Inspection on 08/05/08 for Christ The King

This inspection was carried out on 8th May 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Christ The King 02/11/07

Christ The King 15/11/06

Christ The King 05/12/05

Christ The King 10/08/05

Similar services:

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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 Christ The King 68 Tankerville Road Streatham London SW16 5LP Lead Inspector Lynne Field Key Unannounced Inspection 8th May 2008 09:30 Christ The King DS0000055922.V361437.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 Christ The King DS0000055922.V361437.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. Christ The King DS0000055922.V361437.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Christ The King Address 68 Tankerville Road Streatham London SW16 5LP 020 8480 5028 020 8480 5031 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) The Healthcare Professionals Services Ltd Vacant post Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Christ The King DS0000055922.V361437.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 with nursing - Code N 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: 6 2nd November 2007 Date of last inspection Brief Description of the Service: Christ the King is a small residential care home that aims to provide 24-hour care and support in an independent living setting in the community. It can take up to six residents, men or women aged 18 -65, who are experiencing mental health difficulties and need continual rehabilitation in the community following their discharge from hospitals or from other care institutions. There are six single bedrooms, four with en suite facilities. The registered provider said the current fees payable for each resident range from £750-00 to £1200-00 according to the assessment of needs of the resident. Christ The King DS0000055922.V361437.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 stars. This means the people who use this service experience good quality outcomes. This key inspection took place on 8th May 2008 and facilitated by the new manager who started to work in the home in February 2008. She has applied to be the registered manager and is a trained registered mental health nurse R.M.A., N.V.Q. The manager has a teaching & assessor D32 D14 qualification as well as having past experience in managing a rehabilitation unit and has experience and knowledge having worked in the various fields of Nursing and various aspects of Mental Health Nursing. There were six residents living at the home. We spoke to all six residents and three staff during the inspection. Residents said they liked living at the home and had settled into the community well. ”. One resident said, ”This is a very good place” and “very nice food”. Another said, “The running of the home is OK. With the new manager trying to uplift the place”. The manager returned a standard form, the Annual Quality Assurance Assessment (AQAA), to CSCI. This was taken into consideration. The inspection also involved the case tracking of two residents care, the assessment of a range of the home’s records, procedures and forms as well as observation and a tour of the premises. During the inspection we discussed POVA training with the manager. Since the inspection she has contacted me to say she has booked a days in house training for all the staff and residents on the 23/05/08 that will cover POVA, Safeguarding and Protection of Vulnerable Adults from the prospective of both residents and staff. What the service does well: Commitment continues to be displayed by the registered provider. The manager and staff team are working hard to develop the service to ensure they are meeting the needs of the residents and complying with the standards. All residents are admitted with a full assessment of care needs and only admitted if the home feels they are able to meet the residents’ needs. Emphasis is placed on the standard of care given to residents to improve the quality of the resident’s lives by encouraging residents to develop their skills to reach their full potential rather than being looked after by staff. Staff are being encouraged to develop their skills to provide a holistic and individual approach to the care and needs of each resident. Residents continue to be Christ The King DS0000055922.V361437.R01.S.doc Version 5.2 Page 6 encouraged to become more independent, both in the home and the community with staff support. Home provides a homely environment with adequate communal and individual space. It is furnished in a domestic style and the residents have spacious bedrooms, which they can personalise, and access to a range of communal areas. The home was clean to a high standard and well maintained. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Christ The King DS0000055922.V361437.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 Christ The King DS0000055922.V361437.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): 1,2,3,4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The information in the Statement of Purpose and Resident Guide needs to be revised to include details of the changes in the organisation. Residents have their needs assessed by senior staff before they move to the home and know that staff have decided that the home can meet their needs before they move there. Prospective residents and their relatives can come and look around the home and meet staff before they decide to move there. EVIDENCE: There have not been any residents admitted since the previous inspection in November 2007. We were told the manager always went to see the resident to do an assessment at the place the prospective resident was living and gather information about the resident. The resident would then be invited to come to spend time in the home and meet all the residents living there. If they liked it they would come for a day with any friends or family. If this is successful there would be a discharge meeting when the whole care package is put together. Christ The King DS0000055922.V361437.R01.S.doc Version 5.2 Page 9 We checked the statement of purpose and resident guide and noted these had been reviewed and updated to include all the information relating to the changes in the management of the home. We were told and saw each resident had a copy of the statement of purpose and resident guide in their bedroom. We looked at three residents files and noted they all contained a community care assessment and the relevant assessments and summary of needs that were completed by the home before the resident came to live there were seen on file. Care plans that were developed from these gave a thorough description of resident behaviours, reactions and preferences and how the resident was to be treated. There were immediate, medium term and long-term goals and these are reviewed monthly and recorded. The resident who had moved in most recently said they had visited the home before moving in to see if they liked it and had stayed over night as well as coming for a meal. They said they had a chance to meet the residents who were living at the home. Risks were identified and how these would be minimised, with actions agreed and recorded. Christ The King DS0000055922.V361437.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): 6,7,8,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Families and other professionals are involved when reviews are held. Residents are consulted and supported to make decisions about their lives by staff and appropriate independent professionals. Care plans are thorough and reflect residents’ needs and goals and are reviewed within the allotted time scale or before if needed. EVIDENCE: We looked at three resident files were seen and noted that the care plans gave a thorough description of resident behaviours, reactions and preferences and how the resident was to be treated. The residents care plans and risk assessments are individualized that are developed with the resident participating fully and in consultation with the residents family, care coordinator and other professionals. We were told the risk assessments from the Christ The King DS0000055922.V361437.R01.S.doc Version 5.2 Page 11 previous placement would be checked and then the home would develop their own risk assessments to suit the residents changing needs. Care plans are reviewed regularly within the allotted time scale or sooner if things have changed or there have been developments in the residents’ behaviour and life. At one point one of the homes placing authority’s had intended to move three residents to another placement. A meeting was held at the home to inform the residents of the proposed plan. To support residents in the consultation process and decision on moving from the home, the manager had arranged for the Croydon Advocacy Service to speak to the residents and advocate for them and they were allowed to continue to live in the home. We spoke to all three residents who all said they still enjoyed living in the home. We were shown copies of the minutes of residents meetings and staff meetings where the choice of activities has been discussed by staff and residents. These are held every two months. Residents fully participate in home meeting and one resident said they could say what they wanted to and they were listened to. Christ The King DS0000055922.V361437.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): 11,12,13,14,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to develop independent skills and interests as well as access the community with the support of staff when required. Families and friends are encouraged to keep in touch with the residents and participate in social activities. Residents engage in appropriate, enjoyable and fulfilling activities and mix with the general community. Residents’ rights and responsibilities are respected. A healthy diet is provided, which the residents enjoy. EVIDENCE: Christ The King DS0000055922.V361437.R01.S.doc Version 5.2 Page 13 The activities programme is designed to meet each resident’s individual needs. We noted that some of the weekly activities were related to independent living skills, such as cooking, laundry and keeping their room clean. Residents are also encouraged to take part in activities commissioned by outside specialists such as reflexology, aromatherapy and healthy eating. In this way resident’s are supported and encouraged to take part in activities that are enjoyable, beneficial to their mental and physical health and which give them the opportunity to develop skills within their abilities. We were told by the manager they “aim to excel in the quality of care we give in order to enhance the life experience of our residents”. The residents are encouraged to take part in activities they enjoy instead of being told which ones to participate in. Residents said they felt free to say what type of activity they wanted to take part in. One member of staff has taken the lead in identifying and facilitating appropriate activities in the community and another has taken on the role of facilitating home activities. We noticed one resident making herself a dress and we were told the home has “Individual Social Skills Programmes” in place to structure the day for the residents, and they are being actively encouraged to “persue their individual interest and coperate activities”. The resident said she had made another dress and one member of staff was helping her with this. We were told the home had adopted the “Rehabilitation Recovery Model, of social inclusion” where they ensure that the residents use the community ammenities like anybody else. They do their own shopping for their food, attend local events and eat out in various restaurants. We were told there is one particular favourite Pakistan restaurant which is near the home that they go to regularly. One resident who goes daily to the corner shops has independntly formed friendships with storekeepers from his own country, who shares with him home news. The ladies go to the local hairdresser`s saloon and the males to local barber. Birthdays are celebrated, and family members always attend. Relatives and care coordinators are invited to attend social activities and religeous celebrations. The staff and residents said the home celebrated all faiths of the residents. Residents told us about a recent birthday party which residents’ family had come with gifts and a cake. The residents have said although they are of different faiths and cultures, one from India, one from Mauritius, one from Sri Lanka and two from Britain they all wanted to celebrate Christmas. One resident said they spoke to their family every week. Another resident goes to visit their family and their relatives are always visiting and keeping in touch. Relatives are encouraged to visit the home and keep in contact with the resident. Relatives said “the home keeps them informed about what is going on in the home and the only way they knew about a review meeting was by the home telling them it was to take place”. Christ The King DS0000055922.V361437.R01.S.doc Version 5.2 Page 14 We were invited to join the residents for their midday meal, which was tasty and well cooked. Residents said they enjoyed the meals served at the home. Residents are able to cook their preferred dishes with some supervision from staff. They told us they enjoyed their meals and they are able to choose what they want to eat instead of rigidly sticking to the weekly menus. The staff said this is easy to implement because of the smallness of the home. One resident takes pride in cooking their ethnic meals on a regular basis and another does so once in a while. The resident told the inspector they went out with a member of staff to shop for the type of food she wanted to eat and cook. Another resident goes to Brixton to buy meat they like. We were told each resident has been given a mobile phone and a badge with the homes details on it that they can pin somewhere discreet, to enable them to contact the home in an emergency. This has been agreed with their families and is written in their care plan along with the risk assessment. Christ The King DS0000055922.V361437.R01.S.doc Version 5.2 Page 15 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): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive personal support, in the way they prefer and their physical and emotional needs are met. Medication is handled safely. EVIDENCE: We looked at three residents personal files. We were told the home has developed Holistic Individualised care plans to ensure that the residents needs are thoroughly assessed with their participation, and the appropriate care and support given. These contained all the information staff need to support the residents in their preferred personal care routines and details of how much help an individual requires with different personal care tasks. Residents are registered by the local GP and have the initial baseline medical check appointment. There were records on file of routine checks to the dentist, chiropodist, and appointments. Emergency appointments are made with the GP, if the need arises. All the appointments are entered in the diary, so that Christ The King DS0000055922.V361437.R01.S.doc Version 5.2 Page 16 they will not be missed. The record of health appointments attended indicated that staff supports each resident to attend an appropriate range of healthcare appointments in line with their individual healthcare needs. Records include the outcome of the appointment. The home works with the Diabetic Nurse and Incontinence Nurse to meet the needs of individual residents. One resident attended the smoke cessation clinic run by the local pharmacist. Residents weight, blood pressure, temperature and pulse are monitored and recorded weekly, so that potential health problems can identified dealt with at early stage. The home also work in close liaison with the Community Mental Health Teams for the mental, psychological, social and financial factors of the residents. The residents attend regular appointments with Psychiatrist where their mental state is assessed and medication reviewed. Community Programme Approach meetings are carried out every six months either in the home or at the CMHT. The resident, their family, the staff of the home, their care coordinator and other professionals involved in their care, attend these comprehensive meetings where the whole care package is reviewed. The home now more places emphasis on educating, developing and promoting the independence of residents. To help residents become more independent and give them more control in their lives, two residents are being encouraged to manage their own cigarettes and tobacco-smoking regime. Another resident is managing his alcohol drinking in a socially accepted manner. Two residents have showed keenness in joining the “Ready, Study, Bake activities set up to learn to cook. As part of the residents daily living development plan, each resident is encouraged to take part in the running of the home and has household chores that they do on a regular basis. These are discussed and agreed at the residents meeting, with residents stating what they want to do. The inspector saw this in practice on the day of the inspection when residents helped cook the midday meal and clear away afterwards. We checked three residents medication and all were correct. We found the medication procedures had improved since the previous inspection in November 2007. We were told the storage and handling of medication is managed according to the home policy and this had been reviewed to ensure there were safer procedures in place. Rigorous medication checks have been put in place in order to ensure the correct administration of the medication and to highlight any errors immediately. There is now a running total system that was discussed at a previous inspection in February 2006. This has made it possible to check more easily if there has been a medication error and to know when this had happened. Medication charts are written more clearly and Christ The King DS0000055922.V361437.R01.S.doc Version 5.2 Page 17 different strengths of the same medication are recorded on separate lines. Only the trained nurses dispense medication. The local pharmacist audits the medication every six months and has recorded there were no problems. The manager told the inspector she does a medication spot check every week and records this on the medication charts. The manager said if a mistake was made the manager would immediately contact the member of staff involved and dealt with in supervision and through refresher training. Medication issues are discussed at staff meetings and in supervision. The manager says she feels the more medication is discussed the more it raises staff awareness. None of the residents are self-medicating at the moment. If there are concerned about the effects of medication on a resident, they inform their GP and Psychiatrist and ask for medication review. The home thought one resident could be ready to self medicate, but after some discussion with the care coordinator and other professionals at the residents review meeting, it was decided not to introduce this yet. Christ The King DS0000055922.V361437.R01.S.doc Version 5.2 Page 18 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): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Practices and training at the home ensure that residents are protected from abuse. Residents confirmed that they felt their views were listened to and acted upon. EVIDENCE: The complaints book is on display in the hall for residents or visitors to look at or write in and there is a copy of the complaints procedure on the notice board in the hall. We checked the book and noted there were not any complaints. At the previous inspection we were told about one complaint from a neighbour about noise and this had been dealt with appropriately and there have been no further complaints from this neighbour. The manager said they take all complaints seriously and aim to deal with them promtly and within the time scales. Every resident has the complaint procedure in their information booklet. All communication relating to complaints are well documented. The manager said they have continued to maintain a reflective log on all complaints received to enable them to proactively deal with situations before they arise, by observing a trend. There are diagnostic discussions among staff, which always follow any complaints received, in order to elicit the cause of the complaint and plan ways to resolve the complaints amicably. Christ The King DS0000055922.V361437.R01.S.doc Version 5.2 Page 19 We spoke to five residents and all said they were happy living at the home. We spoke to one resident who said “it is good here and would speak to the manager or staff if they had any complaints”. There is an adult protection policy and procedure in place including whistle blowing. In addition, there is an appropriate restraint policy, stating that restraint should be used only as a last resort. We spoke to the manager and care staff during the inspection about adult protection as part of the themed inspection and they said there were different types of abuse, not just physical abuse, such as verbal abuse and financial abuse. They said if they suspected abuse was happening they would reassure the resident and report what they suspected to the manager. Staff said they had access to all the policies and procedures in the home and if they were not sure of anything they could look it up. Staff said they had training on POVA and whistle blowing and said they felt confident that they would know what to do. The manager said “they have never had to use any restrain on our resident`s”. She said staff are aware that this should be used as a last resort and this is reinforced during any training they have. We saw the latest two copies of the minutes of the meetings and noted that residents are encouraged to speak out about any concerns they may have. In the past residents were put in touch with the Croydon Advocacy Service, an independent advocacy service, to help them speak out about how they feel about the proposed move to another unit and this helped residents feel they had more control. The home told the inspector they were aware that because of the mental health issues the residents have, relying on written documents to facilitate complaints can be disempowering and they endeavoured to find other ways of empowering them. They said they continuously try educating the residents about the complaints procedure and their right to complain and to keep them up to date with the latest complaints procedures from their providers. One resident manages their own money and has a bank account. We were told they had tried to open a bank account for another resident whose money is managed by a trustee but were told they could not do this because of this. Four other residents have their own bank account and staff supports them to the bank and make transactions. All money is recorded in separate named residents books and is checked by two staff at the daily handover. One residents support plan is learning to take responsibility of the budgeting of their money. Christ The King DS0000055922.V361437.R01.S.doc Version 5.2 Page 20 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): 24,25,28,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is comfortable with adequate private and shared space, toilets and bathrooms. Residents’ bedrooms promote their independence. The home is well maintained and furnished. EVIDENCE: The manager showed us around the home, which is well decorated and homely. There is a good range of communal spaces, including large lounge / dining room. The garden has a raised patio area that has been extended to include a walkway to the large heated outhouse that is used for some of the homes activities. Residents are encouraged to smoke outside but in the colder weather they use the heated out house when it is not being used for activities. There is a personal computer available in the lounge area for use by the residents. The large kitchen, which has recently been redecorated, leads off the dinning area. The door between the kitchen and the living area, which is a Christ The King DS0000055922.V361437.R01.S.doc Version 5.2 Page 21 fire door, has been fitted with a fire door guard that was recommended at the last inspection. From the kitchen is a door leading to a small passage. To the left is a laundry that has a washing machine and a dryer. Opposite this is a small toilet with a wash hand basin. There is a sink installed for clothes that need to be hand washed. Residents told the inspector they were supported by the staff to do their washing and ironing and this was written in their care plans. There are six single bedrooms over three floors. There is one bedroom on the ground floor and all bedrooms are of adequate size with four having en-suite facilities. The residents who spoke to us said they were happy with their bedrooms and they had been able to make them homely by bringing personal possessions. All the residents have a television in their bedroom. The home is clean and well maintained. It is decorated and furnished in a comfortable style. The staff and residents continue to do a good job keeping the house clean. Christ The King DS0000055922.V361437.R01.S.doc Version 5.2 Page 22 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): 31,32,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff files and the homes recruitment policy and practices have improved since the last inspection. Staff are having regular appropriate training and supervision to enable them to meet the needs of the residents. EVIDENCE: We checked the staff rota and noted there continues to be a Registered Mental Nurse on each shift as agreed with the relevant care manager who indicated they would not be happy to place a resident in the home unless there was an RMN on every shift, particularly at night when problems when some residents can become more unsettled. Since the previous inspection a new manager has been appointed to run the home. The manager said she plans to recruit slowly to make sure she gets the right staff. Christ The King DS0000055922.V361437.R01.S.doc Version 5.2 Page 23 She has developed an action plan for the home in which one of the key areas she has looked at and wants to develop is staffing. This includes looking at recruitment and recruiting permanent staff, staff induction process, skills and knowledge of the staff and supervision. Then developing their understanding of the aims and vision of the home and developing their understanding of the concept of institionalisation and rehabilitation. We checked two staff files; one was a new member of staff. Both staff files viewed there were two written references, a signed copy of their contract stating terms and conditions and Criminal Records Bureau checks as required including confirmation of training that has been undertaken. The manager said when a new member of staff started they would have weekly supervision sessions then these would be monthly to six weekly after the initial induction period had taken place. Staff development plans were in place on most files but the manager said she was still in the process of the putting files in order she wanted them in. Copies of the meetings were seen by the inspector and indicated that the home had a high level of commitment to raising the standards of care the residents were receiving. The manager emphasised the importance of staff training and encouraged staff to come up with new ideas that will improve the quality of the service. The manager plans to send all support workers on medication training and is arranging for support workers to attend Croydon College to take NVQ level 3. There were copies of the certificates of training the staff had received held on their files. This included induction training and mandatory training, diversity and equality training. Staff said they had regular supervision every six weeks and it was noted there were copies for the supervision notes on file, which were signed by the manager and the member of staff. Christ The King DS0000055922.V361437.R01.S.doc Version 5.2 Page 24 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): 37,38,39,40,42,43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are safe and protected by good management and systems. Service user’s views influence the running of the home. EVIDENCE: The manager started to work in the home in February 2008 and has applied to become the registered manager. She is a trained registered mental health nurse R.M.A., N.V.Q. Teaching & assessor D32 D14 as well as having past experience in managing a rehabilitation unit and has experience and knowledge having worked in the various fields of Nursing and various aspects of Mental Health Nursing. She puts the residents first but doesnt loose sight of the needs of the staff. She says she try’s to be supernumerary when possible. We continue to recommend the manager is supernumerary at all times Christ The King DS0000055922.V361437.R01.S.doc Version 5.2 Page 25 otherwise this means she has to fit in her management work around the activities of the residents and the home. Everyone in the home we spoke to, spoke highly of her and say she has improved the home. She thinks in the terms of rehabilitation and of residents developing their skills to their full potential rather than being looked after by staff as well as believing staff need to develop their skills too. One member of staff said ”since the new manager took over there has been a lot of improvements to provide a holistic care for each resident” and “more outing for residents and staff learning about rehabilitation”. One resident said, ”This is a very good place” and “very nice food”. Another said, “The running of the home is OK. With the new manager trying to uplift the place”. Residents are given the opportunity to give their views of the home at residents meetings, which were recorded in the minutes of the meeting that are held every two months. The inspector was shown copies of the minutes of the meetings. The inspector was shown copies of the completed residents surveys and they were all positive. Staff and residents said they have confidence in the manager and there is a relaxed feel about the home. Residents said they felt that their views were listened to at residents meetings and they felt they could speak to the staff about any concerns they had at any time. The home has policies and procedures in place around health and safety. The inspector was shown the records relating to health and safety measures and servicing of the equipment and these were correct and up to date. On the day of the inspection they could not find the fire book so we were unable to inspect this. The manager contacted us the following day to say it had been found. Christ The King DS0000055922.V361437.R01.S.doc Version 5.2 Page 26 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 3 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 3 2 3 3 Christ The King DS0000055922.V361437.R01.S.doc Version 5.2 Page 27 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA41 Regulation 17,Sch3 & 4 Requirement The registered provider needs to ensure all records are available for inspection at all times. Timescale for action 30/06/08 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 YA37 Good Practice Recommendations The inspector recommended the manager is supernumerary at all times. Christ The King DS0000055922.V361437.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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. Extracts may not be used or reproduced without the express permission of CSCI Christ The King DS0000055922.V361437.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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