Inspection on 04/01/07 for Maison Moti

This inspection was carried out on 4th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found 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

Maison Moti 28/09/07

Maison Moti 09/02/06

Maison Moti 30/08/05

Maison Moti 28/02/05

Maison Moti 31/08/04

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

CARE HOME ADULTS 18-65 Maison Moti 200 Chase Side Southgate London N14 4PH Lead Inspector Caroline Mitchell Key Unannounced Inspection 4th January 2007 11:00 Maison Moti DS0000010639.V321978.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 Maison Moti DS0000010639.V321978.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. Maison Moti DS0000010639.V321978.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Maison Moti Address 200 Chase Side Southgate London N14 4PH 020 8440 7535 020 8441 7378 info@maisonmoti.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) Maison Moti Limited Ms Judith Mshana Care Home 15 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (15), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (1) Maison Moti DS0000010639.V321978.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One specific service user who is over 65 years of age and has mental health needs may be accommodated in the home. This condition will need to be removed at such times as the service user vacates the home. 9th February 2006 Date of last inspection Brief Description of the Service: Maison Moti is registered to provide accommodation and care for fifteen people under the age of sixty five who have a mental disorder (mental health problems). A condition of registration has been approved for a service user who is over the age of sixty five to remain at Maison Moti, as long as the home can meet her needs. The home is situated in Southgate, on a residential street, and blends in well with the other local houses. All the amenities of Southgate are short walk away and the home is well situated for bus and underground transport. Maison Moti Ltd operates this care home and four supported living projects for people with mental health problems. The fees are normally £600 to £900 for each placement per week, and service users are expected to pay separately for items such as hairdressing and clothes. Following “Inspecting for Better Lives” the provider must make information available about the service, including inspection reports, to service users and other stakeholders. Maison Moti DS0000010639.V321978.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on an unannounced basis and took around six hours to complete. The inspector met the home manager, the assistant manager, four support workers and eight of the service users. The inspector spoke to several of the service users individually or as part of small groups. The communal rooms were inspected along with a number of the written records kept in the home. What the service does well: What has improved since the last inspection? What they could do better: Where there are restrictions to service users’ personal freedom, these need to be more clearly documented as part of their risk assessment and these issues need to be monitored at each review. Despite being areas identified for improvement at the previous inspection, one service user had no risk assessment in place regarding self-medication, and staff still need to have annual appraisals. Although the home is decorated to a high standard generally, there are two rooms that have been highlighted as needing some redecoration. Maison Moti DS0000010639.V321978.R01.S.doc Version 5.2 Page 6 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. Maison Moti DS0000010639.V321978.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 Maison Moti DS0000010639.V321978.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): 2, 4 & 5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective service users have a needs assessment carried out before they are admitted to the home so that their needs and preferences are known to the home and are usually provided with opportunities to visit and “test drive” the home prior to moving in. EVIDENCE: The records for two current service users at the home were inspected in relation to the admission process. They all included good quality information regarding peoples’ needs including comprehensive assessments from care professionals and, where appropriate the previous placement. In addition the home had also completed it’s own assessment of the person’s needs. The inspector saw evidence that one service user had had a well-planned introduction to the home, having a number of visits, overnight and weekend stays before being properly admitted. The inspector saw four service users’ records in relation to their written contract between the home and the service user, and theses were available for three service users and included details of the fee payable. The manager explained that, due to the urgent nature of the admission of one service user, they had moved into the home on a trial basis, and were being assessed as to whether they would be properly admitted to the home. It is recommended Maison Moti DS0000010639.V321978.R01.S.doc Version 5.2 Page 9 that the status of one service user, who is on a trial stay, be resolved as soon as possible, and if it is necessary for further time to be taken regarding the decision, that an interim contract be provided to the service user detailing what service the home will provide. Maison Moti DS0000010639.V321978.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 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service users have care plans and risk assessments. However, there is still small room for improvement, in terms of the service users being encouraged to sign up to these. The service users are supported to make decisions for themselves. However, there is room for improvement in documenting and reviewing specific restrictions that are placed on some service users. EVIDENCE: The inspector noted that for the most part the routines in the home do encourage freedom of movement, freedom of choice and independence. However, there were three service users who were subject to some minor restrictions to their personal freedom in relation to smoking. These restrictions were not unreasonable and were related to risks to the persons’ health or the overall safety of all in the home. In one case this was clearly documented, part of a multidisciplinary approach, and the service user has signed a very clear and seperate agreement consenting to the restriction. In the cases of the other two service users, although the issue was touched upon Maison Moti DS0000010639.V321978.R01.S.doc Version 5.2 Page 11 in their risk assessments or care plans, the records were not quite so clear, and a requirement is made in respect of this. At the previous inspection the registered person was required to ensure that all the service users have been supported to understand and sign their care plans once they are satisfied with the contents and to ensure the individual risk assessments remain up to date to reflect changes in the service user’s needs. The inspector reviewed the written records of four service users in relation to these issues and found that risk assessments had been reviewed relatively recently. Three service users had signed up to their plans. Some had also signed up to their assessments and also to their risk assesments, but this was not consistent and, where documents were not signed it was unclear if the service user had not been consulted, or had disagreed with the assessment. A recommendation is made that there is a more consistent approach is taken to supporting service users to sign their care plans and other assessments and, that a note is made if they are reluctant sign a particular document. Due to the nature of their recent admission, one service user’s plan was not complete, although there was lots of evidence that this persons’ needs were being assessed in a proper and thoughtful way. A recommendation is made that this service user’s care plan is completed in a timely fashion, that they be encouraged to engage in the process, and encouraged to sign up to the resulting plan. Maison Moti DS0000010639.V321978.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 good. This judgement has been made using available evidence including a visit to this service. Links with the community and activities are available to service users. The dietary needs of the service users are well catered for. EVIDENCE: In discussion with the manager it was clear that she places emphasis on familly involvement and it was evident that she encourages the service users to maintain contact with their friends and families. At the previous inspection the registered person was required to ensure that each service user is supported in line with their care plan and 1:1 funding to have the input they need to ensure they are supported to achieve their full potential. At this inspection the manager provided evidence that a clear method of monitoring individual 1-1 time is in place. The inspector also monitored the daily records of three service users with regard the activities that they had been involved in and found, that despite some disruption to the planned Maison Moti DS0000010639.V321978.R01.S.doc Version 5.2 Page 13 schedules due to the Christmas break, service users had been getting out and about in the local community and undertaking activities that are designed to enhance their skills, such as going to the gym, cooking, sewing, and various trips out to paces of worship, pubs and restaurants. All of the service users that the inspector spoke to said that the food was of a very good standard and that they were able to make choices. The menu showed a good variety of main meals, with lots of fresh fruit and vegetables on offer, and a vegetarian alternative at each meal. The manager told the inspector that two service users were vegetarian. The inspector also noted that there is a regular cooking group on Sundays and that service users had recently been involved in preparing some Indian dishes. Maison Moti DS0000010639.V321978.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 adequate. This judgement has been made using available evidence including a visit to this service. The service users can be confident that they will be supported by staff according to their individual needs. Service users are supported to access primary healthcare input but this needs to be extended to all the service users. The medication system is organised appropriately EVIDENCE: The inspector spoke to several service users who spoke positively about the support they received from the staff. The inspector also noted that care plans set out the kinds and levels of support needed by service users in the area of their personal care, and emphasise promoting service users’ independence. The service users were all wearing appropriate clothing that was in a good condition. One service user presents some challenges regarding their personal hygiene. The manager was able to explain the progress that has been made in this area, and this was supported by the written records for this service user. At the previous inspection the registered person was required to ensure all the service users have been supported to access dental and optical input. The records seen by the inspector indicated an improvement in the record keeping Maison Moti DS0000010639.V321978.R01.S.doc Version 5.2 Page 15 around service users’ appointments and visits to health care services. The manager explained that one service user has recently moved into the home and it is not clear whether they will be staying in the longer term. They have declined to sign up with a GP in the area. Staff continue to work with this particular service user in order to persuade them that signing up with GP in the area is in their own best interests. In terms of practice around prescribed medication in the home, the registered person was previously required to ensure where PRN medication is needed that the service user is supported to have the necessary input from the GP, and the manager confirmed that this issue had been addressed. A requirement was made previously regarding risk assessments being in place for service users who self medicate. At the time of the inspection the manager told the inspector that there was one service user who administered their own medication. Whereas this was mentioned briefly in their written records, there was insufficient detail regarding the associated risks and the interventions that are in place to minimise these risks. This requirement is restated as part of this report. Maison Moti DS0000010639.V321978.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 good. This judgement has been made using available evidence including a visit to this service. The homes complaints procedure is designed to ensure people’s views are listened to. The home uses the local adult protection procedure and has a clear whistle blowing procedure. Where service users need support to mange their money there is a system in place for this. EVIDENCE: The complaints procedure is very clear and is readily available for the service users. There have been no complaints since the previous inspection. The service users who spoke top the inspector said that they had no complaints, and that if they had any problems they felt comfortable speaking to the staff. There was evidence that staff have been provided with training regarding the protection of vulnerable adults. The records of the personal finances for three service users who need support with managing their money were inspected. There was a clear system in place providing an audit trail for their money. At the previous inspection the registered person was required to ensure that where the home supports the service user to manage their finances that the receipts for goods purchased are kept separately for each service user and found that the service users’ receipts are now being kept in a more organised way. Maison Moti DS0000010639.V321978.R01.S.doc Version 5.2 Page 17 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, 27 & 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, very well maintained, clean and attractive. The service users are satisfied with the facilities available in the home. EVIDENCE: The inspector was shown around the building by the assistant manager who explained that one bedroom is being shared and the rest are being used as single rooms. During the tour of the building the inspector noted that six of the bedrooms have en-suite facilities and in addition there are three toilets, two bathrooms and a shower room. The communal areas include a large lounge, a smaller sitting room that is the smoking room, a dining area and kitchen. The garden has an attractive patio area. There is a utility room and service users have a rota for when they can do their personal laundry. The home shares a handy person with four other homes and was noted to be very well maintained and impressively clean throughout. There were only two areas for improvement identified at this inspection, one being the skirting in the first floor bath/shower room needing re-painting, and Maison Moti DS0000010639.V321978.R01.S.doc Version 5.2 Page 18 the second being the smoking room needing redecorating. Requirements are made in respect of these issues. Maison Moti DS0000010639.V321978.R01.S.doc Version 5.2 Page 19 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 adequate. This judgement has been made using available evidence including a visit to this service. There are sufficient staff employed to meet the needs of the service users and staff benefit from a good level of training. Thorough recruitment checks are in place. Staff are now receiving regular supervision. However, a system of annual staff appraisal still needs to be implemented. EVIDENCE: The inspector looked at three staff files and they all contained the necessary recruitment checks including two references and a CRB disclosure. The staff training records for the three staff showed that they had all completed an induction, there was evidence of an ongoing training programme and certificates were included. Several staff are undertaking, or have completed training to NVQ level 2, 3 and 4. In addition other staff are also undertaking the relevant qualifications including social work training. At the previous inspection the registered person was required to ensure all the staff have regular supervisions and an annual appraisal. At this inspection it was found that staff are now being provided with more regular supervision, and that a method of planning and monitoring of this is in place. However, the Maison Moti DS0000010639.V321978.R01.S.doc Version 5.2 Page 20 staff annual appraisals have yet to be undertaken and requirement is restated as part of this report. Maison Moti DS0000010639.V321978.R01.S.doc Version 5.2 Page 21 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. A competent management team runs the home on a day-to-day basis. Overall the service users and staff are protected by a proactive approach to health and safety in the home. The annual quality assurance exercise needs to be collated and used to inform the development plan for the service. EVIDENCE: The manager who has been in post for almost a year and the assistant manager who has been in her post for around two years. The inspector gained the impression that they work well together and have complimentary skills. The inspector noted that several service users had completed feedback questionnaires and their responses had been retained on file. There was also evidence that a quality assurance exercise had been recently undertaken to seek the views of relatives and care professionals. This information is being Maison Moti DS0000010639.V321978.R01.S.doc Version 5.2 Page 22 collated and a requirement is made for a summary to be provided to the inspector, along with any action plan arising from the responses. At the previous inspection the registered person was required to ensure that an annual quality assurance exercise is completed that seeks the views of relatives and care professionals as well as the service users and that the responses are collated into an action plan. In terms of health and safety the registered person was previously required to ensure the internal fire doors are all able to close properly, ensure the fire alarms are checked weekly and ensure that staff health and safety training is repeated and kept up to date as required. The inspector was able to confirm that all of these issues had been addressed. Maison Moti DS0000010639.V321978.R01.S.doc Version 5.2 Page 23 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 3 3 X 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 1 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 1 X 3 X 2 X X 3 X Maison Moti DS0000010639.V321978.R01.S.doc Version 5.2 Page 24 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 YA9 Regulation 13(4) Requirement The registered person must ensure that, where there are restrictions to service users’ personal freedom, these are clearly documented as part of their risk assessment, and these issues are monitored at each review as part of a multidisciplinary approach. The registered person must ensure that where a service user self medicates that the necessary risk assessment is complete. Timescale for action 31/01/07 2. YA20 13(2) 31/01/07 3. 4. YA24 YA27 23 (2) (d) 23 (2) (d) 5. YA36 18(2) The previous timescale of 31/03/06 was not met. The registered person must 30/04/07 ensure that the smoking room is redecorated. The registered person must 30/04/07 ensure that the skirting in the first floor shower/bathroom is repainted. The registered person must 31/03/07 ensure that all staff have an annual appraisal. The previous timescale of 31/03/06 was not met. Maison Moti DS0000010639.V321978.R01.S.doc Version 5.2 Page 25 6. YA39 24(1) The registered person must ensure that a summary of the annual quality assurance exercise is provided to the inspector along with any action plan arising from the responses. 30/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA5 Good Practice Recommendations It is recommended that the status of one service user, who is on a trial stay, be resolved as soon as possible, and if it is necessary for further time to be taken regarding the decision, that an interim contract be provided to the service user detailing what service the home will provide. It is recommended that the registered person ensure that there is a more consistent approach is taken to supporting service users to sign their care plans and other assessments and, that a note is made if they are reluctant sign any particular document. It is recommended that the registered person ensure that the service user who is on a trial stay has a care plan, that is completed in a timely fashion, that they continue to be encouraged to engage in the process, and are encouraged to sign up to the resulting plan. It is recommended that the registered person ensure that staff continue to persuade the service user who is on a trial stay that it is in their best interests to sign up with a local GP. 2. YA6 3. YA6 4. YA19 Maison Moti DS0000010639.V321978.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Maison Moti DS0000010639.V321978.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. 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