Inspection on 30/05/06 for Chiswick Care Ltd

This inspection was carried out on 30th May 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chiswick Care Ltd 04/09/07

Chiswick Care Ltd 21/02/06

Chiswick Care Ltd 06/09/05

Chiswick Care Ltd 12/10/04

Chiswick Care Ltd 13/04/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Chiswick Care Ltd 11-13 Chiswick Road London N9 7AN Lead Inspector Jane Ray Key Unannounced Inspection 30th May 2006 08:30 Chiswick Care Ltd DS0000010618.V290046.R01.S.doc Version 5.1 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 Chiswick Care Ltd DS0000010618.V290046.R01.S.doc Version 5.1 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. Chiswick Care Ltd DS0000010618.V290046.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Chiswick Care Ltd Address 11-13 Chiswick Road London N9 7AN 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) 020 8803 8002 020 8887 6664 Mr Bhooneswur Krite Luchmun Mrs Reeta Luchman Reeta Luchmun Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Chiswick Care Ltd DS0000010618.V290046.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One specified service user who is over 65 years of age may remain accommodated in the home. This condition will remain until such time as the home can no longer meet his needs. 21st February 2006 Date of last inspection Brief Description of the Service: 11-13 Chiswick Road, London, N9 7AN is a care home owned and run by Chiswick Care Limited. The home is located in a residential area of North London with community resources and facilities within close proximity. Mrs Reeta Luchman is the registered manager of the home. The home has two bathrooms, a kitchen, a lounge and a large paved garden at the back of the building. Chiswick Care provides support and supervision for six adults with a learning disability and associated mental health problems. Each service user has a single bedroom. The home has obtained a variation to its registration with respect to one service user over 65 years of age. Service users are supported to access community-based facilities such as libraries, swimming pools, cinemas and shops. There is a range of leisure activities provided at the home. A vehicle has been recently purchased to facilitate activities and trips further a field for the service users. In addition to support during the day, the home has one member of staff who is awake at night to respond to the needs of the service users at night. At the time of the inspection there were five men living in the service. The current range of fees in the home is from £725 - £1400 a week. The provider must make information available about the service, including inspection reports, to service users and other stakeholders. Chiswick Care Ltd DS0000010618.V290046.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 30 May and was unannounced. The inspection lasted for the five hours and was the main annual inspection. The inspection looked at how the home was performing in terms of the key National Minimum Standards for Younger Adults and the associated regulations. The inspector was able to meet, speak to and observe the support given to the current five service users. The inspector was also able to spend time talking to the manager and a member of care staff who were working in the home. The inspector did a tour of the premises and also looked at a range of records including service users records, staff files and health and safety documentation. What the service does well: The home provides a high standard of care and support to a group of service users with a range of complex needs. The home by working consistently and professionally with the service users in partnership with other care professionals is able to support the service users to make significant progress with their personal development. The manager and staff demonstrated a good knowledge of the service users and were able to recognise their individual needs and how to respond appropriately to them. The service users are supported to develop their independent living skills in the home based on their individual needs. The service users are supported to access a range of educational and leisure activities based on their individual interests and this enables them to have participation in the local community. The manager and staff show a high level of enthusiasm and commitment to their work in the home. The home is very clean, comfortable and homely and the service users each have an attractive single bedroom. The home also has a people carrier vehicle that is helpful in facilitating some of the community activities. Chiswick Care Ltd DS0000010618.V290046.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: The service has two outstanding requirements from the previous inspection one of which is an immediate requirement at this inspection. Unmet requirements impact on the welfare and safety of the service users. Failure to comply with the timescales will lead to the Commission for Social Care Inspection to consider enforcement action to secure compliance. The outstanding requirements relate to the staff not all having a copy of their contract giving their terms and conditions in their staff file and a member of staff still not having two written references. In addition one service user did not have a record in his care plan explaining how he is supported to manage his personal finances. In addition there are ten new requirements from this inspection. Other areas for improvement identified at this inspection include ensuring all the service users have completed contracts with the home, enabling the service users to have regular meetings to give their views on the operation of the home and supporting the service users to have clear individual goals as part of the care planning process that are regularly reviewed and evaluated. The staffing improvements that need to take place include completing the recruitment of staff to fill vacancies on the staff teamand ensuring an up to date training record is kept for all the staff including confirmation of induction and ongoing training. Staff must also have certificates to confirm this training has taken place. The staff also need to receive training on working positively with people who have complex behaviours. The staff need support to receive regular supervision. Chiswick Care Ltd DS0000010618.V290046.R01.S.doc Version 5.1 Page 7 The home also needs to ensure a portable electrical appliance annual check has taken place. 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. Chiswick Care Ltd DS0000010618.V290046.R01.S.doc Version 5.1 Page 8 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 Chiswick Care Ltd DS0000010618.V290046.R01.S.doc Version 5.1 Page 9 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): 2,4 and 5 Quality in this outcome area is adequate. This judgement has been made from evidence gathered during the visit to this service. Service users can be assured that they will be assessed prior to their admission and will be enabled to visit the home as part of the admission process. Contracts between the home and the service users need to be completed fully. EVIDENCE: There have been no new admissions to the home since the previous inspection. The case notes were inspected for the service user who moved most recently to the home. This included assessment information from a care professional and the manager had also been to assess the service user. The manager explained that this service user had moved to the home as an emergency and as a result had not visited the home as part of this process. She did however explain that under normal circumstances the service user would be able to make visits as part of the introductory process to the home. The inspector looked at the case notes for four service users. These all contained a contract between the home and the service user. One of these had not been completed to include the fees. The contract documents need to all be completed in full. Chiswick Care Ltd DS0000010618.V290046.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8 and 9 Quality in this outcome area is adequate. This judgement has been made from evidence gathered during the visit to this service. Service users are each supported to have individual care plans and risk assessments. There is however a lack of clarity on what goals they are working towards and the progress they are making. Service users are supported to make decisions about their daily lives but service user meetings need to take place more regularly to enhance this participation. EVIDENCE: Four service user case notes were inspected. Each service user has an individual “health action plan”. This document is a summary of each persons health, social and emotional needs and how they need to be supported in each area of their lives and what they are hoping to achieve. Three out of four of these documents had not been reviewed or evaluated in the last six months. The manager also explained that each service user is supported with a monthly key worker session to look at how this person is progressing. These documents were very useful but it was not possible to tell what individual goals each person was being supported to achieve and therefore what progress they are making. Each service user needs to be supported to identify what individual Chiswick Care Ltd DS0000010618.V290046.R01.S.doc Version 5.1 Page 11 goals they want to meet and then progress with meeting these goals needs to be regularly evaluated. These goals need to link to action agreed at their care plan review meeting. The four service users all had a named key worker and one service user when asked knew the name of his key worker. A member of staff was asked about her role as a key worker and was able to describe her responsibilities. The four service users all have complex behaviours. Each service user has a document describing these behaviours and enables the staff to identify when the service user is distressed and what action they should take in response to this situation. The incidents of challenging behaviours are recorded separately so any issues can be identified. Some of the service users have restrictions in place, for example one service user keeps his cigarettes in the office and some service users need to place their money in the office for safe keeping. The reasons for these restrictions are recorded in their health action plan and behavioural guidelines. At the last inspection there was a requirement that each service user to have a record of the individual arrangements in place to support them to manage their personal finances. Four service user case notes were inspected at this inspection and three had a record of how this support is provided. One service user did not have a record but the manager explained that the arrangements with the parents had just changed. The requirement to record this arrangement is amended and restated at this inspection. The four service user case notes inspected all included a comprehensive individual risk assessment covering all areas of potential risk and this identified what action the home would take in response to the identified risks. Throughout the inspection the service uses were observed being consulted about decisions concerning their daily lives. This included being asked what they wanted for breakfast and what activities they wanted to do. One service user was able to tell the inspector about the meetings that take place and how they discuss food and holidays. The record of the meetings was inspected. These took place in January and May 2006 and would benefit from happening more regularly. Chiswick Care Ltd DS0000010618.V290046.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16 and 17 Quality in this outcome area is excellent. This judgement has been made from evidence gathered during the visit to this service. The service users are supported to have full and active lifestyles. They also enjoy contact with their relatives and friends. The service users are offered a wholesome and culturally appropriate diet. EVIDENCE: The service users and manager explained that they access a range of activities based on individual needs and interests. One service user attends a day service five days a week. Three service users enjoy going to college one day a week for cookery and gardening. Three go weekly to a drop in leisure centre. Some enjoy going to two evening clubs for people with a learning disability. In addition the daily records show that they enjoy lots of leisure activities including meals out, shopping, cinema and wildlife parks etc. They explained that they will bee looking at holidays later in the year but the service users have said they would like to go abroad. Chiswick Care Ltd DS0000010618.V290046.R01.S.doc Version 5.1 Page 13 The service users were observed helping with domestic activities such as tidying their bedroom and clearing up after breakfast. There is a rota for the service users so they know what assistance they need to give. One service user confirmed the rota is followed and that he enjoys doing the washing up. The manager explained that all the service users have contact with their families and friends. They are made welcome in the home or service users are supported to go to their family homes. One service user told the inspector about his friends and how they visit him in the home. During the inspection the inspector could observe that routines in the home are very flexible. One service user explained how he likes to stay up later at night and watch films on his TV. Another service user was observed getting up later and having a more leisurely breakfast. One service user was observed using the key to his bedroom and another service user said he did not want to lock his bedroom and explained that staff never enter his bedroom without his permission. It was observed that there was a friendly atmosphere in the home with the staff chatting to the service users and the service users also supporting each other. One service user commented on how well everyone gets on with each other. The menu for the week was inspected and this offered a healthy and varied diet. The manager explained that two of the service users are not offered food, containing pork for religious reasons. Three of the service users told the inspector how much they enjoyed their food and said that the staff were all good cooks. Two said how they also help with the food preparation. Chiswick Care Ltd DS0000010618.V290046.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is excellent. This judgement has been made from evidence gathered during the visit to this service. Service users are supported to receive personal care according to their individual needs and wishes. Service users are supported to access healthcare services based on their requirements. Service users have their safety maintained by appropriate medication administration procedures. EVIDENCE: It was observed during the inspection that the service users were given support with their personal care based on their individual needs. Some just need prompting whilst others need individual support. The service users were all very well dressed and groomed. Two service users were able to tell the inspector how they use the local barber for their haircuts. The healthcare records were inspected for four service users. They had all been supported to access the GP, dentist, optician and chiropodist for their primary healthcare checks. They all see the consultant psychiatrist on a regular basis. In addition service users attend outpatient appointments for their specialist healthcare needs and it is also positive to note that a number of other therapy services including psychology have been accessed as required for specialist advice. Chiswick Care Ltd DS0000010618.V290046.R01.S.doc Version 5.1 Page 15 The medication systems in the home were inspected. The home uses the Boots blister pack system. The medication was appropriately stored and the temperature of the medication cupboard was recorded daily. The medication administration records were completed correctly. The medication entering the home is recorded appropriately on the medication administration record. Two service users have PRN medication and there are guidelines in place for both of them explaining when the medication should be administered. Long-standing staff have received medication training and certificates were seen in three staff files. The manager explained that more recently employed staff are undertaking a distance learning medication training course and that test results have been submitted. Chiswick Care Ltd DS0000010618.V290046.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is adequate. This judgement has been made from evidence gathered during the visit to this service. Service users are confident that they know how to complain and their views will be acted on. Staff have access to adult protection policies and training to enable the service users to be safeguarded. Staff do however need to receive training on how to work with service users who have complex behaviours so that the service users can be assured that they will be appropriately supported at all times. EVIDENCE: The manager explained that the home has not received any complaints since the previous inspection. One service user told the inspector that he would speak to the manager if he had any concerns and that he has the telephone number to ring if he is still not happy. The complaints policy is displayed for the service users to access as required. The manager and staff member on duty explained that the staff had all had adult protection training but they are waiting for the certificates to be delivered. The adult protection policy was inspected. This has now been summarized for staff to follow if there is an allegation of abuse. This explains who would need to be contacted and the role of social services. The inspector looked at the personal finances for two service users. They each have a bank account and their DLA is paid directly into this account. Their appointee pays their personal allowance into their cash balance held in the home. The records are clear and where expenditure has occurred this is recorded and where possible receipts are obtained. Chiswick Care Ltd DS0000010618.V290046.R01.S.doc Version 5.1 Page 17 The manager explained that the staff have not received training on working with service users who have complex needs. This training needs to be put into place as the staff are supporting service users who have complex behaviours and need to ensure this is delivered consistently. Chiswick Care Ltd DS0000010618.V290046.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is excellent. This judgement has been made from evidence gathered during the visit to this service. The service users live in a homely, comfortable and safe environment that is clean and well maintained. EVIDENCE: The inspector did a tour of the home and looked at all the bedrooms with the exception of one room where the service user was out and the room was locked. The home was clean and tidy throughout. Each service users bedroom was well furnished and was homely and personalized. The communal space consists of a large lounge and dining area and a separate kitchen. These were also well furnished and comfortable. There are adequate bathing facilities with a bathroom on each floor. The home has a laundry on the first floor. All the equipment in the home was observed to be in good working order. Chiswick Care Ltd DS0000010618.V290046.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 and 36 Quality in this outcome area is poor. This judgement has been made from evidence gathered during the visit to this service. Staff turnover has meant that there are staff vacancies to fill and existing staff are working long hours. Some staff still need two written references even though this was required at previous inspections. Records of staff training must be in place to ensure that training needs are identified. EVIDENCE: At the time of the inspection there were eight care staff employed in the home. During the day there are between two and three staff working depending on the activities taking place. This time is divided into an early and late shift from 8am to 10pm. At night there is one waking member of staff on duty. The rota was inspected. This document was clear but showed that staff are working long hours in order to cover for two staff vacancies. The manager explained that staff have been recruited but she is waiting for the recruitment checks to be completed. Staff records were inspected for five members of staff. This included two staff who had started working in the previous year and three staff who had been in post for over a year. All the staff had application forms, ID and visas where needed and CRB disclosures. One member of staff who had been in post for over a year still had no references despite the fact that this had been required Chiswick Care Ltd DS0000010618.V290046.R01.S.doc Version 5.1 Page 20 at previous inspections. Four of the five staff had no record of a contract in their staff files even though this had also been required at previous inspections. These are now an immediate requirement at this inspection. Staff team meetings have been taking place every two months. The records of these meetings were inspected and show a range of issues relating to the operation of the home and the care of the services users are discussed. The manager explained that four of the eight care staff have completed their NVQ level 2 in care and two staff are studying for their NVQ level 2 or 3. The certificates for this training were not all available and a copy must be placed in the staff training records to provide evidence that this training has taken place. The manager explained that all the staff have completed a comprehensive induction training booklet. These have been sent to the trainer to be marked. The inspector looked at a blank booklet and could see that the training was in line with the TOPPS guidelines. The manager needs to obtain written confirmation that this training is complete to place in the staff training records. The training records for five staff were inspected. The home does not have a training grid showing which staff have received each training and when. There are also training certificates that have not arrived and so again there was not adequate evidence to confirm which training had been completed by each member of staff. The supervision records were inspected for the five staff. The manager is supervising all the staff. The staff had received good quality individual supervision but this had been happening three monthly rather than every two months. Supervision needs to happen on a regular basis. Chiswick Care Ltd DS0000010618.V290046.R01.S.doc Version 5.1 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is good. This judgement has been made from evidence gathered during the visit to this service. The service users are benefiting from living in a well managed service where the focus is on providing a high standard of care and support. Health and safety measures to protect the service users are mainly in place although certificates to confirm staff have received the necessary health and safety training are not all available to provide evidence that this training is complete. EVIDENCE: The home has a registered manager who in conjunction with her husband is also the owner of the home. The manager has the appropriate skills and experience and has also completed the NVQ level 4 in management of care. Since the last inspection the home has completed another quality assurance exercise. This has included asking service users, relatives, care professionals and other stakeholders who know the home to complete questionnaires asking Chiswick Care Ltd DS0000010618.V290046.R01.S.doc Version 5.1 Page 22 for feedback on the service. The results of these questionnaires have been collated but there was no significant action identified from the responses. The home has appropriately reported any serious incidents concerning the service users to the CSCI. Accident and incident reports are also recorded in the home and placed in the service user records. Fire safety measures are in place. The fire safety records were inspected and weekly fire alarm checks and monthly fire drills are recorded. On the day of the inspection the fire doors in the home were closed. The fire alarm and extinguishers had received their service and records were available to confirm this had taken place. The home has a fire safety risk assessment as part of their general work place health and safety risk assessment. The certificates were in place to confirm the gas system and electrical installations had been serviced. The certificate to confirm the portable electrical appliances had been serviced was not available. The current insurance certificate was displayed and was satisfactory. The manager explained that staff had received appropriate health and safety training including fire safety, first aid, moving and handling, infection control and food hygiene. This needs to be confirmed by the provision of the necessary certificates in each staff members training record. Chiswick Care Ltd DS0000010618.V290046.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 4 STAFFING Standard No Score 31 x 32 3 33 2 34 1 35 1 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 1 2 3 x LIFESTYLES Standard No Score 11 3 12 4 13 4 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 x 3 x 3 x x 2 x Chiswick Care Ltd DS0000010618.V290046.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? YES 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. 1. Standard YA5 Regulation 5(1)(c) Requirement The registered person must ensure that the contracts between the home and the service user are fully completed and include details such as the fee. The registered person must ensure that each service user is supported to identify key goals and that progress with meeting these goals is regularly reviewed. The registered person must ensure that the financial arrangements, support and tuition provided by staff to one service user is documented in his care plan. This requirement is amended and restated from the last three inspections. Timescale was 10/04/06. The registered person must ensure that the service users are supported to have regular service user meetings so they can express their views on the operation of the home. The registered person must ensure that all the staff have DS0000010618.V290046.R01.S.doc Timescale for action 30/06/06 2. YA6 15(1)(2) 31/07/06 3. YA7 17(1)(a) 30/06/06 4. YA8 12(2) 30/06/06 5. YA23 12(1) 31/07/06 Chiswick Care Ltd Version 5.1 Page 25 6. 7. YA33 YA34 18(1) 7,9,19 8. YA35 18(1)(c) 9. YA35 18(1)(c) 10. 11. YA36 YA42 18(2) 18(2) 13(4) 12. YA42 13(4) received training on working positively with people who have complex behaviours. The registered person must ensure that the staff vacancies at the home are filled. The registered person must ensure that four staff files contain the following documents: Terms and conditions of employment and written character references for one staff member who has been employed for more that eight years. This requirement is amended and restated from the last three inspections. Timescale was 01/04/06. This is an immediate requirement at this inspection. The registered person must ensure that all the staff have confirmation in their staff records that they have completed their induction. The registered person must ensure there is a training matrix record in place showing for each member of staff when they received training. Certificates must also be available and placed in the staff records for training on health and safety, abuse, NVQ and medication. The registered person must ensure that all the staff have regular supervision. The registered person must ensure that all the staff have received health and safety training including first aid, food hygiene, moving and handling, fire safety and infection control. The registered person must ensure the portable electrical DS0000010618.V290046.R01.S.doc 31/07/06 30/06/06 30/06/06 30/06/06 30/06/06 15/07/06 30/06/06 Chiswick Care Ltd Version 5.1 Page 26 appliances have been serviced and that a copy of the maintenance certificate is available. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Chiswick Care Ltd DS0000010618.V290046.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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