Inspection on 21/05/07 for Goodman Crescent, 9

This inspection was carried out on 21st May 2007.

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 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

Goodman Crescent, 9 06/02/06

Goodman Crescent, 9 22/09/05

Goodman Crescent, 9 18/02/05

Goodman Crescent, 9 31/08/04

Goodman Crescent, 9 26/03/04

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

CARE HOME ADULTS 18-65 Goodman Crescent, 9 Streatham London SW2 4NR Lead Inspector Ms Rehema Russell Unannounced Inspection 21st May 2007 09:00 Goodman Crescent, 9 DS0000022795.V340639.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 Goodman Crescent, 9 DS0000022795.V340639.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. Goodman Crescent, 9 DS0000022795.V340639.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Goodman Crescent, 9 Address Streatham London SW2 4NR 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 8671 2768 jehub2002@yahoo.co.uk Jehunita Baccuslyn Freeman Jehunita Baccuslyn Freeman Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Goodman Crescent, 9 DS0000022795.V340639.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th February 2006 Brief Description of the Service: 9 Goodman Crescent provides residential care for 3 service users in an ordinary family house. It is situated in a small private development just off a main road. The home is in easy walking distance of a large shopping centre, which provides full community facilities and public transport (buses and trains) into central London and to other large shopping and community areas. The home provides individual personal care in a family setting that is fully supportive of service user’s needs, preferences and behaviours and which encourages and supports their independence within the home and within the wider community. The home is not suitable for people with mobility problems. Prospective service users would be given a copy of the Statement of Purpose, the Service User Handbook and the home’s brochure, and would also be given verbal information and responses to any questions. A copy of most recent CSCI inspection report is kept by the visitors book so that it is available for anyone to read and another copy is kept on file. Current fees are from £1,300 - £1,500 per week, varying according to the support needs of the individual service user, and there are no additional charges. Goodman Crescent, 9 DS0000022795.V340639.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on 21st May 2007. The inspector spoke with the deputy manager, a support worker and two service users, toured the premises and looked at documentation and records. There had been no changes to the service user or staff group since the previous inspection of 6th February 2006. Both the service user group and the staff group at the home are very stable: two of the three service users, the registered manager and deputy manager have been at the home since it was registered, the third service user has been at the home for over 3 years and the two support workers have been at the home for an average of two years. What the service does well: What has improved since the last inspection? The one requirement and one recommendation arising from the inspection of 6th February 2006 had been implemented. With the continued consistent care and support provided by the home one service user has managed to stop smoking and another’s particular behavioural characteristic has continued to improve. Goodman Crescent, 9 DS0000022795.V340639.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Goodman Crescent, 9 DS0000022795.V340639.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 Goodman Crescent, 9 DS0000022795.V340639.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, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users have the information they need to make an informed choice about the home and their individual needs and aspirations are thoroughly assessed. Each service user has an individual contract and a statement of terms and conditions. EVIDENCE: The Statement of Purpose and Residents’ Handbook were seen and were both found to meet requirements. The Statement of Purpose is very thorough, explaining exactly how the home is run in plain easily understood language and in a clear and friendly manner. It includes a list of Residents’ Rights and is currently being updated to include reference to the new Mental Capacity Act and the CSCI change of address. The Residents’ Handbook (Service User Guide) is also currently being updated, including being re-written in a more personal way, summarising policies such as equal opportunities in plain English, adding the feedback information to the complaints procedure and adding the CSCI change of address. There is also a brochure available for service users and interested parties. Service users and their relatives therefore have a comprehensive range of information about the home available for their use, and prospective service users have all the information they need to make an informed decision about the home. Goodman Crescent, 9 DS0000022795.V340639.R01.S.doc Version 5.2 Page 9 The admission procedure followed for the most recently admitted service user was assessed and found to be thorough. There is a detailed resident application form, which includes all relevant information and is dated and signed by the service user. There is also a resident application checklist, which includes areas such as religious and cultural needs, emergency arrangements, relatives’ involvement, monies, medication and all documentation given to the applicant, which includes the complaints procedure and signed contract. There is a daily living needs assessment form, which includes the medical history, religious observance, dietary preferences and daily living and social activities, and this form was also signed and dated by the service user. The home also ensures that it obtains a full assessment from the placing authority, including relevant mental health assessments as appropriate. Each service user is given a contract, signed by the proprietor and the service user, and a statement of Terms and Conditions of Residency which is also signed by the service user. Both documents are clear and easy to understand and present on each service users’ file. Goodman Crescent, 9 DS0000022795.V340639.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 excellent. This judgement has been made using available evidence including a visit to this service. Service users’ assessed and changing needs and personal goals are reflected in their individual care plans. Service users are encouraged and supported to make all decisions about their lives and to take risks as part of an independent lifestyle. They are consulted on, and participate in, all aspects of life at the home. EVIDENCE: All three care plans were checked. They are comprehensive and detailed covering every aspect of daily living, and in addition each has been signed by the service user. Each care plan is reviewed six–monthly, and annual reviews by the placement authority were also present. There was evidence that family /relatives are invited to attend reviews, and have done so in the past. Care plans set out how current and anticipated needs will be met and describe any restrictions on choice and freedom (one service user had a restriction in the past which has now been lifted). In addition, care plans also incorporate any issues arising from the Mental Health Action Plans, each annual January review Goodman Crescent, 9 DS0000022795.V340639.R01.S.doc Version 5.2 Page 11 has a service user satisfaction survey attached, and all previous reviews are kept on file for reference, all of which are good practice. A recent placing authority placement review stated that “(the service user) stated he was happy here and the staff are helpful”. Observation and verbal and documentary evidence demonstrated that service users are encouraged and supported to make their own decisions about all aspects of their lives. On the day of the inspection all three service users had individually written out a list of their menu choices for the week. All three service users manage their own personal allowances. Staff accompany service users to the post office to collect their monies and their Disability Living Allowances are paid straight into their bank accounts with no involvement by the home. Although there is a individually structured activity programme for each service user they can decide whether to attend or not, and at weekends decide individually when to get up and what to do. Minutes of Residents’ Meetings evidenced that service users are consulted about all aspects of life at the home and that their choices and decisions are respected and implemented. One service user regularly spends the whole day out of the home, with the freedom to go wherever he pleases. Staff are aware of the different drop-ins and centres he visits and have made themselves known to the various staff groups so that either part can contact each other if they have concerns about his health or safety. All three service users have either their social worker and/or a family member as an advocate, and staff advocate for service users with outside authorities as appropriate. Staff demonstrated a strong commitment to the principle that as this is the service users’ home, they should be consulted on anything that affects it and that their choices and decisions should be respected. The Proprietor discusses any new policies or adjustments to policies and procedures that the home wishes to make with service users, so that they are aware of all aspects of the running of the home that affects them and are able to contribute their opinions if they wish to. Observation and verbal evidence showed that staff discuss all aspects of daily life with residents, in a way that gives them the opportunity to assess situations and risks for themselves. This was observed during the inspection, when a service user was supported to make his own decision regarding a health matter. The options and alternatives were discussed with him in a sensitive and supportive manner and he was able to make his decision. Each care file had a Mental Health Risk Assessment, signed by the registered manager and service user, and risk assessments were also incorporated into care plans as appropriate. Other examples of documented risk assessments were found, which detailed the nature of the risk and how to manage it, but these were not written in the accepted risk assessment “format”. A recommendation has therefore been made for the home to write up the risk assessments they are currently using in a more conventional format. See Recommendation 1. There are no current restrictions on service users’ rights and an indication of the increasing independence and responsibility achieved by service users is that they all now have their own front door key, whereas in Goodman Crescent, 9 DS0000022795.V340639.R01.S.doc Version 5.2 Page 12 previous years this had necessarily been restricted for some. In addition, one service user has become much more co-operative with staff in regard to curbing the excesses of obsessive-compulsive disorder, which evidences the trust that staff have managed to build up whilst safeguarding risks to health and safety in the home. Goodman Crescent, 9 DS0000022795.V340639.R01.S.doc Version 5.2 Page 13 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 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users have full opportunities for personal development, and are fully supported to take part in age, peer and culturally appropriate activities. They are part of the local community, attend individually chosen leisure activities and are supported and encouraged to have appropriate personal and family relationships. Service users rights and responsibilities are fully recognised in their daily lives and they are given a nutritious and varied diet of their choice. EVIDENCE: Goodman Crescent, 9 DS0000022795.V340639.R01.S.doc Version 5.2 Page 14 Service users have opportunities to maintain and develop social, emotional and communication skills during their various daytime activities, when they mix with the general public and journey independently around London. They are encouraged to speak with staff every evening about their experiences, with the manager and staff supporting them to develop their confidence and communication skills as necessary. Staff continue to encourage service users to attend clubhouses and colleges and to take up job opportunities offered to them if this is their choice. One service user has a part-time job and another has held down a part-time job in the past but is not currently interested in doing so. Staff obtain information about local college classes and activities, as well as appropriate cultural and religious centres, so that service users can choose to attend these if they wish. One service user has expressed the wish to undertake a course later in the year and staff are helping him to obtain information and apply. Another service user continues to attend religious temple that he has visited for several years, where he joins in activities and meals and has made friends. Another resident continues to visit several drop-ins each day that are run by the religion he is affiliated to. A third service user attends a local clubhouse and visits friends and a relative who lives in the area. Food eaten at the home and on Fridays when take-aways are bought reflect the individual cultural choices of service users. Service users take part in a range of local community activities, alone or together, with or without staff and at their own individual choice. They use local shops, cafes, cinema and the library. Despite staff encouragement, none are interested in taking part in sports. Staff make sure that residents know about local events that are taking place and service users also get information from the local library. None of the service users wished to go away for a holiday last year but they did go on day trips to the south coast, and regular day trips into central London for sightseeing and window shopping. The daily notes for one service user evidenced that he had been encouraged to exercise his right to vote but had decided not to. Service users are supported and encouraged to chose and take part in a variety of leisure activities. Two service users have radio and audio equipment in their rooms, there is television, audio and video facilities in the lounge, and a selection of games and books available. Service users visit the cinema and some local events together, but also spend time following their individual leisure pursuits, such as reading and listening to music. One service user has taken an interest in growing vegetables and has been supported to cultivate these in the back garden. Goodman Crescent, 9 DS0000022795.V340639.R01.S.doc Version 5.2 Page 15 All three service users have regular contact with family and friends, who they visit, some regularly and some from time to time. One service user stays overnight with relatives who live outside London from time to time and spends Christmas with them. Family members have also visited service users at the home. Staff encourage and support service users to keep in contact with relatives, by visit or telephone, following any events or problems that could lead to a lessening of contact on either part, as had happened in the last few years for one service user. This ensures that family links are not lost unless the service user specifically chooses this to be so. Service users have made friends privately and at the various day centres, drop-ins and other activities which they attend. Service users have also become friends with each other. One service who used to spend every day out of the home now tends to remain in the house for most of the weekend, reflecting his growing trust of staff and friendship with other service users. Daily notes also evidenced that this service user chose to celebrate his birthday at the home this year. Service users are enabled to exercise their rights and responsibilities in as many areas of their lives as possible. They all have their own front door keys, open their own mail, choose when to be alone or in company, and choose which activities and events they wish to participate in. There is an activities timetable on the notice board which states which activities have been agreed for service users to attend on weekdays, however if they choose not to do this on any days staff will discuss their reasons with them and support them to find alternative occupations. Staff do not enter their bedrooms unless with the specific permission of the service user and accompanied by him. Service users write out their individual menu choices for the week each Monday morning. Staff then correlate the menus and ensure that the shopping list includes all ingredients that will be needed. Service users usually shop with staff, which supports them to develop and maintain independent living skills, and then choose each lunch time and evening which meal they wish to eat. All three service users are from different cultural backgrounds and menus evidenced ethnic choices. A cooked breakfast is provided three times per week and once a week the home provides funds for service users to get a take-away of their individual choice. The inspector was told that there is always food available for snacks and that residents could help themselves to food and drink whenever they wished to. Staff suggested that the main meal is eaten in the evening but service users didn’t want this and chose for the main meal to remain at lunchtime with a lighter supper at night. Goodman Crescent, 9 DS0000022795.V340639.R01.S.doc Version 5.2 Page 16 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. Service users receive personal support in the way they prefer and require and their physical and emotional health needs are met. Service users are protected by the home’s policies and procedures for dealing with medicines, but a central record of medications received should be re-instated. EVIDENCE: Goodman Crescent, 9 DS0000022795.V340639.R01.S.doc Version 5.2 Page 17 Service users do not need help with personal physical care but personal support is given in the form of prompting. Examples of the type of emotional and social support given were cited and these evidenced that staff approach service users sensitively and respectfully, and that service users have confidence in staff’s advice and support but feel able to ignore advice and make alternative choices if they wish. Staff speak with service users each evening about how their day has gone, any problems that have arisen or any issues they want to discuss, and also ask them about their plans for the following day. Service users manage their own monies and buy their own clothes, with staff support if requested. The two service users seen were age and lifestyle appropriately dressed, and were observed to have friendly and trustful relationships with. One service user spontaneously told the inspector “They take care of me very well”. Verbal evidence from staff and documentary evidence in files demonstrated that the healthcare needs of service users are assessed and monitored and that service users are supported to access all healthcare services as appropriate, including mental health and other specialists. Evidence was seen of appointments with Community Psychiatric Nurses, opticians, dentists, general practitioners, psychiatrists and social workers. In the past, service users have been supported to visit physiotherapists and chiropodists as appropriate. However, residents’ rights to choose whether to attend appointments is respected and they sometimes choose not to attend appointments made. In these cases staff discuss the health consequences of missing the appointment with the service user so that he can make a fully informed choice about whether to attend an alternative appointment. Only two of the three service users take prescribed medication. The recording, storage and administration of regularly taken medication was seen and found to be in good order. Because the home received medication in monthly amounts from the pharmacist, staff have discontinued the practice of keeping a central recording system of medication received. However, because service users may be given supplementary medication for a limited period at any time, and because of the possibility of error by the dispensing pharmacist, it is recommended that a central record of all medications received is kept, which records the date, full details of name and dosage of medication, and a tablet count. See Recommendation 2. Goodman Crescent, 9 DS0000022795.V340639.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. Service users views are listened to and acted upon, on a daily and also more formal basis. Service users are protected from abuse, neglect and self-harm. EVIDENCE: The home has a clear and well written complaints procedure that covers all of the areas required by regulation. The complaints book was seen but there have been no formal complaints received by the home. In case service users or visitors wish to make informal complaints or comments, the home keeps an easily accessible comments book. There was one comment in it from a service user’s relative who had visited him at the home and said that she was very pleased with the service user’s room and the way that staff were caring for him. The manager and staff speak with service users on a continual, daily basis, discussing any problems or discontents with them and resolving them as feasible or appropriate. This was evidenced from residents’ meeting minutes. In the previous year a service user had requested that breakfast times during weekdays should be a half hour later, and this was discussed with other service users and then implemented at their agreement. Goodman Crescent, 9 DS0000022795.V340639.R01.S.doc Version 5.2 Page 19 The home has a clear abuse policy, which staff are familiar with. The support worker interviewed was able to cite many different forms of abuse that can take place, including emotional abuse, verbal abuse and neglect, and was familiar with the procedure to be followed if abuse was suspected or reported. None of the current service users have been verbally or physically aggressive but verbal evidence indicated that mental health issues are dealt with appropriately, with sensitivity and understanding Goodman Crescent, 9 DS0000022795.V340639.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, 26, 27, 28 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles and toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms and the home is clean and hygienic throughout. EVIDENCE: Goodman Crescent, 9 DS0000022795.V340639.R01.S.doc Version 5.2 Page 21 The home is accessible, safe and well maintained with a small but pleasant rear garden. It is situated in a small private development just off a main road. It is five minutes walk from a large shopping centre that provides full community facilities and public transport (buses and trains) into central London and to other large shopping and community areas. The home is comfortable and homely throughout, and fulfils the aims and objectives of the home which is to provide a house where service users can live as a family. The home is not suitable for people with severe mobility problems/wheelchair needs as it is an ordinary terraced house which is not designed for this and does not have the capacity for mobility alterations. Bedrooms were seen and are suitable for the lifestyles and interests of the service users. All are personalised according to the interests and choices of the individual occupants, who are supported by staff to keep their rooms reasonably tidy and clean. A new bed had been bought for the top bedroom and the inspector was told that bedrooms were going to be redecorated this year. There is a toilet with washbasin on the ground floor, next to the lounge, and a large bathroom with toilet, bath, shower and bidet on the first floor, alongside the bedrooms. These facilities fully meet the needs of service users and ensure their dignity, privacy and choice. The communal areas of the home are well furnished, fitted and decorated and contain comfortable seating and culturally appropriate ornamentation. The lounge is comfortably furnished and has television, video and stereo equipment, plus games and books. Furniture has been arranged, in agreement with service users, so that the dining area of the kitchen-diner is separated off from the kitchen, giving more privacy and also better health and safety. A new microwave has been bought. On the day of the inspection the premises were found to be clean and hygienic throughout. Goodman Crescent, 9 DS0000022795.V340639.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): 32, 33, 34, 35, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by a competent, qualified and effective staff team, who are suitably trained and well supported and supervised. The home’s recruitment procedures are thorough and meet equal opportunities principles, however proof of identity was absent for the most recently recruited member of staff. EVIDENCE: The deputy manager and support worker demonstrated the qualities and competencies required to meet the needs of the service user group. They are approachable, friendly, good listeners and communicators, and service users were observed to be relaxed and confident in their presence. The home has a Registered Manager, a deputy manager and two part-time support workers who also carry out domestic duties. The deputy manager has NVQ Level 3 and both of the support workers have NVQ Level 2, so the home has therefore exceeded the recommended NVQ 2005 care staff training target. Goodman Crescent, 9 DS0000022795.V340639.R01.S.doc Version 5.2 Page 23 The weekly rota was displayed on the notice board, evidencing that there is always one member of staff on duty. As no residents require assistance with physical care and all can travel independently the home can meet their care needs by having only one member of staff on duty at any time. In addition, the manager and other staff are available on call outside office hours and at weekends. As this is a very small home the whole staff team exchanges information on a daily basis and so formal minuted staff meetings are held only two/three times per year. Additional staff meetings are also held if particular circumstances require it, such as when planning summer/Christmas activities or when there are particular implications for the home. For example, a formal staff meeting was held in April to discuss the new Mental Capacity Act and ensure that staff were familiar with its implications, which is good practice. The three service users are from a range of cultural backgrounds and religious beliefs, and the staff team reflects this, also being from a range of cultural and religious backgrounds. At all previous inspections recruitment files have been found to be thorough. At this inspection the staff file of the most recently recruited support worker was seen. The majority of required information was present on the file, including an application form, two references, Criminal Record Bureau check, health check, training certificates, contract and supervision notes. However, there was no proof of identity on the file, and an incomplete employment history. See Requirement 1. The proprietor/manager does not employ support workers unless they have the NVQ Level 2 qualification, which ensures that they have all of the basic training required to work at the home. They then shadow the deputy manager for a fortnight, or until the manager is satisfied that they are competent in their role. Regular supervision and yearly appraisals are given. All staff are kept abreast of current issues and changes of legislation by in-house training and in addition the proprietor supports staff to attend courses and seminars run by the National Care Association. The deputy manager has just passed a certificated course in the new Mental Capacity Act and one support worker has just started a nursing diploma. Goodman Crescent, 9 DS0000022795.V340639.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, 39, 42 and 43 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well run home, in an open, positive and inclusive atmosphere. Their views underpin self-monitoring, review and development at the home. The health, safety and welfare of service users are promoted and protected and service users benefit from competent and accountable management of the service. EVIDENCE: Goodman Crescent, 9 DS0000022795.V340639.R01.S.doc Version 5.2 Page 25 The proprietor of the home is also the registered manager. She has several years experience of managing residential care for this particular client group and formerly managed a much larger residential home for people with mental health needs. She also has academic qualifications to degree and higher levels. She has recently started the NVQ Level 4 qualification in management and care as recommended under this Standard. Staff confirmed that the management approach at the home was open, positive and inclusive, that they felt supported and part of a team, and that the manager and deputy manager were very approachable and supportive. Service users views are sought on all aspects of life at the home. Staff consult with service users on a daily basis, observed during the inspection, and minuted Residents Meetings are held regularly. Minutes were seen and evidenced that service users are consulted about all aspects of life at the home, including any proposed changes to policies and procedures, are kept informed of any external changes that may affect them or the home, and that their views and suggestions are followed up and implemented as appropriate and agreed by everyone. For example, at one meeting last year a service user suggested that the weekday timing of breakfast be extended for another halfhour and this had been discussed and implemented. At this same meeting, annual service user satisfaction surveys had been distributed. Comments returned included “I am happy here and there is nothing to change”, “I am satisfied with the services in the house… I like for it to stay as it is”, “I would like to rise later and have breakfast later” and “I get the sort of food that I want.” Service users are also fully involved in staff recruitment, meeting with potential staff and influencing whether they are recruited. The following health and safety documentation was seen and found to be in good order: • Fire alarm certificate 26/06/06 • Gas safety certificate 09/10/06 • Electricity safety certificate 10/05/06 • Fire risk assessment • Regular, fully documented, fire drills • Internal health & safety checks • COSHH storage • LFEPA (fire safety) inspection September 2003 • First aid box As agreed at a previous inspection, the financial and business report submitted annually to placing authorities to prove viability is deemed suitable for the purposes of this Standard. This plan is produced annually and is available on computer at the home. Goodman Crescent, 9 DS0000022795.V340639.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 4 3 X 4 X 5 3 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 4 25 X 26 3 27 4 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 4 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 4 4 X x 3 3 Goodman Crescent, 9 DS0000022795.V340639.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 YA34 Regulation Requirement Timescale for action 01/09/07 19(1)(b)(i) The Registered Provider must ensure that there is proof of identity, including a recent photograph, and a full employment history, on the file of the most recently recruited staff member. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA9 YA20 Good Practice Recommendations Risk assessments should be re-written in a more conventional format. A central record of all medications received should be maintained. Goodman Crescent, 9 DS0000022795.V340639.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection SE London Area Office River House 1 Maidstone Road Sidcup Kent DA14 5RH 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 Goodman Crescent, 9 DS0000022795.V340639.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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