Inspection on 03/04/07 for Hornsey Lane (148)

This inspection was carried out on 3rd April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hornsey Lane (148) 24/01/06

Hornsey Lane (148) 13/07/05

Hornsey Lane (148) 20/09/04

Hornsey Lane (148) 18/05/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Hornsey Lane (148) 148 Hornsey Lane Hornsey London N6 5NS Lead Inspector Edi O`Farrell Unannounced Inspection 3rd April 2007 10:00 Hornsey Lane (148) DS0000020970.V288062.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 Hornsey Lane (148) DS0000020970.V288062.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. Hornsey Lane (148) DS0000020970.V288062.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hornsey Lane (148) Address 148 Hornsey Lane Hornsey London N6 5NS 020 7272 3036 0207 263 3092 james.brady@familymosaic.co.uk 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) Family Mosaic Housing Association Mr James Brady Care Home 12 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (12), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (12) Hornsey Lane (148) DS0000020970.V288062.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Home for up to 12 adults with mental health needs Date of last inspection Brief Description of the Service: 148 Hornsey Lane has been operating since 1994. It is a registered Care Home, which provides personal care and accommodation for up to 12 adults who have enduring mental health needs. The home can admit people over or under the age of 65, so long as comprehensive assessment has shown that the needs can be met. The Care Home is a detached house on three floors with a pleasant garden and patio area at the rear. There is a lift to all floors. All bedrooms are single, with shared toilets and bathrooms on each floor. One bedroom is on the ground floor. The building has full disabled access. There is an art room and communal space on the first and second floor can be used for meetings and group work. Family Mosaic Housing Association manages the home. The Home provides 24hour support and has a staff team comprising a registered manager and staff who have various relevant qualifications, skills, experience and training. A comprehensive care planning and keywork system is used to promote independence, choice, and well-being. 148 Hornsey Lane is situated in a residential area in North London and is near Hornsey, Highgate and Archway. Fees, if payable, are from £65.35 to £94.45. Some residents do not pay as they are covered by mental aftercare legislation. Hornsey Lane (148) DS0000020970.V288062.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit for this, unannounced, key inspection took place on a weekday during the morning and early afternoon. It took a total of 4.45 hours, and was carried out by one inspector. Prior to the site visit all information about the home that we had received since the last inspection was reviewed. This included any significant events, such as any complaints or allegations, deaths, and incidents. The manager completed a pre-inspection questionnaire that gave us up-to-date information about policies and procedures, and residents. The manager also sent us several very useful documents, such as the latest six monthly quality monitoring report that he prepares for the people who commission the service. We sent postal surveys to all the residents, with six being returned. All the above information was used to develop a site inspection plan. This focused on assessing the key standards that we were not able to assess without a visit to the home. During the site visit we spoke to service users, staff, and the manager. We also looked at written records, such as care plans and keyworker sessions. We looked round the building but did not go in any bedrooms. We also looked at some of the policies and procedures, staff training and recruitment records, and minutes of staff and house meetings. We have used all the information to form the judgements in this report. We left a feedback form with the manager so he could let us know how he felt the inspection was conducted. Residents and staff are thanked for their hospitality and input to the inspection process. What the service does well: In both postal surveys and discussion during the site visit the majority of service users liked the home, and thought the staff listened to them and acted on their views. This reflects the findings of the six monthly in-house surveys. The level of satisfaction has been constant over a considerable period of time. Service users’ views are acted upon. An example of this is the appointment of the community link adviser. This was in response to service users placing a high importance on community involvement. This has lead to increased opportunities for service users, including one taking up paid employment. Hornsey Lane (148) DS0000020970.V288062.R01.S.doc Version 5.2 Page 6 Whilst knowledgeable about psychiatric conditions the staff team place an emphasis on how enduring mental health problems affect peoples’ day-to-day lives. They provide support and encouragement to enable people to be as independent as possible, and to learn new skills. They get past the psychiatric diagnosis to work with each service user in a positive way. There is a very individualised and person centred approach. This allows each person living at the home to identify the things they want to change, and to do so at their own pace. This approach is also used with people who are thinking of moving into the home. The home recognises that this is an important decision and plan with the person so any move is as positive, and anxiety free, as possible. This approach identifies diverse needs, due to such things as age, level of disability, and racial origin, at an early stage. This means that plans are in place to meet these needs before the person moves in. The house is homely, airy and bright. It is well furnished, and there is a pleasant garden area, which has very recently been worked on by a service user and a member of staff. This is a good example of how service users and staff work together to continuously improve the service. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hornsey Lane (148) DS0000020970.V288062.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 Hornsey Lane (148) DS0000020970.V288062.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 4 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Prospective service users’ individual aspirations and needs are comprehensively assessed. EVIDENCE: Four residents, out of six returned surveys, stated that they had chosen to move into the home, and had information about it before doing so. The information seen during the site visited supported that view. The two most recent people to be admitted were case tracked. This involved meeting them to discuss their care. It also involved studying their case files, and the case file of a service user where the risk had been considered too great, and the move had not gone ahead. In all three cases pre-admission assessment was comprehensive. It included visits by home staff to the people where they were living at that time. These visits were undertaken by two members of staff, and documented in detail. There were very clear objectives for each visit, and very clear actions to achieve specific outcomes. The number of visits was based on the individual needs and personalities of each service user. For example, where a higher level of anxiety about moves was known to trigger relapse a greater number of visits were carried out over an extended period of time. Hornsey Lane (148) DS0000020970.V288062.R01.S.doc Version 5.2 Page 9 Staff have put together a large photo collection of the home, and various activities, which they take along to the visits. This enables people to get a feel for the home, and the people living and working there, prior to their first visit. The visits were followed by individually tailored introductory visits to the home. These were again well documented, identifying the type of support needed. The visits ranged from a few hours, to over night, and week stays. Once the service user moved in there was a trial period of 12 weeks, following which a Care Programme Approach (CPA) review was held. Community Care and CPA assessments and review documents were on the three files. There were also case summaries from psychiatrists and care coordinators. The home’s own assessment was risk management and objectives focused. This was then used to develop an initial six week care plan. The home’s assessment process had a very person centred focus, taking account of individuality and diversity. The views, wishes, and aspirations of the service users were central. Hornsey Lane (148) DS0000020970.V288062.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 & 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users’ needs, wishes, and aspirations, are set out in detailed care plans, which they are fully involved in planning and delivering. EVIDENCE: The short term care plan is agreed between the keyworker and service user following admission. The process provides an opportunity for both to put objectives in writing, and come to agreement as to key objectives, actions, and support needs. Two weekly keywork sessions are then used to review progress. There was ample evidence of the pace being set by the service users, for example in registering with a local GP. This was balanced by staff using a variety of approaches to remind and support service users in carrying out this task. The individual and person centred approach to care planning ensures that diversity is recognised and responded to at an early stage. This is important, as the resident group is diverse in terms of age, level disabilities and racial Hornsey Lane (148) DS0000020970.V288062.R01.S.doc Version 5.2 Page 11 origin. They are also becoming more diverse in terms of background, as new people move in from the community. There was very good follow through to the care plans from the information collected prior to the person moving in. This included the identification of possible triggers to mental health relapse. It also included indicators of wellbeing. Once the 12 week trial period is completed and the service user, multidisciplinary team, and the home agree that the placement is suitable, a longer term care plan is agreed. This again is person centred, with the service user identifying objectives, and timescales. Service users make the decisions about the length and frequency of keywork sessions, and all documents such as care plans and both the service user and the keyworker sign keywork records . Rights, responsibilities, and risk, are well balanced. Individuality and choice are key elements of this service, and this is reflected throughout all documentation. The two service users case tracked stated that the home met their needs well. They enjoyed, and got a lot from, their keywork sessions, and living in a community. They felt supported in doing the things they wished to, but not pressurised. Hornsey Lane (148) DS0000020970.V288062.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 15, 16 & 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are supported to achieve their maximum potential. This includes personal relationships, lifestyle, and the development of new, including daily living and social, skills. EVIDENCE: Service users said that they enjoyed living in the home. There was a lot of evidence of their involvement in the running of the home. This included each having allocated tasks, such as sweeping the patio. These were incorporated into the care plans, and personal objectives, so they contributed to personal development. Because record keeping is so good, it is possible to see small changes over a period of time. These changes are often due to increased confidence and self-esteem. Staff are experienced and competent in using the daily routine as a therapeutic process, in both practical and psychological ways. For example, Hornsey Lane (148) DS0000020970.V288062.R01.S.doc Version 5.2 Page 13 assisting with bedroom cleaning, also being used to discuss personal and environmental hygiene. This then being followed up in keywork sessions. House meetings are held weekly, with both service users and staff being able to voice their views. Records demonstrated that the meetings are well used. Since the last inspection a community link advisor has been working with the staff and service users. Their role is to research and liaise with external agencies to identify resources and feed the information back to service users and staff. This role was introduced in June 2006 and has seen good progress. Applications have been made to a number of London attractions for concession tickets. One person has undertaken a computer course, and is due to start a job. This post was established directly as a result of a service user survey, where community involvement was seen as a high priority. Service users take turns to cook the communal evening meal. This can often be a daunting prospect to new service users. Staff, and other service users, support and advise, to the level needed. This approach has developed some excellent cooks. Service users have chosen to eat as much organic food as possible, and the menu is varied. One of the service users spoken to had cooked the previous evening. She had greatly enjoyed baking a homemade steak and kidney pie, which everyone thought was really good. It was particularly positive to hear in the morning handover that some staff had learnt how to make the dish as well. This demonstrates the shared approach to care that the home takes. Hornsey Lane (148) DS0000020970.V288062.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users’ personal and healthcare needs are met in sensitive ways that maintain their independence and dignity. EVIDENCE: Three case files were examined in detail, including medication records. Individual needs were discussed with two service users, the manager, assistant manager, and some support workers. A great deal of care is taken by the home in collecting and checking health and personal care information prior to and after admission. They take time to get to know each individual as a person. This helps them to work with each service user to identify what support is needed. This is with an emphasis on the service user’s independence and them taking action, such as attending clinic appointments. This is very important for service users, who have often been in health settings, where they may have lost some skills and confidence. As a mental health service psychological well-being is a focus, but this is accompanied by attention to physical well-being. As a majority of service users are older people they have physical conditions associated with aging. Hornsey Lane (148) DS0000020970.V288062.R01.S.doc Version 5.2 Page 15 These are well documented and responded to. In addition many of the service users are on complex medication regimes, with potential side effects. Staff were able to describe the use, and possible side effects of, these medications. Important checks, such as blood level tests, and appointments for depot injections, were recorded. Nationally a criticism of mental health services has been that compliance with medication is generally the major focus of treatment and support. Whilst acknowledging the importance of medication the home puts this within a social care context. Combined with the person centred approach this promotes rehabilitation and well-being. The home uses a monitored dosage system for medication, and those checked were correct. There is a daily audit of all none monitored dosage medication. Where medication is prescribed and staff have not come across it before they research it, and share the information with colleagues. Hornsey Lane (148) DS0000020970.V288062.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are actively encouraged to raise concerns and complaints, and to work with staff towards resolution. They are protected by the home’s policies’ procedures and practices. EVIDENCE: There have been no formal complaints recorded since the last inspection. However complaints and suggestions are a fixed agenda item at the weekly residents’ meeting. The records seen supported the view of the manager in the last six monthly monitoring report. “It is clearly noticeable during house meetings, that residents have become increasingly confident to openly raise the issues that affect or worry them” The two service users spoken to felt able to raise any concerns in the meeting, with staff, and with other service users. Keywork records demonstrated that any concerns were followed through to resolution and agreed outcomes. Since the last inspection staff have attended safeguarding adults training. Two were asked how they had applied what they learned to their work. They saw open communication between service users and staff as key, as well as knowing service users well; including what would constitute unusual behaviour. They were also clear about the differing kinds of abuse, and this was reflected in the care plans seen. For example, identifying the potential for financial abuse where the service user had tried to give an unusually large tip. Hornsey Lane (148) DS0000020970.V288062.R01.S.doc Version 5.2 Page 17 The general vulnerability to abuse of people with mental health problems was also recognised, and where necessary reflected in the care plans. Increased confidence, self-esteem, and awareness were seen as central to service users avoiding unnecessary risk. Hornsey Lane (148) DS0000020970.V288062.R01.S.doc Version 5.2 Page 18 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 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users live in a homely, comfortable, and safe environment. EVIDENCE: The building was toured at the start of the visit, though no bedrooms were visited. The service users spoken to preferred to be seen in the office. All parts of the home seen were clean, tidy and well decorated. Furnishing and fittings are to a good standard, and the home has a light and airy feel. The day before the visit a service user and staff member had worked hard in the garden stocking the flowerbeds. This gives an extremely pleasant outdoor space for when the warmer weather comes to stay. There is good attention to detail, such as attractive planters at the front door, and pictures and ornaments in communal areas. The available space is used well. For example, the bedrooms on the first and second floor lead off sizable rooms. These are furnished with easy chairs, and used for therapeutic groups, and individual keywork sessions. There is an art room, with examples of recent work displayed on the walls. , Hornsey Lane (148) DS0000020970.V288062.R01.S.doc Version 5.2 Page 19 Since the last inspection two bedrooms, the lounge, dinning room and kitchen have been redecorated. New flooring has also been laid in the kitchen. Further redecoration to communal areas and bedrooms is planned for Spring 2007, and the outside of the house is also going to be painted. The staged approach to the redecoration reduces any negative impact on the lives of both service users and staff. Hornsey Lane (148) DS0000020970.V288062.R01.S.doc Version 5.2 Page 20 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 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are supported by a competent, well trained, and experienced, staff team. EVIDENCE: The home has a very low sickness level with only four days in a six-month period. Low sickness levels are a positive indicator of the stability and high level of functioning of a staff team. During the site visit staff were observed in the morning handover, and generally carrying out their duties. Three carers were asked about their work, and supervision and recruitment records were examined. Two service users were asked their views on staff, and how they treated them. In survey service users were generally very positive about staff. In the handover staff demonstrated a good understanding of the individual personalities of each service user. It was very positive to hear them discuss the achievements of service users, and then to be able to match these with care plan information. Concerns about the current health of individuals were discussed in sensitive ways, with appropriate action being agreed. As with Hornsey Lane (148) DS0000020970.V288062.R01.S.doc Version 5.2 Page 21 other elements of this service there was always follow through, i.e. who would do what, when, and how. Observation, discussion, and examination of the care plans, demonstrated that the staff team has a sound understanding of enduring mental illness. It also demonstrated that this is within a social model of care, with independence, choice, and well-being at the core of all interventions. This is coupled with a very genuine concern for service users, and warm relationships, based on mutual respect. There were some excellent examples of the staff team working closely with the multi-disciplinary team to enable service users to avoid hospital admission. The high standard of the keywork session records demonstrated a reflective practice approach by staff. Staff clearly think about the work they are doing, and change approaches as, and when, needed. They are able to use a range of psychological approaches, in order to meet individual need. Where specialist in-put will benefit service users, such as analytical group work, this is bought in. This is currently being done for the weekly feelings and reminiscence groups. Two recruitment files were examined and all necessary documents were in place. There are eight care staff, with 6 holding NVQ2 or above. All staff hold current first aid certificates. There is a comprehensive staff training programme, which is job related. In the past year this has included understanding mental health, assessment support planning and review, moving and handling, medication, boundaries and ethics, POVA, tenant involvement, H & S, diversity, and care planning in mental health. Two staff will commence NVQ3 in April ’07 and the deputy attended management development training in March 2007. As new members of staff commence a personalised induction plan is devised. These are tailored to meet residents’ needs and governing legislation. There is an emphasis on self-development and the skills and attributes specific to the role. Staff training needs are discussed and identified in supervision and the appraisal process and are undertaken in line with Skills for Care Common Induction and Foundation Standards. Training is then organised against the 10 induction and foundation standards. Safeguarding adults, and diversity, training is seen as a high priority, as is new legislation. It was very positive to see that training in preparation for the full implementation of the Mental Capacity Act 2005 was on-going. Hornsey Lane (148) DS0000020970.V288062.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42 & 43 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well run home, where their views are sought and acted upon for service improvement EVIDENCE: An excellent element of this service is the way that policies, procedures, processes, and practice, follow on and through to successful outcomes for service users. For example, staff supervision and appraisal is used to identify training needs based on the needs of the service and residents. The training programme is structured to meet these training objectives, and the Skills for Care standards. These feed into the NVQ programme. Important new policy and legislation is included, such as the Mental Capacity Act 2005. Record keeping and storage is excellent, with the most important documents, such as care plans, being the most readily to hand. However, they are also Hornsey Lane (148) DS0000020970.V288062.R01.S.doc Version 5.2 Page 23 categorically working documents, as opposed to paper exercises, as in some services. Responsibility for key tasks, such as medication or health and safety, is delegated to team members. This has a number of benefits on top of ensuring that tasks get carried out. It ensures that the home continues to run smoothly in the absence of the manager. It contributes to the career development of individual staff, and to effective team building. The manager completes a six monthly in-house quality assurance report, which he sent to us prior to the site visit. This includes service user surveys, which are conducted by service users so remain independent of staff. The manager also sent us a copy of a social services report regarding the reletting of the contract. This states that service users have expressed a high level of satisfaction and confidence in the home. Contracts and commissioning officers have also commented positively about the service quality. The organisation also carries out an annual service user survey, independent of the home. Islington adult social services and the provider have agreed a new five year contract as of April 2007. This has an option to extend for a further two years. This provides flexibility in ensuring the continuity of high quality care for older people with functional mental health needs. The contract will be subject to a continuous improvement regime. Since the last inspection there has been a merger with a larger housing association. This has increased the infrastructure capacity for things such as finance and personnel. The home maintains excellent health and safety records. A sample were checked and found to be fully up to date. Hornsey Lane (148) DS0000020970.V288062.R01.S.doc Version 5.2 Page 24 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 4 2 4 3 4 4 4 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 4 4 X LIFESTYLES Standard No Score 11 4 12 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 X 4 4 4 4 4 4 4 Hornsey Lane (148) DS0000020970.V288062.R01.S.doc Version 5.2 Page 25 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 Hornsey Lane (148) DS0000020970.V288062.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Camden Local Office Centro 4 20-23 Mandela Street London NW1 0DU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hornsey Lane (148) DS0000020970.V288062.R01.S.doc Version 5.2 Page 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!