Inspection on 08/11/06 for Harrow View, 157

This inspection was carried out on 8th November 2006.

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 no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Harrow View, 157 16/10/07

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Harrow View, 157 157 Harrow View Harrow Middlesex HA1 4SX Lead Inspector Judith Brindle Key Unannounced Inspection 8th November 2006 08:10 Harrow View, 157 DS0000065615.V307149.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 Harrow View, 157 DS0000065615.V307149.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. Harrow View, 157 DS0000065615.V307149.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Harrow View, 157 Address 157 Harrow View Harrow Middlesex HA1 4SX 020 8537 5392 020 8537 5392 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) Residential Care Providers Ltd Mr Nigel Brookarsh Care Home 5 Category(ies) of Learning disability (5), Physical disability (2) registration, with number of places Harrow View, 157 DS0000065615.V307149.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection N/A Brief Description of the Service: 157 Harrow View is a care home providing personal care and accommodation for up to 5 adults with a learning disability, two of whom could have a physical disability. The registered owner is Residential Care Providers Ltd. The registered manager is Mr Nigel Brookarsh. The care home was registered by the Commission for Social Care Inspection in March 2006. The home is located in a residential street close to central Harrow. The care home is within a few minutes walk from the variety of shops, restaurants, library, banks and other amenities of Harrow. There are also a variety of local shops. Public bus and train facilities are accessible close to the home. The property is in keeping with other houses in the vicinity, and consists of four single bedrooms rooms and a self contained flat. Two of the bedrooms are located on the ground floor. The flat has been designed to meet the needs of a resident who requires residential care support, but who does not benefit from communal living. There is parking for 2 cars at the front of the house. There is an enclosed garden at the rear of the property. Information and documentation about the service is accessible to prospective residents, residents, and significant others. Fees vary in regard to the needs of the individual residents, and this information is available from the registered manager. Harrow View, 157 DS0000065615.V307149.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection of this newly registered care home took place throughout 7 hours during a day in November 2006. There were two vacancies at the time of the inspection. The inspector was pleased to meet, and talk with two of the residents. The inspector also spoke with staff. Staff were very helpful during the inspection, and supplied all documentation and information asked for by the inspector. The registered manager was present for most of the inspection. The residents have varied communication needs, some of whom have verbal needs and communicate by sounds, signs, gestures and actions. The inspection included spending time talking with, and in particular observing residents, and their interaction with staff. One resident was unwell so the inspector did not have the opportunity to meet him during this inspection. Documentation inspected included, all the resident’s care plans, complaints and accident/incident records, the staff rota, and medication records. 25 National Minimum Standards (including key National Minimum Standards) for adults were inspected. The inspector thanks all the service users and staff for their help and support in the process of this inspection. What the service does well: The care home has a very welcoming atmosphere. Staff and residents make visitors feel very welcome. The care home has ‘homely’ features, and is very clean. The environment of the care home is well maintained. Staff have a good knowledge and understanding of resident’s complex and sometimes challenging needs, and have the skills to meet those assessed needs. Staff were observed to be very sensitive and respectful to residents during the unannounced inspection. The care home ensures that prospective residents have a comprehensive transition programme that includes several visits to the care home prior to them moving in. Staff receive constant support and advice from the registered manager to ensure that all residents needs are assessed and met. Harrow View, 157 DS0000065615.V307149.R01.S.doc Version 5.2 Page 6 The care home ensures that there is very close liaison and regular communication with residents’ families. Residents are supported by staff to ensure that they maintain and develop relationships with family and friends if they so choose to. 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. Harrow View, 157 DS0000065615.V307149.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 Harrow View, 157 DS0000065615.V307149.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 1 and 2 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Arrangements are in place for prospective service users to have the information that they need to make an informed choice about where to live. Arrangements are in place to ensure that prospective resident’s needs are assessed. EVIDENCE: The care home has a statement of purpose, and a service user guide, which had been provided to the Commission for Social Care Inspection and was judged to meet requirements and the National Minimum Standard. A copy of this documentation was not accessible in the care home at the time of the inspection, though there was an accessible brochure about the service. There should be accessible information within the care home about the service to enable prospective service users and others to gain knowledge and understanding of the service provided by the care home. The registered person confirmed that prospective residents and significant others are provided with documentation and information about the service. All the residents have lived in the care home for only a few weeks or months. The registered manager spoke of the process of assessment of prospective residents. This includes a referral with assessment information from the relevant purchasing Local Authority. The registered manager then completes a Harrow View, 157 DS0000065615.V307149.R01.S.doc Version 5.2 Page 9 comprehensive assessment of the needs of the prospective resident. This assessment continues during the visits by the prospective service user to the care home, and throughout the trial period. The manager confirmed that family, and significant others are generally included in the assessment process, particularly when the prospective resident has complex needs, which include communication needs. There are reviews of resident’s needs at six weeks (following admission), three monthly, monthly, and more often if required. The care plans inspected included evidence of the needs of residents having been comprehensively assessed. The initial assessment (HALO) completed by the registered manager should be accessible in the residents care plans. Records confirmed that residents had participated in a comprehensive transition programme of pre admission visits to the care home that included overnight stays. Harrow View, 157 DS0000065615.V307149.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 6,7 and 9 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Arrangements are in place to ensure that all residents have a plan of care, with recorded personal goals. Residents are supported and encouraged to make decisions. Residents are supported to take risks as part of an independent lifestyle. EVIDENCE: The care plans of all three residents were inspected. These documents included assessment information, and significant personal information, which included a summary of health, needs, and cultural needs, social and emotional needs. A photograph of the resident was included in the care plan. Family contact and relationships, resident’s behavioural needs, medical needs and day care/activity needs were all recorded in the care plans inspected. Staff guidance to meet the varied and often complex needs of the residents was clearly documented, and staff had recorded that they had read this Harrow View, 157 DS0000065615.V307149.R01.S.doc Version 5.2 Page 11 guidance, but there should be development in regard to some recorded staff guidance to meet residents individual behaviour needs, which includes reporting and recording of the ‘incident’. There was recorded evidence of family, and previous placement contact in regard to the development of the care plans. The resident involvement with their care plan varied according to the needs and abilities of each resident. Staff who kindly spoke with the inspector had knowledge and understanding of the complex varied needs of individual residents. Staff record ‘daily’ records of each resident’s progress. Recorded care plans from Local Authority funding authorities were recorded in care plans inspected. The home carries out a monthly summary, which includes a key worker ‘checklist’ of each residents health, social and welfare needs, and includes planned objectives for the resident and staff. Records and staff confirmed that residents are supported to make decisions about their lives. Staff were observed to offer residents choices during the inspection. Resident’s morning routines and preferences were documented. Care plans documented residents individual communication needs, which included non verbal communication. The registered manager spoke of the process of offering residents a variety of choices such as particular activities, and then from the response of the resident staff could identify if this was liked or not like by the resident. The resident’s relatives generally manage resident monies. The registered manager supports a resident in the management of his monies. Appropriate records of incoming and outgoing payments, and receipts are maintained. The care plans inspected recorded evidence of risk assessment in resident’s care plans. These risk assessments included, behaviour risk assessments, bathing, travelling by car, eating, bathing, and risk to others and to property. During the unannounced inspection the registered manager reviewed several risk assessments in regard to a resident, and reviewed the staff guidance to minimise assessed risk. The home has a missing persons policy/procedure. Harrow View, 157 DS0000065615.V307149.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 12,13, 15 16 and 17 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Residents have the opportunity to take part in a variety of activities including those promoting personal development, and being community based. Arrangements are in place to enable residents to maintain contact with family/significant others, as they wish. Resident’s rights are respected and responsibilities recognised in their daily lives. Meals are varied and wholesome. EVIDENCE: Records, and speaking to staff confirmed that residents take part in a variety of valued and fulfilling activities. There was recorded evidence that a resident had attended college courses. The manager, a resident, and records confirmed that residents are supported in continuing to take part in activities that they engaged in prior to entering Harrow View, 157 DS0000065615.V307149.R01.S.doc Version 5.2 Page 13 the home. There was verbal, and recorded evidence that residents were supported by staff to travel sometimes significant distances to enable them to continue with previous day care arrangements, and activities such as attendance of clubs that they enjoy. A resident attended a day resource centre (that he had attended prior to his admission) during the unannounced inspection. Other activities included regular attendance at a gym, and a variety of ‘in house’ activities such as participation in everyday living skills/household duties. Community presence and community participation by residents with staff support was evident from records and observation during the inspection. Records and speaking to staff confirmed that staff understand the cultural needs of residents. From inspection of records including the visitor’s book, and from talking to staff and the manager, family links with the residents was very much in evidence. The manager spoke of being proactive in ensuring that residents are supported in maintaining contact with family and friends if they so wish. Records confirmed that residents visit their family regularly, and that there are frequent visitors to the care home. There was recorded and verbal evidence, that staff contact family members regularly to ensure that they are aware of their relative’s progress. Residents also have the opportunity to meet and maintain friendships at the various clubs, and resource centres that they attend. Records, and staff informed the inspector that residents are supported in developing and maintaining their independence in accordance to their assessed needs. Residents preferred form of address is recorded. Staff were observed to interact with the residents in a positive and respectful manner. Residents were observed to access their bedroom and the communal areas of the care home freely. The home has a non smoking policy. The home has a menu. The format of the menu should be reviewed to improve its accessibility to residents, and it should be prominently displayed. In regard to residents individual communication needs, staff spoke of having conversed with resident’s family members in regards to residents’ food particular ‘likes’ and ‘dislikes’. These food preferences were recorded in the care plans inspected. The family supplied a list of preferred foods for one resident. Staff confirmed that residents are offered, and supported in making dietary choices, and that snacks were available at anytime. The manager spoke of staff supporting residents to purchase local produce from local shops. Harrow View, 157 DS0000065615.V307149.R01.S.doc Version 5.2 Page 14 A resident ate his breakfast during the unannounced inspection. This was unhurried, and he was provided with support from staff as and when he needed. Records confirmed that resident’s religious and cultural dietary needs are respected, and that there is appropriate recorded staff guidance to meet residents individual nutritional/dietary needs. Staff had recorded that they were aware of this guidance. A variety of fresh, dried and frozen foods were stored. Fresh fruit was accessible. Records, and staff confirmed that the care home promotes healthy eating. Meals recorded, confirmed that residents received varied wholesome meals. The registered person should ensure that there are no gaps in the recording of meals eaten by residents. Harrow View, 157 DS0000065615.V307149.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 18,19, and 20 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Arrangements are in place to ensure that resident’s personal and healthcare needs are met. Some guidance to meet a specialist healthcare need needs to be further developed. Medication is stored and administered safely, but there needs to be development in regards to some medication administration staff training. EVIDENCE: All the three care plans inspected recorded assessment of resident’s individual personal care needs, and staff guidance to meet these needs. Equipment including a wheelchair, ramps and handrails are accessible to support resident’s maximum independence. Guidance in the use of a wheelchair by a resident was documented. The registered manager reported that support, and advice from an occupational therapist and physiotherapist for a resident would be accessed as needed via the GP. He spoke of plans to access this specialist healthcare support. Residents each have a key worker. Harrow View, 157 DS0000065615.V307149.R01.S.doc Version 5.2 Page 16 Records and staff confirmed that resident’s health needs were assessed, and reviewed, and monitored, and that there is recorded staff guidance to meet those assessed needs. There was evidence that changes in health needs were promptly identified at an early stage and that advice from the appropriate healthcare professional was sought. All the residents are registered with a GP, and have the opportunity and support to ensure that specialist health needs are monitored and treated, including psychiatric support. Guidance to meet specialist medical needs of a resident was accessible. This needs to be further developed to ensure that there is evidence that staff have knowledge of when to call an ambulance. Residents weight is monitored. Records confirmed that residents have received chiropodist, dentist, optician, and also support from the Local Authority learning disability team. An annual health check review, which included health objectives, was recorded. The home has a medication policy/procedure. This was supplied to the Commission for Social Care Inspection following the unannounced inspection, as it was not available at the time of the inspection. This document recorded evidence of having been recently reviewed. This medication policy needs to be accessible to staff at all times. It is recommended that a copy of the medication policy/procedure be filed with the medication administration records or in the medication storage system. The medication storage and administration systems were inspected. Medication is stored securely, and medication administration records are maintained. There were no gaps in this recording. There needs to be evidence that care staff have received appropriate training from a qualified competent person (i.e. district/community nurse) in regards to the administration of a particular medication. This was discussed with the registered manager, who confirmed following the inspection that this training had been planned, and that only trained staff were administering this particular medication. Harrow View, 157 DS0000065615.V307149.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 22 and 23 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Arrangements are in place for ensuring that complaints are taken seriously and handled objectively. Arrangements are in place to ensure that service users are protected from abuse, neglect and self-harm, but required reporting and recording procedures in regard to incidents needs to be carried out. EVIDENCE: The care home has a complaints procedure. This is accessible in written and pictorial/sign format within the service user guide documentation. There are no recorded complaints. The home has a protection of vulnerable adults (POVA) policy/procedure. The registered manager reported that staff had received POVA and/or abuse awareness training, and that there was further training planned. The registered manager reported that abuse awareness training was included in staff induction programme. Staff who spoke with the inspector had knowledge, and understanding of the appropriate response, and the recording and reporting procedures following an allegation or suspicion of abuse. A staff member spoke of having received Protection of Vulnerable Adults training in 2005 and in 2006. Records confirmed that there had been several ‘challenging behaviour’ incidents of by residents due to their behavioural needs. Records confirmed that there was appropriate staff guidance to meet these needs and that these Harrow View, 157 DS0000065615.V307149.R01.S.doc Version 5.2 Page 18 incidents were judged to have been managed suitably by staff. These incidents were recorded in daily records but not always in the incident record documentation, nor reported to the Commission for Social Care Inspection as and when required. The registered manager needs to have knowledge and understanding of when to report significant incidents to the CSCI, and to ensure that these are recorded in the appropriate incident recording documentation, and that the action taken to minimise the risk of the incident occurring again is recorded. Harrow View, 157 DS0000065615.V307149.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 24, 26 and 30 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. The environment of the home is safe, homely and comfortable. The premises are suitable for the care home’s stated purpose. Residents bedrooms are individually personalised, meet their individual needs. The care home is very clean, and odour free. EVIDENCE: The home is in keeping with other houses in the vicinity. It is suited for its stated purpose. The home consists of 4 single rooms and a self contained flat. The flat is on the first floor of the home and has a bedroom, living/dining / kitchen area, shower /toilet and small utility room. The home has ramps at front and back with suitable gradients for wheelchair users. Handrails are located throughout the care home. Public transport facilities are accessible close to the care home. The premises were judged to be safe, comfortable, homely, bright and cheerful, and free from offensive odours. Furnishings and fittings were judged Harrow View, 157 DS0000065615.V307149.R01.S.doc Version 5.2 Page 20 to be of quality. The ground floor of the care home is accessible to wheelchair users. The garden at the rear of the property is enclosed and there is a patio area. It is well maintained, and has seating for people living in the care home. The registered manager spoke of plans to develop an outbuilding. The registered manager should dispose of waste material/rubbish located close to this outbuilding. Records confirmed that the premises meet requirements of the local fire service. A resident’s bedroom was inspected. This showed evidence of having been personalised. Pictures are displayed, and the resident had a their own television. The manager spoke of supporting the resident (who had recently moved into the home) to further develop his room to include more pictures and other personal items. The home has an infection control policy/procedure. The care home was very clean at the time of the inspection. Laundry facilities are located away from food storage and food preparation areas. There is an industrial washing machine and dryer. Hand washing facilities and disposable gloves and aprons are easily accessible to staff. The home completes a daily cleaning checklist. The home should have a dishwasher. The home has an infection control policy/procedure. The registered manager reported that all staff had received infection control training. Harrow View, 157 DS0000065615.V307149.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 32,34, 35, and 36 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Staff receive training to ensure that they are competent and skilled in regard to carrying out their roles and responsibilities. Arrangements are in place to ensure that residents are supported and protected by the care home’s recruitment policy and procedures. Arrangements are in place to ensure that staff receives supervision, but this could take place more regularly. EVIDENCE: Staff who spoke to the inspector were knowledgeable, and understanding of residents individual needs. Records and staff confirmed that staff have the skills and experience necessary for the tasks they are expected to do. The registered manager and staff confirmed that staff complete an induction programme. Records confirmed that staff are informed on a daily basis about each residents activities and plans for the day, and that the staff role and duties are communicated to ensure that these needs are met. Staff confirmed that they have the opportunity to attend staff meetings on a two weekly basis, which they said were very useful particularly in gaining knowledge and understanding of the residents varied needs. Harrow View, 157 DS0000065615.V307149.R01.S.doc Version 5.2 Page 22 The manager reported that staff turn over is negligible, and that several staff employed in the care home have worked previously in another home owned by the manager. The registered manager reported that the majority of care staff (one staff member is in the process of completing level NVQ level 2) had completed NVQ level 2 and/or 3 in care. A certificate of NVQ level 2 care qualification was available for inspection in a staff file. A staff member confirmed that she had completed NVQ level 3 in care. The care home has a recruitment and selection policy/procedure. Three staff personnel files were inspected. These contained required documentation including an enhanced Criminal Record Bureau check, but one file did not include evidence of satisfactory references. The manager supplied copies of this documentation to the Commission for Social Care Inspection following the unannounced inspection. The manager reported that all staff receive a staff code of conduct when employed by the care home. Staff informed the inspector of the varied training that they had received. This training includes Ist Aid training, moving and handling training, health and safety training, fire training, and food and hygiene training. Certificates of staff training were available for inspection. A staff member spoke of having completed Person Centred Approach training, fire training and infection control training as well as other statutory training. Staff should have an up to date individual training plan. The registered manager reported that epilepsy training was planned for all staff. Records confirmed that staff complete a comprehensive induction programme. Records of staff supervision were available for inspection. The most recent recorded supervision records of two staff were dated 26/1/06 and 23/2/06. There needs to be evidence that staff receive 1-1 supervision more regularly, particularly in regard to the home being newly registered, and the residents having recently moved into the care home with their varied and sometimes complex needs. A staff appraisal was recorded. Harrow View, 157 DS0000065615.V307149.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 37,39 and 42 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. The management approach of the care home creates an open, positive and inclusive atmosphere. The registered manager is qualified, competent and experienced to run the care home. Arrangements are in place to ensure that effective quality assurance and quality monitoring systems are in place to monitor and improve the quality of the service provision by the care home, but this should continue to be further developed. Arrangements are in place to ensure that so far as reasonably practicable the health, safety and welfare of residents and staff is promoted and protected. EVIDENCE: The registered manager has many years experience of working with residents who have a learning disability. He has worked in care support services for Harrow View, 157 DS0000065615.V307149.R01.S.doc Version 5.2 Page 24 adults with a learning disability since 1986, and has worked in a variety of care and support settings including day services and residential care services. He has also managed a care home with adults with a learning disability prior to managing 157 Harrow View. He has a Diploma in Social Work, BA (hons), and has completed in June 2005 a NVQ 4 in management, and is a qualified moving and handling instructor. He in an existing Responsible Individual for Residential Care Providers Ltd, which includes another care home since 2000. The registered manager spoke of ensuring that he regularly updates his skills by completing varied appropriate training. The home has a quality assurance policy/procedure. The manager reported that a six monthly audit of the service provided by the care home is completed by another registered manager, and that the organisation has an Investors in People Award (2005). Records confirmed that documentation including care plans, and policies are regularly reviewed, and that staff meetings take place. The registered person should ensure that there are questionnaires provided to stakeholders (in and that an annual development plan is completed within the first year that the home is registered. Certificates of worthiness in regard to servicing of electrical and gas safety systems in the care home were up to date. A certificate in regard to the fire system servicing commissioning was also available for inspection. The registered manager reported that the care home was a non smoking service. The radiators are covered and specified to be of low surface temperature, thermostatic controls are on hot water outlets. Records in regard to fire safety requirements including fire drills, weekly fire checks, and staff fire training were available for inspection. Fire safety procedures are displayed in the care home. The care home has an up to date fire risk assessment. There were several bags of clinical waste located in the garden area. The manager reported that arrangements were being made to ensure that they a collected by the appropriate service. The registered person needs to ensure that this action is carried out. There is an accident reporting procedure, and health and safety checks including fridge/freezer checks are carried out regularly. The registered manager spoke of there having been a recent health and safety check of the premises carried out by the Local Authority. The registered person should ensure that there is a risk assessment in regard to kitchen cooking knives, which are stored on the kitchen worktop The employer’s liability insurance certificate was displayed and up to date. Harrow View, 157 DS0000065615.V307149.R01.S.doc Version 5.2 Page 25 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 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 3 X 3 X X 2 X Harrow View, 157 DS0000065615.V307149.R01.S.doc Version 5.2 Page 26 N/A 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 YA19 Regulation 12,13 Timescale for action Recorded staff guidance needs to 01/03/07 be further developed to ensure that staff have knowledge of when to call an ambulance if a resident does not respond to medication administered by staff in response to symptoms of a medical need. 01/01/07 • There needs to be evidence that care staff have received appropriate training from a qualified competent person (i.e. district/community nurse) in regards to the administration of a particular medication. • This medication policy/procedure needs to be accessible to staff at all times, and available for inspection. • The registered manager 01/02/07 needs have knowledge and understanding of when to report significant incidents to the CSCI, • and to ensure that these are recorded in the appropriate DS0000065615.V307149.R01.S.doc Version 5.2 Page 27 Requirement 2 YA20 12, 13(2), 18 3 YA23 17, 37 Harrow View, 157 4 YA36 18(2) 5 YA42 16(k) documentation. • and that the action taken to minimise the risk of the incident occurring again is recorded. There needs to be evidence that staff receive 1-1 supervision more regularly, particularly in regard to the residents varied and sometimes complex needs and the care home being newly registered. The bags of clinical waste need to be removed from the garden area as soon as possible, by the appropriate certified service. 01/03/07 01/02/07 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 YA1 Good Practice Recommendations There should be accessible information about the service in the care home to enable prospective service users and others to gain knowledge and understanding of the service provided by the care home. The initial assessment (HALO) completed by the registered manager should be accessible in the residents care plans. There should be development in regard to recorded staff guidance to meet residents individual behaviour needs, which includes reporting and recording of the ‘incident’. • The format of the menu should be reviewed to improve its accessibility to residents, and it should be prominently displayed. • The registered person should ensure that there are no gaps in the recording of meals eaten by residents It is recommended that a copy of the medication policy/procedure filed with the medication administration records or in the medication storage system. The registered person should regularly review the records of incidents that have occurred in the care home. The registered manager should dispose of waste material/rubbish located close to this outbuilding. DS0000065615.V307149.R01.S.doc Version 5.2 Page 28 2 3 4 YA2 YA6 YA17 5 6 7 YA20 YA23 YA24 Harrow View, 157 8 9 YA30 YA35 The home should have a dishwasher. Staff should have an up to date individual training plan. Harrow View, 157 DS0000065615.V307149.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 Harrow View, 157 DS0000065615.V307149.R01.S.doc Version 5.2 Page 30 - 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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