Inspection on 30/08/06 for Kiver Road (128)

This inspection was carried out on 30th August 2006.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kiver Road (128) 08/02/06

Kiver Road (128) 17/12/04

Kiver Road (128) 07/07/04

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 09/07/2008.

CARE HOME ADULTS 18-65 Kiver Road (128) 128 Kiver Road Finsbury Park London N19 4PQ Lead Inspector Ms Edi O’Farrell Unannounced Inspection 30th August 2006 11:05 Kiver Road (128) DS0000020965.V287322.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 Kiver Road (128) DS0000020965.V287322.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. Kiver Road (128) DS0000020965.V287322.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kiver Road (128) Address 128 Kiver Road Finsbury Park London N19 4PQ 020 7700 2807 0207 700 0085 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) Centre 404 Ms Rachel Wallis Care Home 3 Category(ies) of Learning disability (3), Physical disability (3) registration, with number of places Kiver Road (128) DS0000020965.V287322.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 08/02/06 Brief Description of the Service: Kiver Road is a registered care home for three people with learning disabilities and physical disabilities. The home is a small family-type home, and aims to provide a ‘home for life’. The property is owned by Mosaic Homes, and is managed by Centre 404, a local voluntary agency. Centre 404 provides other services, which residents can access, for example a Family Support Service and ‘Clubs’. Kiver Road is managed under the organisation’s housing section. There is a staff team of registered manager, senior support worker, and support workers. During daytime hours two staff are on duty on each shift. A member of staff ‘sleeping in’ covers night hours. One of the support workers lives in, which provides additional help, if required. The property is a flat on the ground floor of a purpose built block situated in a close, just off Holloway Road, North London. There are three bedrooms, laundry room, adapted shower, bathroom, kitchen/diner and a lounge. There is an enclosed garden to the rear. All parts of the building have disabled access, though the bath is not suitable for use by anyone with restricted mobility. The home is close to public transport; thought the level of disability of the service users restricts their access. Holloway Road and the surrounding area have a range of shops, cinema, restaurants and cafes, leisure centre, and public houses. The full charge is £324.88 per week, with service users contributing £62.35, and the local authority paying the remainder. Service users pay for their own toiletries, outings and holidays, and clothing. Any other additional charges should always be agreed with the service user. Where they are unable to give informed consent then agreement should be made with their relatives and placing social workers. Kiver Road (128) DS0000020965.V287322.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 inspection was unannounced. It was carried out on a weekday from 11.05 to 4.05. Paperwork was looked at, the building toured, and discussions held with the manager and staff whilst the service users were out. Staff were observed with two of the three service users when they came home from the day centre. The third person was on holiday in Skegness. Prior to the visit the manager completes a pre-inspection questionnaire. This gives us information about any changes that have happened since the last inspection. This helps us to plan our visit. The three service users completed an easy read version of our service user (resident) survey. The manager arranged for someone independent of the home to help. Service users said what they thought about the home, and also about the form. ‘Think this is not best way of getting my words across’. ‘Please can you review the format’. ‘Having someone else filling the form in does not fully get my exact words across’. We will look at different ways of getting these service users’ views for future inspections. Surveys were also sent to service users’ relatives, two of which were returned to the Commission. Information received from the home since the last inspection, such as incident reports, was reviewed prior to the visit. The two service users seen communicate mainly by sound and behaviour, due to the level and type of their disabilities. This means that many of the judgements in this report have to be made based on the views of others, such as relatives and staff, and on the records kept by the home. Observation of staff and service users has also been used. Care plans and daily records were examined, and compared to the care being provided. Staff were asked about recent training and what support and supervision they receive. They were also asked what they thought the home did well, and what could be done better. The flat was toured, and the requirements set at the last visit were discussed with the manager. A questionnaire was left at the home for the manager to let the Commission know how she felt the inspection went. All who contributed to the inspection are thanked for their time. In particular the three service users, and independent person, who completed the survey. Their views on the format will be acted upon. What the service does well: Kiver Road (128) DS0000020965.V287322.R01.S.doc Version 5.2 Page 6 This is a very individualised service, where choice, dignity, respect and rights are given a high priority. Staff and service users have a warm relationship. Staff are knowledgeable about the needs of the service users, and how they prefer them to be met. Service users say that they make decisions about their daily life. ‘I have a daily routine I am happy with, and could change this when I wanted to.’ Assessment and care planning is of a high quality, as is daily record keeping. Thought is given to maximising independence within the home. An example is the use of contrasting colours for the seats and the carpet in the lounge. This means that one service user, who has cataracts, can move round safely, and independently. Service users, and relatives, indicate, via surveys, satisfaction with the service. They feel that staff treat them well. ‘Always asked my opinion, activities and movements etc. always explained, treated as an equal’. Staff feel that they, and service users, are listened to and that their views are acted upon. They describe the manager as ‘approachable’. They receive regular, structured, supervision and have access to training appropriate to their jobs. The home is well managed with robust systems for health and safety checks and quality assurance. What has improved since the last inspection? What they could do better: The bathroom is unsuitable for both service users and staff. It is not possible to use a hoist, and the bath is too low for staff to assist service users in bathing. This restricts service user choice, as they are only able to have a shower. Decision-making about the spending of service users’ monies needs to be tightened. This is particularly important where service users do not have capacity to make financial decisions. Families and placing social workers need to be included in any decisions. This can be easily done during the assessment and care planning system at review meetings. Kiver Road (128) DS0000020965.V287322.R01.S.doc Version 5.2 Page 7 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. Kiver Road (128) DS0000020965.V287322.R01.S.doc Version 5.2 Page 8 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 Kiver Road (128) DS0000020965.V287322.R01.S.doc Version 5.2 Page 9 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): 1&2 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Any person moving into the home would have the information, including experiencing the service, they need to make a choice. Service users’ needs are assessed, and their aspirations known. The terms and conditions needed to be clearer about the extras that service users are expected to pay for. EVIDENCE: All required documents are in place and charges are already included in the Service User Guide. There is a new Regulation that has been introduced so that there is transparency about fees and other charges. This helps people when making choices about long term care. Some of the extras are included in the guide, whilst others are not. This is Requirement 1. Two recent examples of the latter are bedroom carpet cleaning, and the purchase of a reclining chair. As the service users do not have capacity to make financial decisions this is dealt with further in the section on protection. The guide is only available in written English. This was discussed with the manager, in terms of equality and diversity. She stated that if a referral was received for someone who needed translated information then this would be done on an individual basis. She also felt that there would be limited usefullness in producing the guide in a pictoral format. This view was substantiated by the service users in relation to our survey form. As one service user put it, ‘ think this is not best way of getting my words across’. Kiver Road (128) DS0000020965.V287322.R01.S.doc Version 5.2 Page 10 Thought has been given to producing information in different formats. In practice the level of disability of prospective service users means that face to face contact with staff is the most useful means of contact. Time spent in the home during the assessment period i.e. for overnight and weekend stays is also more useful than videos or audio tapes. The three service users moved into the home together in 1990. The standard of assessment and care planning is extremely good. It is therefore reasonable to assume that a similar standard would be applied to the assessment of any future prospective service users. Kiver Road (128) DS0000020965.V287322.R01.S.doc Version 5.2 Page 11 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): 6, 7 & 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 are assessed and met, including changing needs. They are supported to take risks as part of an independent lifestyle. Choice, dignity, independence and respect are the underlying prinicples to this service. EVIDENCE: One service user’s file was examined in depth, and compared to the care being given. The assessment and care planning system is excellent. It includes person centred planning, strengths and weaknesses, and robust risk assessment. The risk assessment format is particularly good as it uses a cost/benefit, system. This weighs up the benefits of one course of action against another. For example, service user being supported to use public transport, which would be seen as a very positive step. There is however a risk of loss of benefits, both monetary and practical. Risk assessments and care plans are very orientated to dignity, choice, independence, and respect. For example, privacy in using the toilet is well balanced with risk of falling. Simple environmental changes have been made to enable the two service users with sensory impairment to move round the home unaided. For example the carpet and settees in the lounge are in contrasting colours. There is a Kiver Road (128) DS0000020965.V287322.R01.S.doc Version 5.2 Page 12 raised plaque on one person’s bedroom door, which helps them to identify their own room. The level of disability of the service users presents a challenge to staff in trying to make choice meaningful. Small choices, such as choosing to drink tea or coffee, can be a major step forward. There are appropriate programmes in place, with in-put from members of the community learning disability team, such as occupational, and speech and language therapists. For one person this includes detailed instructions for each meal, which take account of both choice and risk. Staff were observed to follow the guidelines when offering drinks in the afternoon. Kiver Road (128) DS0000020965.V287322.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 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 enjoy a lifestyle that matches their aspirations and abilities. They are actively encouraged to maintain contact with their families and friends. Their rights underpin service delivery. They are offered a healthy diet. EVIDENCE: One service user was on holiday in Skegness. There were photos on the board in the kitchen from a previous holiday where staff had arranged for her to meet up with her mother in Jamaica. Although her mother lives in America there is extended family in the Caribbean. This enabled the service user to both see her mother, and meet other relatives. Another similar holiday is planned for the future. For another service user, whose mother has fairly recently moved away from the borough, staff enable weekly phone conversations. Evidence was seen on file where staff had raised concerns with the provider of the mother’s accomodation when there had been difficulties in her accessing the calls. Staff also assist the service user in making monthly visits to her Mother’s home. Kiver Road (128) DS0000020965.V287322.R01.S.doc Version 5.2 Page 14 The other two service users were met when they came home from the day centre. There is good communication between the centre and the home, via a written record which goes between the two services. One service user had been in a music session, and her facial expressions and sounds indicated that she had enjoyed it. The centre contributes reports to reviews. There are weekly discussion about each service user and what they have been doing. The write ups of these are very detailed, and give a good picture of each person’s lifestyle. Activities includes going to local amenities, such as the pub, massage, attending BBQs with other Centre 404 service users, and attending religious services. One service user commented on the survey form, ‘activities are arranged for every weekend and I can do it or not, the decision is mine’. The logs of each shift also detail what each staff member has done with each service user. Staff were observed to refer to the three people as either the tenants or the ladies, or by their first name. All comments heard were very respectful. There was a warmness observed between staff and service users, with service users being obviously happy to be home. The staff all valued the fact that being a small unit they can offer a highly individualised service. Staff on the pm shift were taking the opportunity of being 1:1 to go out with the two service users out after dinner. The sample menu sent with the pre-inspection information was varied and staff were aware of individual likes and dislikes regarding food. There was a vegetarian dish for the evening meal, which staff were cooking from fresh. Personal development, dignity, respect and choice were well reflected in care plans and risk assessments. Kiver Road (128) DS0000020965.V287322.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): 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 receive personal care in the way they prefer and require. Their physical and emotional health needs are met. The homes medication policy, procedures and practices protect service users. EVIDENCE: Two relatives returned completed surveys. They felt that they were consulted, and kept informed, about the care their relative received. As stated earlier in this report the risk assessments and care plans are very detailed. They include input from professionals, such as occupational therapists, speech and language therapists and district nurses. Guidelines for the giving of personal care reflect dignity, choice and independence. Where there are physical risks, such as vulnerability to pressure sores, these are identified in the care plans. There is monitoring by the district nurse and an air matress. When one service user recently broke her arm staff followed up with fracture clinic how further fractures could be avoided. They identified that at day centre there may be an additional risk, due to there being a larger number of people. As it is thought that the fracture may have occurred by her banging down her arm, lightweight splints are now being used when she is there. The risk assessment includes consideration of how this might restrict Kiver Road (128) DS0000020965.V287322.R01.S.doc Version 5.2 Page 16 her. Specialist agencies, such as the Royal National Institute for the Blind have been involved in assessments, and the advice followed. Self-medication is promoted as much as possible, within a good risk management framework. There are individual, wooden, cabinets in each bedroom. In two cases the keys are kept in the bedrooms. The third person self-medicates with supervision, and the key is kept in a cupboard in the study. This is part of the risk assessment as she can at times get confused. Kiver Road (128) DS0000020965.V287322.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): 22 & 23 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The service is actively seeking the views of service users, and needs to continue to find ways to do so. Current financial systems do not fully protect service users from possible abuse. EVIDENCE: There have been no complaints recorded in the last 12 months. This was discussed with the manager, as it is unusual. The level of disability of the service users means that it is unlikely they will use a formal complaint procedures. This view was reflected in the surveys. Currently there are no advocates involved but Centre 404 has recently appointed a volunteer tenants association facilitator. The manager had already asked him to assist the service users in completing the tenant’s survey. This will be a challenge, but could help the home to start identifying ways for the service users to raise any concerns. The surveys completed by relatives stated that they knew about the procedure, but had never had to use it. Staff have had adult protection training and understand what constitutes abuse. The concern is the use of service users monies to pay for carpet cleaning and reclining chairs. This is not stated in the contract, Statement of Purpose or the Service User Guide. Neither had the payments been agreed as part of a care plan, or agreed with relatives and social workers. There are two distinct elements to this issue. Firstly a registered care home must provide adequate furniture and equipment suitable to the needs of Kiver Road (128) DS0000020965.V287322.R01.S.doc Version 5.2 Page 18 service users. They must also keep all parts of the care home clean. These points are covered further in the environmental section of this report. Secondly, the service users do not have capacity to make financial decisions. The organisation is their appointees, and the manager is the trustee of their bank accounts. This leaves the service users vulnerable to financial abuse. It also leaves the manager and organisation vulnerable to allegations. Where capacity to make financial decisions is either in doubt or absent then decisions to spend service users’ monies must be made in conjunction with the placing authority and familes. This could be carried out as part of the initial assessment and care review system. This is Requirement 2. One service user’s account was checked and the money counted. The sums held corresponded with the written accounts. The responsible individual checks the accounts on her monthly visit. It would be good practice for this to be recorded in the accounts. This is Recommendation 1. As stated above the manager is the trustee of the service users’ bank accounts. In such circumstances the Commission recommend that regular, independent, audit is carried out. This could be periodically included in the responsible individual’s monthly visit. This, again, offers protection to both the service user, and to the manager. This is Recommendation 2. Kiver Road (128) DS0000020965.V287322.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): 24, 27, 29 & 30 Quality in this outcome area is adequate This judgement has been made using available evidence, including a visit to this service. There have been some improvements since the last inspection, but there is still outstanding work. EVIDENCE: Maintenance and repair are the responsibility of the housing association. This can sometimes mean that there are delays in necessary works being carried out. There is ample evidence to demonstrate that the manager makes strenuous efforts to comply with environmental requirements set by the Commission. A tour of the building demonstrated that there have been some improvements since the last inspection. The hall carpet and the bathroom floor covering have been replaced. The shower room has been refurbished and disabled access improved. Other work remains to be done. The lower walls and door frames in the corridor remain scuffed. This is damage caused by wheelchairs and is likely to be repeated after redecoration. Consideration should be given to how such damage can be minimised, such as durable covering to specific sections. This is Requirement 3, which is restated from the last inspection. Kiver Road (128) DS0000020965.V287322.R01.S.doc Version 5.2 Page 20 The toilet seats are broken due to heavy use by one service user. The occupational therapist assessment was seen, along with the order for specialist seats for people with disabilties. Therefore no Requirement has been set. The bath remains unsuitable for the client group. It is only accessible from one side so a hoist cannot be used. It is also unsuitable for staff to use in assisting service users to bathe, as it is very low. This means that the current service users have no choice but to have showers. The manager has requested an assisted bath, and changes to the layout of the bathroom. She is very concious of the reduced choice for both current and future service users. This Requirement 4, which is restated from the previous inspection. The flat is furnished in a homely fashion. Service users have personalised their bedrooms. Attention has been given to how the environment may impact on the independence of the service users. For example, having carpeting and furniture in contrasting colours in the lounge. This enables the service user who has cataracts to move round independently. The home was clean and hygienic. As stated earlier in this report service users’ monies have been used to pay for the cleaning of a bedroom carpet and the purchase of a reclining chair. The service provider has a responsibility to both keep the home clean, and to provide furniture suitable for the people living in the home. This is Requirement 5. Kiver Road (128) DS0000020965.V287322.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): 32, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users are supported by an effective staff team. Staff are competent and working to gain appropriate qualifications. Service users needs are met, and they benefit from well supported and supervised staff. EVIDENCE: In response to a previous Requirement and the outcome of an occupational therapist assessment the rota has been rearranged. This means that there are normally two people on duty all waking hours, and that service users’ needs are met safely. A member of staff sleeping in covers nights. There is also a live-in support worker, which provides extra assistance when needed. Staff reported that they seldom get called at night. Training, supervision and staff meeting records were examined and discussed with three members of staff. The afternoon handover meeting was observed. Staff were also observed greeting the service users when they returned from the day centre late afternoon. Staff demonstrated a sound knowledge of the needs of service users. They were observed following care plans, including offering choice of drinks and activities. There is a warm relationship between service users and staff. There is a thorough induction programme. Recent records were seen and a staff member described the process. This had included extra induction time Kiver Road (128) DS0000020965.V287322.R01.S.doc Version 5.2 Page 22 being allocated where carrying out certain task under supervision had not been enough for the staff member. Recruitment files were not seen during this visit, as no new staff have been employed since the last inspection. Centre 404 recruitment was examined in May 2006, during the inspection of their domiciliary care service. The procedure was found to be robust. As the same policy, procedure and practice is used for this home this standard is assessed as met. Staff meeting records showed that they are interactive and inclusive. The three staff members spoken to supported this judgement. Staff feel able to raise issues and feel that they get fully discussed. They feel the organisation listens to them and to service users. They described the manager as very approachable. Staff confirmed that they receive regular supervision. The supervision records seen were structured and job related. Two of the staff members spoken to are nearing completion of their NVQ. Both felt that they had gained from the work, and that it had resulted in them reflecting on their daily work. Kiver Road (128) DS0000020965.V287322.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): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users benefit from a well run home, though may benefit even more if it was a supported living scheme with domiciliary care support. EVIDENCE: There are very good systems in place for induction, supervision, risk assessment, care planning, and shift management. Records of all were seen and discussed with staff. The manager is aiming to complete the Registered Manager Award by October 2006. She is knowledgable about the needs of service users. There are regular Health & Safety checks. In discussion the manager was clear about the responsibilties of the registered manager in relation to the environment. There was ample eveidence of her making strenuous efforts to get the housing association to take required action. Service users needs are put first with dignity, choice, privacy and rights being the foundation of the service. Kiver Road (128) DS0000020965.V287322.R01.S.doc Version 5.2 Page 24 The Responsible Individual sends monthly reports to the Commission, using a structured format. The latest report was sent in the day of site visit. It accurately reflected the findings of the visit. A tenant’s survey is currently being carried out. The manager has passed the forms onto the new volunteer tennant association facilitator, who is himself diabled. He will be doing the forms with the service users over the next few weeks. The results of the surveys will then be collated. Issues are fed back to individual services, and there is an overall report to the Housing Committee and funders. A copy of last report was seen in the service user guide. At the last inspection the issue of the most appropriate registration was discussed with the manager. Currently the service is registered as a care home. Given the type and ethos of the service registration as domiciliary care may be more appropriate. Reviews of each service user are currently being carried out by Islington social services to see if their needs can be met by domiciliary care. Kiver Road (128) DS0000020965.V287322.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 2 2 3 3 X 4 3 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 2 25 X 26 X 27 2 28 X 29 2 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 x 3 X 3 X X 3 X Kiver Road (128) DS0000020965.V287322.R01.S.doc Version 5.2 Page 26 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA1 Regulation 5 Requirement Full details of all extras chargeable to service users must be included in the service user guide. The process and procedures for taking decisions on the spending of service users’ monies must provide protection from financial\abuse. The Registered Person must ensure that the walls and doorframes are repaired/redecorated and preventative measures taken to minimise future damage. This Requirement has been restated. Previous timescale of 15/07/06 not met. The Registered Person must take action to have the bathroom refurbished so that bathing facilities are appropriate to meet the assessed needs of service users. This Requirement has been restated. Previous timescale of 15/07/06 not met. The Registered Person must DS0000020965.V287322.R01.S.doc Timescale for action 31/10/06 2 YA23 13 (6) 31/10/06 3. YA24 23 31/12/06 4 YA27 23 31/12/06 5 YA29 16(2)c & 31/10/06 Version 5.2 Page 27 Kiver Road (128) YA30 23(2)(d) provide suitable furniture for service users. They must also take financial responsibility for maintaining the cleanliness of the home. 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 1 Refer to Standard YA23 YA23 Good Practice Recommendations Where senior managers carry out audit of service users’ financial records they should record this in the account. A senior manager should carry out periodic audits of service users’ bank accounts. Kiver Road (128) DS0000020965.V287322.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Camden Local Office Centro 4 20-23 Mandela Street London NW1 0DU 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 Kiver Road (128) DS0000020965.V287322.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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