CARE HOME ADULTS 18-65
High Gable House 292 & 295 Lincoln Road Enfield Middlesex EN1 1SY Lead Inspector
Tony Brennan Key Unannounced Inspection 10th October 2007 10:30 High Gable House DS0000010676.V350191.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 High Gable House DS0000010676.V350191.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. High Gable House DS0000010676.V350191.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service High Gable House Address 292 & 295 Lincoln Road Enfield Middlesex EN1 1SY 020 8804 1115 020 8443 5070 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) Mr V Kowlessur Mr V Kowlessur Care Home 9 Category(ies) of Learning disability (9) registration, with number of places High Gable House DS0000010676.V350191.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. 4 persons of either sex with learning disabilities in 295 Lincoln Road and 5 persons of either sex with learning disabilities in 292 Lincoln Road. Mr Kowlessur must have regular documented supervision and support from the company until he has successfully completed his NVQ level 4 in management. Two specified service users who are over 65 years of age may remain accommodated in the home. The home must advise the regulating authority at such times as either of the specified service users vacates the home. 19th October 2006 Date of last inspection Brief Description of the Service: High Gabel House is a private care home of two separate semi-detached houses located on either side of Lincoln Road, Enfield. One house has four registered places (No. 295) and the other has five (No. 292). Both houses have similar ground floor layouts, a lounge and dining area with kitchen attached to the rear. Each of the houses has a small front garden and a larger back garden that is partly paved and accessible to users. The home is close to a good selection of shops, restaurants, transport links and other community facilities located along the A10 and within Enfield Town. The fees are between £450 and £600 a week. This report is available through the internet. Copies may also be obtained from the provider of this service. High Gable House DS0000010676.V350191.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced key inspection was undertaken as part of the annual inspection programme. I sought to confirm that the seven areas for improvement identified at the last inspection had been addressed. The inspection took place over one day. I was assisted by Mr Kowlessure, the registered person, with the inspection. I spoke with the three people who live at High Gabel House, and two members of staff. I observed care practice and interaction between staff and people living at the home. I toured the building and examined a number of records relating to the care, health and safety and management of the home. I would like to thank the staff that assisted me by answering questions about the running of the home. I would also like to thank the three people who live at the home who discussed their views of the service they receive. What the service does well:
The statement of purpose clearly sets out the philosophy and objectives of the home.The statement of purpose positively promoted the rights of people living at the home to express their diversity. Initial assessments identified the needs of people living at the home. Admissions to the home are made on the basis of a detailed assessment. This ensures the the best outcomes for people who live at the home. Care plans were found to provide detailed information on the support provided to meet the needs of people.One person told me, “ staff are okay, and they treated me fine.” The home involves individuals in the planning of care that affects their lifestyle and quality of life. People said that they could choose from a range of activities. One person spoken to told me, “ theres a lot to do here, go into the church or the pub or Community Link.” People who live at the home are involved in meaningful daytime activities of their own choice, according to the individual interested capabilities. They are fully involved in planning their lifestyles and the activities that they participate in. The menu is prepared at a weekly meeting of people living at home. I saw minutes of these meetings these confirmed that people suggestions. A variety
High Gable House DS0000010676.V350191.R01.S.doc Version 5.2 Page 6 of meals are provided that reflect the individual preferences of people live at the home. I spoke with people who explained that staff provided support and encouragement to maintain their personal hygiene. Personal support is responsive to the varied individual needs and preferences of people who live at the home. Medical needs had been identified as part of the initial assessment and were referred to in care plans and risk assessments. Peoples health needs are addressed to ensure their well-being. The medication policy contained all the required information. The home has an open culture that allows residents to express the views, and concerns in a safe and understanding environment. People who live at the home told me that they could challenge and raise concerns about the way they were treated. The home understands the procedures for safeguarding adults and where necessary provides external agencies with the information they need. I walked around the home and found that the home was clean throughout. There were separate dining and sitting rooms. People were able to choose where they wish to set or spend time in their bedrooms. Maintenance records showed there were no outstanding repairs. The home provides a physical environment that is appropriate to the specific needs of people who live there. People who use the service are encouraged to personalise their bedrooms. I found that the rota showed that a consistent staffing level was maintained. The home was staffed effectively and sufficient staff are provided at busy times of the day to meet the changing needs of people living at home. Training records showed that 50 of staff has either level 2 or 3 in the National Vocational qualification in care. The registered manager showed me a copy of the current training plan. This identified future training needs and how these would be addressed. The home ensures that all staff receive relevant training that is focused on delivery of improved outcomes for people using the service. The home has a stable management and the registered manager has experience and understanding of the needs of people with learning disabilities. The registered manager has the necessary qualifications and experience to manage high Gable house in the best interests of people who live at the home. A system is in place to monitor the quality of the service provided by the home. Theres a strong emphasis on being open and transparent in all areas of running the home. Action to improve the service had been agreed with people who live at the home. People are consulted about how the home is run. High Gable House DS0000010676.V350191.R01.S.doc Version 5.2 Page 7 Minutes were seen of meetings held with people who live at the home to discuss the quality of the service provided. The registered person ensures that the safety risks to people living at the home and staff are identified. People living at the home are aware of safety arrangements and have confidence in the safe working practices of staff. What has improved since the last inspection?
There were six areas for improvement identified at the last key inspection and all have now been addressed. The registered manager explained that the contract for people living at home is now available in a pictorial form. I was able to see an example of this. People spoken to explained that they had been involved in preparing a pictorial contract form. People coming to live at the home receive a contract that outlines their rights and obligations in a way that they can understand. I found that risk assessments had been reviewed to ensure changes to the level of risk were addressed. The risk assessments had been agreed with people or their representatives. Risk assessments were found to cover all areas that affected the people’s daily life. Risk assessments identified the specific risk facing people. These are reflected in care plans. The registered manager has put in place clear guidance on the use of medication as part of managing Peoples challenging behaviour. This outlined when it was appropriate to use medication. Medication is only used to manage peoples behaviour when it is clearly agreed and required to meet their needs. I observed that the carpet in bedroom number two had been cleaned. Also a handrail that was loose had been replaced. The home provides a safe environment for the people who live there. The registered manager explained that since the last key inspection staff had received training on first aid, learning disabilities and challenging behaviour. The home ensures that all staff receive relevant training that is focused on delivery of improved outcomes for people using the service. The registered person has applied to the central registration team to be the registered manager for high Gable house. Prior to the inspection I had received confirmation of this from the registered manager and the central registration team of the commission. The registered manager has the required
High Gable House DS0000010676.V350191.R01.S.doc Version 5.2 Page 8 qualifications and experience to run the home to ensure the best outcomes for people. 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. High Gable House DS0000010676.V350191.R01.S.doc Version 5.2 Page 9 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 High Gable House DS0000010676.V350191.R01.S.doc Version 5.2 Page 10 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): 125 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The statement of purpose is an accurate description of the service provided. People’s needs are assessed prior to admission to the home to ensure they receive the care and support required. Contracts are available in a format that is accessible to people who live at the home EVIDENCE: The statement of purpose clearly sets out the philosophy and objectives of the home. I found that the needs of the people case tracked were within a range of those specified in the statement of purpose. The statement of purpose also identified the skills and staffing resources that are to be available to meet the needs of people living at home. As is outlined in the following outcome areas these resources effectively meet the needs of people living at the home. The statement of purpose positively promoted the rights of people living at the home to express their diversity. I discussed the issue of equalities and diversity with registered manager who demonstrated that she would respond positively to people diverse and varied needs. Comments from relatives and professionals confirmed that High Gable House was able to meet the diverse
High Gable House DS0000010676.V350191.R01.S.doc Version 5.2 Page 11 needs of people. Care plans show that a number of people who live at the home attend church regularly. A person commented, “I like living here, they help me to go to church.” I case tracked four people who live at the home and found that there were assessments from the home and care management. Initial assessments identified the needs of people living at the home. This included a history of their needs and any resulting behavioural management issues. These identified the needs of people prior to admission to the home. Admissions to the home are made on the basis of a detailed assessment. This ensures the best outcomes for people who live at the home. There have been no new admissions since the last key inspection. I found that the needs of the people case tracked had been reviewed both by the home and by social workers. People told me they had been consulted about and received feedback from the review. A person told me that his key worker had, “ talked with me about how they would help me.” Changes in needs had been addressed to ensure that people receive a consistent level of care to meet their needs. Since the last inspection the registered manager explained that the contract of people living at home is now available in a pictorial form. I was able to see an example of this. People spoken to explain that they had been involved in preparing pictorial contract form. New people coming to live at the home receive a contract that outlines their rights and obligations in a way that they can understand. High Gable House DS0000010676.V350191.R01.S.doc Version 5.2 Page 12 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): 679 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Care plans provided detailed information on the needs of people living at home. People are supported to make decisions about their lives. Risks to service users are assessed to ensure their safety. EVIDENCE: Care plans were found to provide detailed information on the support provided to meet the needs of people. Care plans were personalised and referred to the cultural needs of people. This included whether or not they wish to take part in religious practices. There was also information on peoples’ interests. People I spoke to told me that they felt staff understood their needs. One person told me, “ staff are okay, and they treated me fine.” High Gable House DS0000010676.V350191.R01.S.doc Version 5.2 Page 13 I found that care plans had been developed with the involvement of people living at home. People case tracked told me that they had been consulted about their views of the support they required. I observed that staff took time to understand people and do things in the way they had been asked. I observed that staff asked people about going out. People wanted to go to Edmonton Green and staff supported them to do this. The home involves individuals in the planning of care that affects their lifestyle and quality of life. People felt that staff understood their views and wishes regarding how they wanted to live in the home. Care plans generally identified the cultural, religious and disability issues facing people living at home. I observed that one of the people living at home was enjoying reading. Staff spent time discussing the book with him and encouraged him to express his views. Details of behaviour that might challenge the service of people living in the home were identified in their risk assessments and care plans. Actions to address and manage these behaviours are outlined in detail. Where appropriate staff and discussed and recorded the views of those people living at the home whose behaviour might be challenging. Staff spoken to understood both the general principles, and specific needs of people living at the home with regards to managing challenging behaviour. I found that since the last key inspection risk assessments had been reviewed to ensure changes to the level of risk were addressed. The risk assessments had been agreed with people or their representatives. Risk assessments were found to cover all areas that affected the people’s daily life. Risk assessments identified the specific risk facing people. These are reflected in care plans. Staff were able to describe how they prevented risks to ensure that people were safe and were supported to exercise control over how they live. Risks relating to behavioural issues were identified and actions to prevent or lessen the level of risk were discussed in team meetings. I observed that staff engaged with people living at home in an appropriate adult way. A comprehensive risk assessment that is reviewed regularly is in place to ensure the safety and independence of people living at the home. High Gable House DS0000010676.V350191.R01.S.doc Version 5.2 Page 14 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): 12 13 15 16 17 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are supported to engage in a range of activities that meet their needs. People have community contacts and are supported to maintain personal relationships. People are supported to maintain a nutritious diet that reflects their personal choice. EVIDENCE: People said that they could choose from a range of activities. People spoken to gave examples of activities these consisted of going to the pub or other local community groups and listening to music. Daily notes and care plans confirmed that people were regularly involved in activities both in and outside of the home. People spoken to told me that they had been consulted and could choose from a range of activities. One person told me, “ theres a lot to
High Gable House DS0000010676.V350191.R01.S.doc Version 5.2 Page 15 do here, I go into the church or the pub or community link.” Care plans and daily notes also confirmed that a number of people living at home attend day centres. All the people case tracked had individual activities are planned. This outlined what activities they are involved in throughout the week. The support they needed to participate in these activities was outlined in their care plans and risk assessments. People who live at the home are involved in meaningful daytime activities of their own choice, according to the individual interested and their capabilities. They are fully involved in planning their lifestyles and the activities that they participate in. People spoken to confirmed that they were involved in the cleaning of their bedrooms and cooking. People are able to make hot drinks whenever they wish to. Daily records showed that people were supported to maintain contacts with family and friends. People living at home were enabled to develop contacts in the local community. The menu is prepared at a weekly meeting of people living at home. I saw minutes of these meetings these confirmed that people suggestions for meals were recorded. People spoken to confirmed that they had been involved in preparing the menu. The registered manager explained that the weekly meeting is held to plan the menu and staff accompany people living at home and support them to do the weekly shopping. The menu is varied and reflected the cultural and dietary needs of individuals. A person told me, “ the food is lovely. Staff asked me what I like to eat.” I observed that there were fresh vegetables and fruit available. One person explained that they had been involved in doing the weekly shopping. He told me, “I go shopping with staff.” I saw that meals were well presented and were provided in a relaxed and supportive environment. A variety of meals are provided that reflect the individual preferences of people who live at the home. High Gable House DS0000010676.V350191.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 People who use this service experience good outcomes in this area. This judgement has been made using available evidence, including a visit to this service. People are supported with their personal care needs to maintain their independence. People are able to access the medical care they need. People are protected by safe procedures for handling medication. EVIDENCE: Care plans outlined the support people require and how they could be supported to maintain their independence in doing their personal care. I spoke with people who explained that staff provided support and encouragement to maintain their personal hygiene. People living at the home are self-caring. Staff provide support to maintain peoples personal care through prompting. Male and female carers are employed in the home to ensure that those people who prefer same gender care can be supported sensitively. Personal support is responsive to the varied individual needs and preferences of people who live at the home
High Gable House DS0000010676.V350191.R01.S.doc Version 5.2 Page 17 Medical needs had been identified as part of the initial assessment and were referred to in care plans and risk assessments. I spoke with people living at the home who told me that staff support them to follow a healthy diet. People confirmed that they had been supported by staff to attend hospital appointments. Daily notes recorded that people had access to the opticians, dentists and chiropodists services. Peoples health needs are addressed to ensure their well-being. The medication policy contained all the required information. I found that records for the administration of medication were complete. Records of medication received and returned were also complete. All medication was held securely. People’s medication had been reviewed regularly to ensure their continued well-being. Since the last inspection the registered manager has put in place clear guidance on the use of medication as part of managing Peoples challenging behaviour. This outlined when it was appropriate to use medication. It clearly stated the types of behaviour that would indicate that it was appropriate to use medication. Medication is only used to manage peoples behaviour when it is clearly required to meet their needs. Daily notes showed that health professionals had been consulted to ensure that people were receiving the medicines they required. Training records and discussions with staff confirmed that they had received training on the safe administration of medicines. Advice was available for staff on the side effects of medication. Medication is administered by staff that are properly trained to ensure the safety of people living at home. High Gable House DS0000010676.V350191.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 People who use this service experience good outcomes in this area. This judgement has been made using available evidence, including a visit to this service. People can be confident that their complaints are listened to and acted upon. Adult protection procedures protect people from abuse. EVIDENCE: People told me that they understood how to make a complaint. The complaints policy explained how to make a complaint and how it would be dealt with. The complaints policy is available in a pictorial format so that people who live at the home are supported to share their concerns. Copies of the complaints policy were available around the home for people to consult when necessary. The complaints procedure is available in a number of formats to help anyone living at home, or involved with, the service to complain or make suggestions for improvement. Staff explained that people are encouraged to discuss their views of the service in weekly meetings. The home has an open culture that allows residents to express the views, and concerns in a safe and understanding environment. People who live at the home told me that they could challenge and raise concerns about the way they were treated. The inspector observed staff approach people and this was done appropriately and sensitively. There were
High Gable House DS0000010676.V350191.R01.S.doc Version 5.2 Page 19 policies on handling abuse and adult protection. Training records showed that staff had received training in adult protection. I spoke with staff and they demonstrated their understanding of adult protection issues. There had been one adult protection strategy meeting since the last inspection. The homes management had responded appropriately to this. The allegation was found after investigation to be not proven. The home understands the procedures for safeguarding adults and where necessary provides external agencies with the information they need. High Gable House DS0000010676.V350191.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 30 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a home that provides a safe and homely environment. The home is clean and hygienic. EVIDENCE: I walked from the home and found that the home was clean throughout. There were separate dining and sitting rooms. People were able to choose where they wish to sit or spend time in their bedrooms. Maintenances records showed there were no outstanding repairs. High Gable House DS0000010676.V350191.R01.S.doc Version 5.2 Page 21 The home provides a physical environment that is appropriate to the specific needs of people who live there. I observed that toilets and bathrooms had been adapted with raised seats to ensure easy access for people that live at the home to use them safely. The well maintained environment provides specialist aids and equipment to meet the needs of people who live at the home. I observed that since the last inspection the carpet in bedroom number two had been cleaned. Also a handrail that was loose had been replaced. The home provides a safe environment for the people who live there. Bedrooms were personalised with items of furniture and pictures belonging to people who live at the home. People living at home and chosen how they wanted their bedrooms decorated. People spoken to were pleased with their bedrooms and told me they had chosen items to bring with them when coming to live at the home. People who use the service are encouraged to personalise their bedrooms. Appropriate measures are in place to prevent cross infection. The home has detailed policies on the prevention of cross infection. Staff have received training on infection control measures. Staff spoken to understood how to work to minimise the possibility of cross infection. Staff confirmed that they had access to disposable gloves and aprons. Liquid soap and paper towels were available throughout the home. High Gable House DS0000010676.V350191.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 34 35 People who use this service experience good outcomes in this area. This judgement has been made using available evidence, including a visit to this service. Sufficient staff with the necessary skills are available to meet the needs of people. A training plan is in place that identifies all areas of training needed to meet the needs of people living at home. People are protected by the home’s recruitment procedures. EVIDENCE: I found that the rota showed that a consistent staffing level was maintained. The rota also showed that staff were on duty to provide escorts to appointments and support with activities when this was necessary. On the day of inspection I observed that people were supported to go out of the home into the local community. There was sufficient staff available for this to happen. One person I spoke to told me, “ I needed to visit the doctor, staff were there to come with me.” Staff spoken to confirmed that sufficient staff were available at all times. People living at home told me that there is enough staff to provide them with the support and care they need. Sufficient staff are
High Gable House DS0000010676.V350191.R01.S.doc Version 5.2 Page 23 provided at busy times of the day and to meet the changing needs of people living at home. The registered manager explained that since the last key inspection staff had received training on first aid, learning disabilities and challenging behaviour. I was able to confirm this as Training records showed that staff had been on these training courses. The home ensures that all staff receive relevant training that is focused on delivery of improved outcomes for people using the service. The registered manager showed me a copy of the current training plan. This identified future training needs and how these would be addressed. Training records confirmed that all staff are up to date with, and had all the statutory required training. Staff commented that the registered manager positively encouraged them to go on training to develop their skills and understanding of the needs of people. Training records showed that 50 of staff has either level 2 or 3 in the National Vocational qualification in care. Staff files had been examined at the last key inspection and were found to contain all the necessary documentation relating to the recruitment and appointment of staff. Two new staff have been appointed since the last key inspection Staff go through an interview process and there were notes to confirm this. People can be confident that they are protected by the home’s recruitment procedures. High Gable House DS0000010676.V350191.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 People who use this service experience good outcomes in this area. This judgement has been made using available evidence, including a visit to this service. The registered manager has the skills and understanding to manage the service in the best interests of people. People’s views of the service are sought and used as the basis for improvement. People who live at home and the staffs health and safety is always promoted and safeguarded. EVIDENCE: The home has a stable management team and the registered manager has experience and understanding of the needs of people with learning disabilities. Staff and people spoken to confirmed that they felt that the registered manager was supportive and approachable. The registered manager has a
High Gable House DS0000010676.V350191.R01.S.doc Version 5.2 Page 25 number of year’s experience of managing services for people with learning disabilities. The registered manager has the necessary qualifications and experience to manage high Gable house in the best interests of people who live at the home. Since the last inspection the registered person has applied to the central registration team to be the registered manager for high Gable house. Prior to the inspection I had received confirmation of this from the registered manager and the central registration team of the Commission. The registered manager has the required qualifications and experience to run the home to ensure the best outcomes for people. A system is in place to monitor the quality of the service provided by the home. The registered manager explained that he carries out quality monitoring on a regular basis. Theres a strong emphasis on being open and transparent in all areas of the running of the home. The registered manager explained that an action plan is developed to address any areas for improvement that are identified. I was able to see these action plans and confirmed that issues raised were addressed. Ideas for improvement are sought. People are consulted about how the home is run. Minutes were seen of meetings held with people who live at the home to discuss the quality of the service provided. Action to improve the service had been agreed with people who live at the home. The registered person ensures that the safety risks to people living at the home and staff are identified. Measures are put in place to provide a safe living and working environment. Records showed that fire equipment was tested regularly and maintained. Drills were taking place. The fire risk assessment provides details of potential risks of fire. All health and safety policies were available. Certificates for gas and electrical testing were in date. COSHH guidance now in place and chemicals were stored safely. Training on health and safety topics was complete. People living at home have been involved in identifying safety issues. People living at the home are aware of safety arrangements and have confidence in the safe working practices of staff. High Gable House DS0000010676.V350191.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 X 3 3 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X 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 3 3 x 3 X 3 X X 3 x High Gable House DS0000010676.V350191.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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations High Gable House DS0000010676.V350191.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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
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