reasonably well maintained. Views expressed by clients indicate that the Home is meeting individual needs and that it provides the necessary communal facilities. Laundry facilities are provided in a separate laundry room. Clients rooms presented as reasonably furnished and decorated, and are personalised with personal possessions and photographs. The Home presented as a reasonably safe environment. Cleaning agents and chemicals are securely stored, and a Health and Safety policy is in place. The home presents as being clean, hygienic and free from any offensive odours. Staff receive training in food hygiene, and health and safety. Care Homes for Adults (18-65 years) Page 23 of 33 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The best interests of clients are being protected through the maintenance of appropriate staffing levels, and by clearly defined staff roles and responsibilities. The needs of clients are being met by appropriately trained staff. Clients are being protected by the Home’s recruitment practices and procedures. Evidence: All staff are being provided with a job description, and have clearly defined roles and responsibilities. The Home has a staff handbook which details a number of key policies including the grievance and disciplinary procedures. The staff rota was examined. This indicated that the home is maintaining appropriate staffing levels, with 2 staff on during the day and 2 sleep-in staff on call at night. There was an appropriate number of staff on duty at the time of inspection. Care Homes for Adults (18-65 years) Page 24 of 33 Evidence: There is a keyworker system in the home, with each client being allocated their own keyworker. There are regular staff meetings which are attended by the acting manager and training manager, together with supervision sessions for all staff. Inspection of staff files indicates that supervision is being held with staff on a 6 to 8 weekly basis. Care Approach has a qualified training and quality assurance manager, who organises the induction programme for new support staff. This includes an initial 3 days mandatory training and a Skills For Care learning pack which is completed over the first six months of employment. There is an ongoing training programme for staff which includes training in mental health, challenging behaviour, POVA, medication, First Aid and Food Hygiene. Training for each staff member is monitored, and recorded, and contributes to the appraisal process. Staff are encouraged to study for NVQ qualifications, 8 staff currently possessing NVQ Level 2 or above and 5 staff working towards this qualification. The Home also accesses training from external training providers, and utilises a number of training resources and materials to enhance staff learning. Views were elicited from a support worker, who has worked in the Home for about 18 months, 6 of which have been under the new owner. This indicated that the support worker felt she had been well supported in carrying out her duties and that her training and development needs were being met. Recruitment checks were completed on the files of 5 support staff, together with those files for the acting manager and training manager. These indicated that all the necessary recruitment checks had been completed and that all staff had two references and up-to-date CRB checks. Evidence of relevant qualifications and training were also present on individual staff files. The Home has plans to involve clients more fully in the recruitment process (i.e in interviewing) and to develop a more in-depth induction and foundation training which meets with Skills For Care specification. Care Homes for Adults (18-65 years) Page 25 of 33 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. While clients are living in a home that is being generally well managed, it needs to be demonstrated over the longer term that it is being run in their best interests. The home needs to demonstrate, through the development of its quality assurance processes, that it is obtaining feedback from clients, relatives, friends and professionals, regarding the extent to which the home is meeting its aims and objectives. Clients’ rights and best interests are being safeguarded by the home’s record-keeping policies and procedures. While, generally, the health, safety and welfare of residents and staff are being appropriately protected, there are two health and safety concerns which need to be addressed. Care Homes for Adults (18-65 years) Page 26 of 33 Evidence: The home has been managed for a period of six months since the change of ownership to Jonathan Davids Ltd. Whilst there is evidence to indicate that the home is being wll managed, it is to early to make any definitive assessment in this regard. The day-to-day management of the Home is presently the responsibility of the responsible individual for Care Approach, Mr Ade-Odunlade, together with an acting manager, Ms Adeola Fapohunda. Ms Fapohunda has replaced the recently departed registered manager, and has been registered as the manager for another Care Approach home (The Hope Unit) which is not currently operating. Should Ms Fapohunda apply to become the Homes registered manager, she will need to be deregistered as manager of the Hope Unit. Ms Fapohunda has an RMN nursing qualification, a degree in social policy and an MA in resource management. She has had over two years experience of working in a care home for adults with mental health problems. It was confirmed that Ms Fapohunda is to study for an NVQ Level 4 in management and that she will be applying to become the Homes registered manager. The provider organisation (Care Approach) employs a manager with responsibility for Quality Assurance and training. Quality assurance processes are in the process of being developed. There is, however a need for user surveys for clients, relatives/friends and professionals to be completed. These need to evidence the extent to which the aims and objectives of the Home (as stated in the Statement of Purpose) are being met, and identify those areas where improvements need to be made. The providing organisation (Care Approach) has developed a range of polcies and procedures for the Home. These will need to be reviewed and updated on an annual basis. All records are being kept securely, with confidentiality being respected. From the evidence of this inspection, clients’ and staff records are generally being well maintained. The Home has policies and procedures in place for Health and Safety, Fire Safety, Food safety and nutrition, Infection Control, and COSSH (the Control of Substances Hazardous to Health). Inspection of health ans safety records indicated that the home is complying with health and safety requirements, and that there is up-to-date certification in place. Care Homes for Adults (18-65 years) Page 27 of 33 Evidence: The Home has completed both a Health and Safety, and a Fire Risk assessment. Fire alarms are being tested weekly, and were recently inspected on 6/10/08. Regular checks are being maintained on water temperature in the Home, and for fridge/freezers. There were two health and safety issues identified on the inspection, for which requirements apply. The responsible individual, Mr Odunlade, advised that fire drills are being held on a two-weekly basis. There was not, however, any record to evidence these. The Home was not able to provide certification of an inspection for legionella, of its water supply. Care Homes for Adults (18-65 years) Page 28 of 33 Are there any outstanding requirements from the last inspection? Yes £ No R 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 33 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 Requirement 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 Requirement Timescale for action 1 1 5 The details for the CSCI 31/12/2008 must be revised on the Statement of Purpose, Service User Guide, Complaints Procedure, and all key documentation, so as to provide up-to-date contact details for the CSCI. These should be: CSCI Regional Contact Team, 4th Floor Caledonia House, 223 Pentonville Road, London N1 9NG. Tel: 0207 239 0330 So as to provide users with the correct and up-to-date CSCI contact details. 2 6 15 A CPA review must be arranged for one client whose last review was in July 2007 and is overdue. So as to ensure that the clients mental health and support needs are being met. 31/12/2008 Care Homes for Adults (18-65 years) Page 30 of 33 3 20 13 For clients to be sufficiently protected from medication errors, all staff must undertake accredited medication training. For clients to be sufficiently protected from medication errors. 31/01/2009 4 37 9 The home must apply to CSCI to complete the registration of the new manager. To asssure users, and other stakeholders, that the Home is being managed by a person who has proved their fitness to manage. 31/03/2009 5 42 13 In the interests of safety, the Home must provide certification of an inspection for legionella, of its water supply. To protect clients and staff from any infection from the watwer supply. 31/12/2008 6 42 13 So as to evidence that clients and staff are being protected from the risk of fire, the Homes responsible individual must ensure that a record of all the Homes fire drills is maintained. To evidence that the safety of clients and staff is being protected. 31/10/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards Care Homes for Adults (18-65 years) Page 31 of 33 and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 39 The Home needs to develop its quality assurance processes so as to evidence, through user surveys and other feedback, the extent to which it is meeting its aims and objectives. Care Homes for Adults (18-65 years) Page 32 of 33 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). 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