Inspection on 28/08/08 for La Rosa

This inspection was carried out on 28th August 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

La Rosa 20/08/07

La Rosa 05/07/06

La Rosa 14/03/06

La Rosa 21/11/05

Extracts from inspection reports are licensed from CQC, this page was updated on 13/11/2008.

CARE HOME ADULTS 18-65 La Rosa 97 Babington Road Streatham London SW16 6AN Lead Inspector Sonia McKay Unannounced Inspection 28th August 2008 10:00 La Rosa DS0000065081.V369144.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 La Rosa DS0000065081.V369144.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. La Rosa DS0000065081.V369144.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service La Rosa Address 97 Babington Road Streatham London SW16 6AN 020 7787 9694 020 8835 0981 vadee.larosa@yahoo.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) Mrs Parvadee Shumoogam Gopalakrishnen Naidoo Nursigadoo Care Home 7 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7) of places La Rosa DS0000065081.V369144.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Mental Disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 7 20th August 2007 Date of last inspection Brief Description of the Service: La Rosa is a private residential care home that provides 24-hour care and support for seven adults with mental health needs. The home is situated in a residential area, close to high-street shopping and transport links. The home opened in September 2005. Fees range between £550.00 and £900.00 per week and vary according to the support needs of the individual. The home provides prospective residents with a written guide that provides information about the service. A copy of the most recent Commission inspection report is available in the reception hallway. La Rosa DS0000065081.V369144.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1star. This means the people who use this service experience adequate quality outcomes. One inspector carried out this unannounced key inspection in one day. The methods used to assess the quality of service being provided include: • • • • • • • • • • • • Talking with the registered home manager and deputy manager Looking at the Annual Quality Assurance Audit document completed by the manager (this document is sometimes called an AQAA and it provides the Commission with information about the service) Talking to staff on duty during the inspection Talking to four of the seven residents A tour of the communal areas of the premises Looking at records about the care provided to three of the residents Looking at records relating to recent staff recruitment and training Looking at the way medicines are handled by staff in the home Looking at issues that the Commission has been notified about since the last inspection and how they were handled Sending surveys to residents, relatives, staff and visiting professionals before the inspection Three residents completed, or were assisted to complete and return surveys A relative and a staff member also completed surveys The Commission would like to thank all who kindly contributed their time, views and experiences to this inspection process. What the service does well: The home is comfortable, clean, safe and homely and people have single bedrooms and communal areas that suit their needs. The registered manager is qualified and experienced. A relative commented, “ The care home looks after the service users well and sees to it that their needs are sorted out”. A resident commented, “ The staff are very nice and friendly and the home is always clean. Staff and service users work together to keep it clean and fresh”. La Rosa DS0000065081.V369144.R01.S.doc Version 5.2 Page 6 Residents are able to maintain friendships and relationships whilst living in the home and there are a variety of activities available at home and in the community. Residents have a good diet and are able to develop their shopping and cooking skills whilst in the home. Cultural needs are considered and steps are taken to include menu choices for all residents. What has improved since the last inspection? What they could do better: The registered manager but must update his knowledge in regards to Care Homes Regulations and National Minimum Standards, to ensure that residents are protected when new staff are recruited. There must be a better assessment of the training needs of each member of staff and a training and development plan formulated to ensure that staff are adequately trained. This will ensure that staff are trained to meet the stated aims of the home and also the individual needs of current residents. Staff would also benefit from training in adopting a more ‘person centred approach’ to care planning. Care plans should be written in a way that is more ‘person centred’ and not just “problem based”. This would ensure that each person’s life goals and aspirations are also included in care planning systems and would encourage residents to become more involved in planning for their future. La Rosa DS0000065081.V369144.R01.S.doc Version 5.2 Page 7 One resident thought there could be more organised activity, such as outings. Some essential information is stored on a computer. This makes it less accessible and if the computer is not working, inaccessible. Care should be taken to ensure that a hard copy of all current information is available in each persons care files. 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. La Rosa DS0000065081.V369144.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 La Rosa DS0000065081.V369144.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 & 5. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The home manager obtains enough information about prospective residents needs, but there should be a better record of the homes own assessment of how each persons aspirations and goals are identified. Each person has a copy of the contract of service with the home but some are not signed so are not in effect. EVIDENCE: The admission of two new residents was examined during this inspection. In both cases an adequate amount of information had been obtained by the home from the referring bodies. Information retained includes a copy of the community care assessment of need, risk assessments and care programme approach (CPA) meeting minutes. This gives the home manager sufficient information about a persons care needs but does not necessarily identify their individual aspirations and goals. (See recommendation 1) The home manager visited the people referred to conduct his own assessment of need. This is an opportunity to find out what the person themselves is looking for from the placement and to tell them a bit about the home. Hand written notes of these assessments could not be located during the inspection, La Rosa DS0000065081.V369144.R01.S.doc Version 5.2 Page 10 but the information obtained had been transferred into a set of initial care plans so that local authority funding could be agreed at panel. The home does not accept emergency admissions. Residents are encouraged to visit the home to meet staff and residents before moving in for a trial period. Discussion with the home manager indicates that compatibility with existing residents is also considered. Residents are issued with contracts detailing the bedroom to be occupied and the costs, although some contracts were lacking in signatures of one or both parties (the resident and the home manager). This had not been picked up in an admission s checklist in use, which identified that contracts were in place. The newly appointed deputy home manager began to address this oversight on the day of the inspection. It is recommended that contracts be signed as part of process of admission to the home, with any necessary provision for a probationary periods included. (See recommendation 2) La Rosa DS0000065081.V369144.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Assessed needs are documented in written plans for care and this includes recording any risks that may be associated. Plans are reviewed regularly and this enables staff to provide care in accordance with current needs. Care plans could be more meaningful to residents if they were written in a more person centred way and were written in plain English. EVIDENCE: Staff maintain a single file of current information about each resident. As recommended, there is now a standard format for how information is stored in these files making it easier for staff to access information. Written information is stored securely in a lockable cabinet. There are written plans for how each element of care will be delivered, for example, support with maintaining a healthy diet for a person with diabetes, La Rosa DS0000065081.V369144.R01.S.doc Version 5.2 Page 12 support in maintaining continence, assisting residents to develop their independent living skills, and maintaining good mental health. There are risk assessments in an appropriate range of topics for each person, including any risks for staff when lone working and for when people experience relapse or periods of mental ill health. Risk is also considered in multidisciplinary forums under Care Programme Approach protocols, minutes of which are available. Care plans are detailed and have been reviewed regularly but are sometimes written in complex language. It is noted that one resident has refused to sign her plans. It is recommended that a more person centred approach to care planning be adopted and plain English be used in written plans. This will make them of more interest to residents and encourage them to add their personal goals and aspirations. (See recommendation 3) Some care plans have been revised but are still only stored electronically. This makes them less accessible to staff. Care plans should be available in a written form in case, as on a recent occasion, the computer was not working. (See recommendation 4) Residents meet with staff often to discuss house issues. Minutes of these meetings are retained for reference. Residents also join some areas of staff meetings so that they can contribute ideas to the running of the home. Each resident has a key worker from within the staff team, who has responsibility for administration of records and planning. La Rosa DS0000065081.V369144.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are able to maintain friendships and relationships whilst living in the home and there are a variety of activities available at home and in the community. Residents have a good diet and are able to develop their shopping and cooking skills whilst in the home. EVIDENCE: Current residents engage in a variety of daytime activities, and mostly do so without support from staff. Residents are able to maintain friendships and relationships whilst living in the home. Current residents attend a variety of day services suitable to their individual or cultural needs. The resident population is culturally diverse, as is the staff group and local community. La Rosa DS0000065081.V369144.R01.S.doc Version 5.2 Page 14 There is a payphone for residents to use and people open their own post, but can request staff support to keep letters and documents safely stored. The staff have arranged some activities with the residents as a group. These have included regular trips to the cinema, a day trip to Brighton and Eastbourne, barbeques, birthday parties and bingo nights. There are also regular movie and popcorn nights for those interested. There is a television, DVD player and music system in the communal lounge/diner. The back garden is not currently accessible as there is building work underway to increase the communal area available to the residents. Residents are consulted about the choice of activities provided in regular house meetings. On the day of the inspection residents were relaxing in the communal areas, shopping or attending day services. One resident was chatting with a member of staff about suitable presents for his grandchildren. Emphasis is placed helping new residents to get to know the local area. This involves a member of staff going out with all new residents to familiarise them with the local area, transport links, shops and leisure facilities. All residents are registered on the electoral role and staff assist residents to obtain a freedom bus pass if appropriate. There is a four-week rolling menu programme available and records are kept of all meals served. The records show that a range of meals have been prepared, including culturally appropriate dishes. The deputy home manager is introducing cookery classes for those interested. Residents who wish to cook something other than what is on the menu can do so (one resident said that he was going to cook curried goat for himself for his dinner). Some residents are preparing for moving to more independence by becoming more self-catering whilst living in the home. Each resident completes household chores to the best of their abilities. These include responsibilities for the care of their own bedrooms and the communal areas of the home. Responsibilities for the cleaning the communal areas are discussed and agreed in house meetings. There is a petty cash system in place. This enables staff to re-coup any costs incurred whilst supporting residents to take part in community-based activities and for paying for some activities for the residents as well (such as some of the cinema trips). Staff maintain a record of the activities that each resident has taken part in as part of the daily recordings. Residents who commented said that they were able to do what they want when they wanted to do it but one thought there could be more outings and things to do. La Rosa DS0000065081.V369144.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents receive appropriate level of support and encouragement to maintain their personal appearance. Physical and emotional health needs are recorded and staff assist residents to make local connections for maintaining their health. Residents are protected by the homes procedures in regards to handling and administering medications. EVIDENCE: Staff can provide assistance with personal care tasks if needed, but generally support residents by verbal prompting. There are both male and female staff available if assistance with personal care is required. If assistance is required, this is detailed in a specific care plan. Residents can get up a go to bed at times of their choosing and staff encourage people to use their own alarm clocks for appointments. When a new resident moves in there is a ‘community attachment plan’. This plans identifies healthcare needs and ensures that new residents register with La Rosa DS0000065081.V369144.R01.S.doc Version 5.2 Page 16 appropriate local health services. These plans are effective. Residents attend appointments by themselves if they wish, although staff can provide support and assistance to keep records and dates of appointments as required. Residents attend appointments with either the community mental health teams (CMHT) or psychiatric teams attached to their placing authority. There is progress in ensuring referral to local community mental health teams for all residents. All are registered with a dentist, optician and chiropodist. Residents are weighed regularly and the weight is recorded. This assists staff in identifying possible health problems. Staff assist residents to manage their medication and there is appropriate lockable storage for medications in an office. Residents can also administer their own medication if assessed as being safe to do so. Residents have a lockable cabinet in their bedrooms so that they can store medications themselves if required. At the time of this inspection staff are assisting all of the residents with their medication. All prescribed medications are in stock and there are no controlled drugs in storage or use, although appropriate storage is available should any be prescribed. A spot check of the administration of an anti-biotic medication indicates correct administration and recording and a check of blister packs indicates that medications have been given at the right time. As required in the previous inspection report, a member of the team conducts regular justified stock checks to check that medications are being administered correctly by staff and the results are recorded. A record is also kept of any medication administered outside the home, for example depot injections administered at clinics. There is information about common side effects of each drug in use. Medication administration records are well kept, with no gaps in recording. This indicates compliance with a requirement made about keeping better records. There is a small stock of common home remedies, such as a cough syrup and analgesic, should residents have a minor cough or headache. La Rosa DS0000065081.V369144.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The views of residents are listened to and acted upon and residents are protected from abuse and self-harm. Policy should be developed to ensure that staff are aware they are not allowed to accept gifts, money or bequests from residents. EVIDENCE: There is a complaints procedure in place. The record of complaints and the AQAA (Annual Quality Assurance Assessment) show that there have been four minor complaints made by residents. Appropriate action was taken to address the issues raised. There are regular opportunities for residents to discuss concerns during regular key work and house meetings and for staff to take action. Procedures are in place for responding to suspicion or evidence of abuse or neglect (including whistle-blowing) to ensure the safety and protection of residents. A copy of the local authority ‘safeguarding adults procedures’ are available for reference and staff have been trained in adult protection. No adult protection referrals have been made. A spot check on resident’s money held in safe keeping with staff show that satisfactory arrangements are in place for assisting residents to safely store La Rosa DS0000065081.V369144.R01.S.doc Version 5.2 Page 18 and account for their personal expenditure. However, examination of the homes AQAA indicates there is no policy about staff being prohibited from accepting cash or gifts from residents. Discussion with the manager indicates that this is ‘known’ by staff to be wrong. It is recommended that this position be formalised by a specific policy prohibiting staff from accepting gifts, money or bequests from residents. Residents will be better protected and staff will have clear guidance. (See recommendation 5) La Rosa DS0000065081.V369144.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home is comfortable, clean, safe and homely and people have single bedrooms and communal areas that suit their needs. EVIDENCE: The large home is clean, comfortably furnished and well decorated. All bedrooms are single occupancy. The ground floor has a small staff office, a small kitchen, and a dining/sitting room with access to a back garden. There is currently building work going on ion the back garden. This will provide a larger communal space. Since changes in legislation about smoking in communal settings, residents are asked to smoke in the garden and not in the communal lounge diner. There are adequate toilet facilities and a small ground floor laundry area. La Rosa DS0000065081.V369144.R01.S.doc Version 5.2 Page 20 The ground floor has one bedroom. The first floor has four bedrooms, three with en-suite facilities. There is also a bathroom. The second floor has two bedrooms, both with en-suite facilities and there is an additional bathroom with a shower unit. There is also a staff room. Residents said that bedrooms are comfortable and warm enough. Bathrooms and toilets are fitted with appropriate privacy locks and hot water is regulated to within safe temperature limits and tested regularly. The safety of unguarded radiators and hot central heating pipes must be assessed if any resident who experiences falls, epileptic seizures or absences of any sort is admitted to the home. (See recommendation 6) There is good access to local transport links and high street shopping. There is a payphone available. La Rosa DS0000065081.V369144.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 35 & 36. Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. Staff recruitment procedures are not thorough enough to provide residents with protection and must be improved immediately. The home manager must develop a staff training and development plan to ensure that staff are fully trained and equipped to meet the needs of current residents. EVIDENCE: There is a registered manager, a newly appointed deputy home manager and seven support workers. There are currently four male and four female staff. Staff are ethnically diverse, as is the resident group and local population. There are two staff on duty during the day and one member of staff is awake on premises each night. A lone working risk assessment is in place for each resident. Seven of the nine staff have already completed a national vocational qualification (NVQ at level 2 or above) in care and the two remaining staff are currently undertaking the award. La Rosa DS0000065081.V369144.R01.S.doc Version 5.2 Page 22 During a check of the recruitment of staff most recently employed it was noted that two members of staff have been employed in the home before their criminal records check was complete. POVA First checks were not in place either (The POVA check is a less thorough check made against the list of staff who are prohibited from working with vulnerable adults). Two members of staff had only one reference on file and one member of staff had no references. It should be noted that staff should only start work with a ‘POVA First check’ in exceptional circumstances, and are not allowed to work without supervision until a satisfactory full criminal records check is in place. This is evidence of inadequate recruitment procedures. This does not provide residents with the necessary protection that a thorough vetting process provides. An immediate requirement was issued on the day of the inspection. IMMEDIATE REQUIREMENT Issued on 28th August 2008. The registered Person must not employ a person to work in the home unless they have established that they are fit to work, in that, there are two satisfactory references and a disclosure of their criminal record has been obtained and is also satisfactory. The registered home manager took immediate action by stopping the staff working until references and POVA First checks could be obtained. POVA First checks were obtained and additional references obtained or found. Future recruitment must provide residents with adequate protection. (See requirement 1) There is evidence of ongoing training opportunities for staff, although records and certificates are not available in some cases. There is no training and development plan for the service. Analysis of current staff training needs must be formulated into a training and development plan. A staff member commented that there should be more training available. (See requirement 2) Staff induction training is better recorded, as required in the previous inspection report. Staff supervision meetings are held by the manager and the deputy manager, both of whom have been trained in supervision. There was some slippage when the previous deputy home manager resigned but there is a supervision La Rosa DS0000065081.V369144.R01.S.doc Version 5.2 Page 23 matrix in place and evidence that staff are now being supervised regularly and minutes of the meetings are retained in staff records. Staff on duty indicated that they were able to access support as they needed. La Rosa DS0000065081.V369144.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. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The manager is qualified and experienced but must update his knowledge in regards to Care Homes Regulations and National Minimum Standards. Systems are being introduced to assess the quality of a service being provided, although there is no development plan for the home. EVIDENCE: The home manager is qualified and has many years experience of senior management and mental health nursing care. He has been registered with the Commission. He must familiarise himself with all regulations and national minimum standards in regards to staff recruitment, as the provider does not have a human resources department. Discussion with the home manager indicates that a recruitment agency may take over this function. La Rosa DS0000065081.V369144.R01.S.doc Version 5.2 Page 25 There are regular residents meetings and residents also join in part of the staff meetings to discuss house issues. The home manager said that the views of current residents are also considered when new placements are being considered and when new staff are being interviewed. Service satisfaction surveys have been sent out and returned by the residents and the manager said that he has addressed some of the issues identified in individual surveys. A written analysis could not be located during the inspection. The registered provider visits the service each month to conduct an inspection visit in accordance with Regulation 26. Brief reports of the findings of these visits are available in the home. There is no annual development plan for the home. (See recommendation 7) A health and safety and fire risk assessment are in place and have been reviewed, as required in the previous inspection report. Fire evacuation procedures and a building floor plan are displayed. Fire detection equipment is tested each week, and the fire fighting and detection equipment is also professionally tested on a regular basis. La Rosa DS0000065081.V369144.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 X 2 2 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 1 35 1 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 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 2 X X 3 X La Rosa DS0000065081.V369144.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. 1. Standard YA34 Regulation 19 Schedule 2 18 Requirement Timescale for action 10/10/08 2. YA35 The registered must operate a thorough recruitment procedure based on equal opportunities and ensuring the protection of service users. The registered person must 19/12/08 ensure that there is a staff training and development programme which meets the Skills for Care training targets and ensures staff fulfil the aims of the home and meet the changing needs of service users’. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA2 YA5 YA6 Good Practice Recommendations A record should be kept of the homes own assessment of the needs and aspirations of people referred to the service. Contracts must be agreed with any new resident (signed by both parties). Care plans should be more person centred and should be written in plain English to make them more accessible to DS0000065081.V369144.R01.S.doc Version 5.2 Page 28 La Rosa 4. 5. YA6 YA23 6. YA24 7. YA39 residents. Staff would benefit from training in writing person centred care plans with residents. Care plans must be available to staff as a hard copy (rather than stored electronically alone). There should be a specific policy about staff not being allowed to accept gifts; money and bequests from residents to ensure better protection from abuse and to give staff clear guidance. The registered persons must assess the safety of radiators and hot pipe-work if any prospective resident experiences falls or seizures. Appropriate remedial action must be taken in this event to ensure adequate protection from contact burns. There should be an annual development plan for the home. This plan should be based on the outcomes of the quality assurance and quality monitoring systems. La Rosa DS0000065081.V369144.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 La Rosa DS0000065081.V369144.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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