Inspection on 09/09/05 for Hainault

This inspection was carried out on 9th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 but made no statutory requirements on the home.

Other inspections for this house

Hainault 11/11/08

Hainault 18/12/07

Hainault 16/11/06

Hainault 04/05/05

Hainault 07/09/04

Hainault 11/05/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

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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 Hainault 35 Lesney Park Road Erith Kent DA8 3DQ Lead Inspector Elizabeth Brunton Announced 9 September 2005 10:00 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 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 Stationary 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. Hainault G51 G01 S38196 Hainault V225777 09.09.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hainault Address 35 Lesney Park Road Erith Kent DA8 3DQ 01622 769 100 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.mcch.co.uk MCCH Society Ltd Mrs Rita Fitton Care Home 14 Category(ies) of The home is registered to provide registration, with number accommodation and care for up to fourteen of places service users who may have a learning disability, a physical disability and/or sensory impairment. Hainault G51 G01 S38196 Hainault V225777 09.09.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 4 May 2005 Brief Description of the Service: Hainault is a care home, which provides care for fourteen adults with learning disabilities. The home has been open since October 1988 and is operated by Maidstone Community Care Housing Ltd (MCCH). Hainault is a large, old, detached building on two floors, with a large, rear garden. There is no lift. The house is divided into three flats. Flat 1 accommodates two people and flats 2 and 3 can both accommodate six people. However, it was recently decided by MCCH, that only five service users would live in flat 2, due to the limited space and shared bedrooms in that flat. All service users now had single bedrooms, apart from two service users who share a room in flat 2. All bedrooms have washbasins and three rooms have en-suite facilities. Each flat has a lounge, kitchen, bathroom and toilet(s). Flat 3 has very spacious communal rooms. There is also an office and a small sensory room on the ground floor. There were twelve service users staying in the home on the day of inspection and one vacancy in flat 1. Hainault G51 G01 S38196 Hainault V225777 09.09.05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and started at 10am. Two inspectors were in the home for seven hours. Four service users were spoken to and three additional service users were seen. Three service users completed preinspection comment cards, with the assistance of the client services manager. It was not possible to find out the views of some service users, because of communication issues. Three relatives were spoken to and four relatives completed pre-inspection comment cards. Pre-inspection comment cards were also received from two health care professionals. The manager, a number of care staff, the handy person and the MCCH finance officer were spoken to. Communal rooms, the garden and service users’ bedrooms were seen. Records were looked at, together with some service users’ individual case files. What the service does well: What has improved since the last inspection? Staff had been provided with written information about how best to protect a service user who regularly went missing from the home. A reward chart had been used and this had worked well. An alternative home had been identified for a service user who had been physically aggressive towards others, at times. The lounge carpet and suite had been replaced in flat 2, a bedroom carpet had been cleaned and there were no unpleasant odours anywhere in the home. Hainault G51 G01 S38196 Hainault V225777 09.09.05 Stage 4.doc Version 1.40 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. Hainault G51 G01 S38196 Hainault V225777 09.09.05 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Hainault G51 G01 S38196 Hainault V225777 09.09.05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 4 & 5 Introductory visits and other arrangements were being made prior to a new service user moving into the home. The diverse needs of service users had been well met by staff. Contracts for service users were still needed, in order to give service users full information about the services provided in the home. EVIDENCE: There were plans for a new service user to move into flat 1. The manager said she had been provided with much information about this service user and he had made a number of visits to the home. This service user was used to attending college and the manager was rightly wanting this to be organised, together with the necessary transport, before it was finally decided that Hainault was the right placement for this young man. Staff had worked hard to meet the needs of service users. A service user suffering from dementia had been supported by staff with sensitivity and understanding. Staff had worked with other service users to reduce absconding and aggressive behaviour. Comprehensive contracts for service users were still needed. Service users and their relatives or representatives needed clear information about the terms and conditions of residence at Hainault and the details of services provided. (see requirement 1) Hainault G51 G01 S38196 Hainault V225777 09.09.05 Stage 4.doc Version 1.40 Page 9 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 standard(s) 6,7,8 & 9 Service users had participated in regular individual planning meetings. They were involved in making decisions and choices about their lives and the running of the home, though opportunities for this could be increased. Good work was being done with a service user in an effort to reduce the risks from his going missing from the home. Service users needed to receive all necessary support in order to make their views known about the future of Hainault and relatives needed to be kept fully informed. EVIDENCE: Individual planning meetings had continued to be held with service users and their relatives twice a year. Service users said they decided whether they wanted to attend day centres, participate in outings and activities and that they helped to plan the menus. The service users in flat 2 had recently chosen their new lounge carpet and suite. However, one service user stated in the pre-inspection comment card that she would sometimes like to be more involved in decision making in the home. The manager agreed to look into this further. Residents meetings had not been held for some time in flat 2. Another service user had been provided with an advocate to support her in Hainault G51 G01 S38196 Hainault V225777 09.09.05 Stage 4.doc Version 1.40 Page 10 deciding whether she wished to move from Hainault into another home, which she was currently visiting. (see recommendations 1 & 2) Service users and their relatives and advocates were currently being consulted about the future of Hainault. Person centred planning was to take place and advocacy was to be provided for service users, if the ultimate decision was to close the home. However, it was not clear how service users were being supported and encouraged to make their views known about the future of the home. The difficulties in doing this are appreciated, as some service users were said to have become distressed and unsettled on hearing about Hainault’s possible closure. Relatives did not feel they were being told the real reasons for the closure of Hainault being considered. They also appeared not to know what the process was to be and seemed unaware of the role of the advocacy service and the proposal for person centred planning to take place with each service user. (see requirements 2 & 3) One service user had recently moved from Hainault into supported living. His continuing letters to the manager and staff showed that he had been well supported in making this move and could still rely on support and advice from staff at Hainault. Another service user was delighted to be moving to supported living accommodation in the very near future. She praised staff for the help and encouragement they had given her. One service user had continued to go missing from the home, day centre and college. Comprehensive guidelines were accessible to staff, the psychologist was involved and the necessary door alarms and additional waking night staff had been provided. All incidents had been recorded, together with possible triggers for each absconding. Staff are to be commended for their thorough analysis of the changes in this service user’s life during the past year and for the consistent and effective use of a reward chart. The manager said that staff were also working with this service user on safely increasing his independent movements outside the home. Hainault G51 G01 S38196 Hainault V225777 09.09.05 Stage 4.doc Version 1.40 Page 11 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 standard(s) 12, 13, 15 & 16 Staff supported service users in their activities, though some service users might benefit from more opportunities to engage in activities outside the home. Service users maintained contact with relatives and friends and had limited involvement with local people and community resources. Service users were treated with respect by staff and exercised choice about their daily routines. EVIDENCE: Service users attended day centres and some had interests such as colouring, puzzles, music and videos, which they pursued at home. Records showed that some service users regularly went out with staff on social pursuits, whereas others did so less often. This was also reflected in the feedback from relatives. Additional dedicated social pursuits staffing hours might enable more service users to go out regularly. Some service users had been away with staff on holiday. On the day of inspection, two service users left with staff for a short holiday and two others went out with staff for the day. It is suggested that the details of ‘social pursuits’ undertaken are recorded in service users’ daily records. (see recommendations 3 & 4) Hainault G51 G01 S38196 Hainault V225777 09.09.05 Stage 4.doc Version 1.40 Page 12 Service users had limited involvement with the local community. They used local facilities such as swimming, bowling, the cinema, shops, restaurants, pubs, a local club, the library, religious services and went for walks locally. Most service users had contact with relatives and some people visited their families regularly at weekends. Goals set at individual planning meetings included developing friendships by inviting people to tea. One service user had been supported by staff in maintaining her friendship and resolving issues with the person with whom she would soon be sharing supported accommodation. Relatives spoken to and those who completed pre-inspection comment cards said they were welcomed by staff when they visited at any time and could talk to service users in private. Some relatives spoken to said they were not always made welcome by agency staff, who were not always clear about arrangements for service users to stay with their families. Relatives confirmed that they were informed about important matters affecting service users. (see recommendation 5) Service users’ likes and dislikes were documented on file and there were detailed guidelines for working with some service users in their preferred way. Service users spoken to confirmed that they exercised choice over their daily routines. All service users spoken to and those who completed pre-inspection comment cards confirmed that staff respected their privacy. Service users in flat 2 had keys to their rooms, which they said they were happy to leave in their doors. Service users said that staff talked to them and staff were heard to address service users in a friendly and courteous manner. Hainault G51 G01 S38196 Hainault V225777 09.09.05 Stage 4.doc Version 1.40 Page 13 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 standard(s) 18, 19 & 20 Service users’ personal care and emotional needs had been well met. Health care needs also appeared to have been met but evidence of regular health care checks was incomplete. Medication was safely stored and properly administered, though further information about a medication incident was required. EVIDENCE: Service users confirmed that they chose their own clothes and had their hair attended to regularly. This was confirmed by relatives. Service users also said that personal care was provided discretely and with respect for their privacy and dignity and staff were seen to do this. One relative was pleased with the understanding and support which a service user had received from staff over recent emotional issues. The psychology service had been involved but it is suggested that counselling is also considered. (see recommendation 6) Information about service users’ health care needs was seen on file. Service users said they were supported by staff in attending health care appointments. However, it did not appear from some files seen that all service users had attended the dentist and optician on a regular basis. One service user had not been given regular blood tests, until her relative reminded staff about the need Hainault G51 G01 S38196 Hainault V225777 09.09.05 Stage 4.doc Version 1.40 Page 14 for this. Service users’ weights had been regularly monitored. (see requirements 4 & 5) Pre-inspection comment cards were completed by two health care professionals. Both commented that the home communicated clearly, worked in partnership and incorporated any specialist advice into service users’ plans. Also, that staff demonstrated a clear understanding of the needs of service users. However, one health care professional commented that that there was not always a senior member of staff available to confer with, as when the senior on duty was a bank or agency worker, (s)he did not know the system or the service users. This health care professional also commented that she was satisfied with the overall care provided, apart from the fact that staff vacancies caused disruption to service users and to the services provided. Medication and medication records were inspected in flat 2, where medication was safely stored and had been properly administered. An incident of missed medication had been recorded but there was no record of a follow-up investigation by the manager and the CSCI had not been notified. (see requirement 6) Hainault G51 G01 S38196 Hainault V225777 09.09.05 Stage 4.doc Version 1.40 Page 15 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 standard(s) 22 & 23 There had been no recent complaints and relatives expressed confidence in the procedure. Staff did all they could to keep service users safe. However, the aggressive behaviour of one service user continued to place others at risk. EVIDENCE: The manager said there had been no complaints since the last inspection. Some service users had limited communication and it could be difficult for them to complain, if they wished to. All relatives spoken to and who completed pre-inspection comment cards said they had been given a copy of the home’s complaints procedure. Relatives said that the manager and permanent staff had always responded promptly to any concerns. There had been no adult protection investigations during the past year and staff spoken to were aware of safe practice. Two of the three service users who completed pre-inspection comment cards, said they felt safe in the home but one service user said she only sometimes did. This response was thought to relate to the aggressive behaviour of another service user and the manager agreed to look into this matter further. The three relatives spoken to felt that service users were safe in the home, although one relative did not consider this was the case when agency staff were on duty. (see requirement 7) The aggressive behaviour of one service user in flat 3 had continued to place other service users and staff at risk. There had been a number of incidents, where this service user had assaulted other service users and staff. Incidents had been recorded and the CSCI notified. All possible steps were being taken by staff to protect other service users and the service user in question was currently paying introductory visits to another home. Another service user was Hainault G51 G01 S38196 Hainault V225777 09.09.05 Stage 4.doc Version 1.40 Page 16 placing himself at risk by regularly going missing and this was referred to under a previous standard. All possible measures to protect him were in place. Hainault G51 G01 S38196 Hainault V225777 09.09.05 Stage 4.doc Version 1.40 Page 17 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 standard(s) 24 & 30 The home was spacious, comfortable, clean and well maintained. The garden, one bedroom and the kitchen in flat 2 needed attention. EVIDENCE: Service users and relatives said they liked the building and found it comfortable and spacious. Bedrooms were generally well decorated and furnished and highly personalised. One bedroom in flat 2 needed some redecoration and the flooring was marked. Few of the service user’s personal possessions were evident in this room but the manager said that he removed anything on display. It is hoped that this service user’s keyworker can work with him to make his room more personalised and attractive. Communal rooms were comfortable and the lounge in flat 2 had recently been re-carpeted and a new suite had been ordered. (see recommendation 7) There was a spacious rear garden with sturdy garden furniture, which service users and staff were said to regularly use. However, rubbish and cigarette ends needed clearing from the patio area and the sensory garden needed attention. (see recommendation 8) Hainault G51 G01 S38196 Hainault V225777 09.09.05 Stage 4.doc Version 1.40 Page 18 Part of the kitchen work surface in flat 2 had been damaged and needed attention. All parts of the home appeared clean and there were no unpleasant odours. (see requirement 8) Hainault G51 G01 S38196 Hainault V225777 09.09.05 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35 & 36 Service users were cared for by an able permanent staff group. Recent use of bank/agency staff and difficulties over recruitment and retention could be linked to salary levels and the home’s uncertain future. This needs to be explored. Staff appeared to have been properly recruited and the necessary checks made, though records were incomplete. Staff received supervision and training, though some additional provision is recommended. EVIDENCE: Staffing levels appeared to be adequate and relatives thought there were normally enough staff on duty. The home had been without a deputy manager and a senior support worker in flat 2 for some time. Unsuccessful attempts had been made to recruit to these posts. There was some concern about the quality of recent applicants for these posts and the possibility that this was linked to salary levels. MCCH should review whether salary levels are affecting the recruitment and retention of staff, in order to ensure that the home can remain adequately staffed. (see recommendation 9) Service users said that staff were kind and helpful and treated them well. Relatives praised the permanent staff team but were concerned about the Hainault G51 G01 S38196 Hainault V225777 09.09.05 Stage 4.doc Version 1.40 Page 20 number of agency staff on duty, particularly at weekends and in flat 2. Relatives said that agency staff did not know the service users, could not communicate and ‘could not be bothered’. The manager said that bank/agency staff regularly worked at weekends because additional staff were rostered on duty but that they always worked alongside permanent staff. Recent rotas showed that bank and agency staff were often on duty at weekends in flat 2, and sometimes with no permanent staff. However, some of the agency and particularly bank staff included in the rota may have worked at the home on a regular basis. (see requirement 9) The inspectors shared the manager’s concern that that the uncertainty over the home’s future was inevitably leading to staff leaving. Five members of staff were said to have already resigned for this reason. Service users will need the support of a stable and experienced staff group in order to manage the changes which may lie ahead. Those recruitment records retained in the home showed that staff had been properly recruited and checked before starting work. However, there were no records in the home for a recently recruited support worker. (see requirement 10) There was a clear record of the training undertaken by staff, which indicated that this was given high priority by the manager. A record was also maintained of training scheduled for the near future. There was said to be limited availability of places on MCCH’s foundation training programme, which meant that some staff had to wait several months to attend. A number of staff were undertaking NVQ training but progress had slowed over recent months due to a lack of assessor support. The provider should explore ways to improve the availability of foundation training and NVQ training completion times. (see recommendation 10) Records suggested that 1:1 staff supervision took place on a regular basis and was well recorded. The one file sampled was well maintained. However, it was suggested that the manager should undertake more thorough monitoring of the supervision provided by other senior members of staff. (see recommendation 11) Hainault G51 G01 S38196 Hainault V225777 09.09.05 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39 & 42 The home was very well managed and adequate attention had been paid to ensuring the environment was free of avoidable risks. EVIDENCE: The home benefited from a highly competent and motivated manager. There was clear evidence of regular staff meetings in each of the three flats and of regular meetings of senior staff. Unfortunately, this effort had not been supported by the required monthly visits from the provider, which are important for providing an additional, external perspective to the running of the home. Only one such visit had been recorded during the past year, which was well below the acceptable level. This must be addressed by the provider as a matter of urgency. Evidence that the views of service users underpin all self-monitoring, review and development by the home, was not available and MCCH are asked to provide this. (see requirement 11 and recommendation 12) Hainault G51 G01 S38196 Hainault V225777 09.09.05 Stage 4.doc Version 1.40 Page 22 The building appeared to be safe and no hazards or risks to the safety of service users were noted. Fire equipment had been inspected and serviced within the past year. Fire drills had been regularly carried out and fire alarms tested weekly. The manager confirmed that staff had received recent fire training, gas and electrical installations and equipment had been checked within the past year and that all hoists had been recently serviced. Checks were made in the kitchen of flat 2, which showed that food was properly labelled and stored and fridge/freezer temperatures regularly monitored. However, this flat had been without a food probe for some time, so the temperature of cooked foods had not recently been checked. (see requirement 12) Accidents and incidents had been properly recorded. As mentioned under a previous standard, an incident of missed medication had been recorded and marked for the manager to investigate. However, there was no evidence that this had happened and the CSCI had not been notified of the incident. (see requirement 6) Hainault G51 G01 S38196 Hainault V225777 09.09.05 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 1 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 2 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 2 2 x 3 3 x Standard No 31 32 33 34 35 36 Score x 3 2 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Hainault Score 3 2 2 x Standard No 37 38 39 40 41 42 43 Score 4 x 2 x x 3 x G51 G01 S38196 Hainault V225777 09.09.05 Stage 4.doc Version 1.40 Page 24 Yes 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 5 Regulation 5(1) Timescale for action Service users must be provided 1 with comprehensive November contracts/statements of the tems 2005 and conditions of their residence in the home. (Previous timescales not met) Service users must be consulted 1 about the future of the home. November 2005 Relatives must be given accurate 1 information about the reasons November why the closure of Hainault is 2005 being considered. They must also be provided with clear information about the consultation process. Service users must be seen 1 regularly by the dentist and November optician and the outcome of 2005 these appointments recorded. A system must be put in place to 1 ensure that any health care November checks, such as blood tests, are 2005 carried out as required. The CSCI must be informed 1 about the outcome of the November managers investigation into the 2005 medication error which occurred on 6.7.05. The service users comment that 1 October she only sometimes felt safe in 2005 Version 1.40 Page 25 Requirement 2. 3. 8 8 12(2) 12(2) 4. 19 13(1) 5. 19 13(1) 6. 20 13(2) 7. Hainault 23 13(6) G51 G01 S38196 Hainault V225777 09.09.05 Stage 4.doc the home must be investigated. 8. 9. 30 33 13(3) 18(1) The worn and unprotected area of the work surface in flat 2s kitchen must be attended to Priority must be given to the recruitment and retention of staff and to a reduction in the use of bank and agency staff. Those staff recruitment records listed under schedule 4 to the regulations must be retained in the home. (Previous timescales of 1/11/04 and 1/07/05 not met) Monthly recorded visits must be made to the home by the provider, as required by regulation. Probes must be made available for the checking of food temperatures. 1 October 2005 1 October 2005 1 October 2005 10. 34 16(2) 11. 39 26 1 October 2005 1 October 2005 12. 42 13(3) 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. 3. Refer to Standard 8 8 12 Good Practice Recommendations Residents meetings should be regularly held. The service users comment that she would sometimes like to be more involved in decision making in the home should be explored further. All service users should have the opportunity to regularly pursue activities outside the home, including at weekends. Additional staffing hours may need to be made available for this. The nature of social pursuits undertaken should be included in service users daily records. The concerns expressed by relatives concerning agency staffs management of the arrangements for service users contact with their families should be addressed. Counselling should be considered for the service user who has recently had emotional issues to deal with. One bedroom in flat 2 should be decorated and the flooring cleaned/replaced. The keyworker should attempt to work G51 G01 S38196 Hainault V225777 09.09.05 Stage 4.doc Version 1.40 Page 26 4. 5. 6. 7. 12 15 18 24 Hainault 8. 9. 10. 11. 12. 24 33 35 36 39 with this service user to make his room more personalised and attractive. The garden should be kept free of cigarette ends and other rubbish. The sensory garden should be attended to. Staff salaries should be reviewed, in order to promote staff recruitment and retention. The availability of resources for foundation training and NVQ training should be reviewed. The manager should periodically review the supervision notes for all staff to ensure that good practice is being maintained. MCCH are asked to provide CSCI with information about the self-monitoring, review and proposed development of the home and the ways in which service users views underpin this. Hainault G51 G01 S38196 Hainault V225777 09.09.05 Stage 4.doc Version 1.40 Page 27 Commission for Social Care Inspection River House 1 Maidstone Road Sidcup Kent, DA14 5RH 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. Extracts may not be used or reproduced without the express permission of CSCI Hainault G51 G01 S38196 Hainault V225777 09.09.05 Stage 4.doc Version 1.40 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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