Inspection on 20/12/07 for Matthew Residential Care Home

This inspection was carried out on 20th December 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 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Matthew Residential Care Home 09/03/07

Matthew Residential Care Home 17/01/06

Matthew Residential Care Home 24/08/05

Matthew Residential Care Home 02/03/05

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 Matthew Residential Care Home 1 Milton Avenue Kingsbury London NW9 0EW Lead Inspector Julie Schofield Unannounced Inspection 20th December 2007 08:05 Matthew Residential Care Home DS0000059266.V354781.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 Matthew Residential Care Home DS0000059266.V354781.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. Matthew Residential Care Home DS0000059266.V354781.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Matthew Residential Care Home Address 1 Milton Avenue Kingsbury London NW9 0EW 020 8907 8435 F/P 020 8907 8435 matthewres@hotmail.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) Matthew Residential Care Limited Darren Matthew Forde Catherine Lewis Care Home 4 Category(ies) of Learning disability (4), Mental disorder, registration, with number excluding learning disability or dementia (4) of places Matthew Residential Care Home DS0000059266.V354781.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th March 2007 Brief Description of the Service: Matthews Residential Care Ltd is registered to provide accommodation and care support for up to 4 residents at 1 Milton Ave. The home is a semi-detached property located in the residential area of Kingsbury, Northwest London. It has four single bedrooms for residents, including one ensuite. It also has a communal lounge, kitchen, dining room, designated smoking area, one bathroom and toilet, one shower room and toilet, a utility and laundry room. The home has a well-maintained garden. It is close to the town centres of Harrow and Wembley with a variety of local shops, public transportation services, health and social care facilities and services, plus leisure and recreational facilities. There is off street parking for 1 or 2 cars at the front of the house and there is parking available in the street outside the home. At the time of the inspection there were 3 residents living in the home and there was 1 vacancy. The manager said that the weekly fees were £1,295 per week. Fees do not cover, hairdressing, dry cleaning, chiropody or purchase of clothing and personal effects. This information was provided in January 2008. Matthew Residential Care Home DS0000059266.V354781.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on a Thursday in December. It consisted of a morning visit that started at 8.05 am and an afternoon visit that finished at 5.40pm. On the afternoon visit I was accompanied by an expert by experience that talked with staff and residents in the home. During the inspection records were examined, discussions took place with the manager, staff and residents and a tour of the building was carried out. What the service does well: The visits were made about a week before Christmas and the home was decorated with a Christmas tree in the lounge and with presents underneath the tree. Residents were looking forward to the holiday and there was a seasonal atmosphere in the home. Residents are aware that Milton Avenue is their home and one resident was very hospitable and invited us to stay for a meal at the end of the inspection. The home has encouraged residents to develop their skills and abilities and to socialise more with the other residents. The Inspector knew one of the residents living in the home when the resident was living in a previous care home. Although the resident has limited verbal communication skills these have greatly improved since the previous placement. The resident most recently admitted to the home had spent most of her time in her room during her previous placement. Since moving into Milton Ave she has gone downstairs to the lounge to sit with other residents and has been encouraged to dress in the morning rather than wear her dressing gown all day. The home has tried to make the resident feel comfortable in their surroundings and supporting a new resident in their previous placement so that the resident became used to the members of staff from Milton Ave helped the resident make the transition from one care home to another. Similarly when a resident was in hospital, having a member of staff from Milton Ave with them helped the resident through what must have been a distressing time and ensured that the resident was relaxed and willing to cooperate with the hospital staff. Matthew Residential Care Home DS0000059266.V354781.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: In terms of the building, some work has been done recently on the damp course on the ground floor and there is bare plasterwork that needs to be made good and redecorated, when it has dried out sufficiently. Privacy when using the first floor bathroom is compromised by the lack of a lock. Recruitment practices need to be more thorough in terms of obtaining all the necessary checks and references before a member of staff starts working in the home and the home’s own recruitment and selection policies and procedures need to be followed. In order to demonstrate good practice a personnel file for each member of staff needs to be in the home and available. Support for members of staff would be strengthened by regular individual supervision sessions taking place with the manager. In order to identify what training individual members of staff have received or might need the use of individual training profiles would be beneficial but attendance certificates for training sessions or courses must be included to help track when refresher training is needed. The training programme needs to demonstrate that both core and refresher training is provided to staff, particularly so that recommended frequencies for refresher training are followed. In respect of ensuring that changes in the needs of residents are identified and addressed a system of regular reviews for risk assessments must be in place and a system for obtaining feedback from relatives and other interested parties on the quality of the service provided. Please contact the provider for advice of actions taken in response to this Matthew Residential Care Home DS0000059266.V354781.R01.S.doc Version 5.2 Page 7 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. Matthew Residential Care Home DS0000059266.V354781.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 Matthew Residential Care Home DS0000059266.V354781.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 People who use this service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. An assessment of the needs of the resident, prior to admission to the home, enables the home to determine whether a service tailored to the individual needs of the resident can be provided. EVIDENCE: Since the last key inspection a resident has been admitted to the home and their case file was examined. The information provided as part of the preadmission procedure included a copy of the local authority FACS Eligibility and Care Plan, a copy of the minutes of the most recent review meeting and information from the previous care home where the resident was living (including the care plan). The manager of Milton Ave went to the home where the resident was living and met the prospective resident and spoke to the assistant manager. After this one of the members of staff from Milton Ave went to visit. In order to support the resident through the transition period of moving from the previous care home and settling into Milton Ave, staff from Milton Ave went to work in the other care home, with the prospective resident, Matthew Residential Care Home DS0000059266.V354781.R01.S.doc Version 5.2 Page 10 for the 2 week period prior to the resident’s admission to Milton Ave. This is to be commended. Matthew Residential Care Home DS0000059266.V354781.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 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Reviewing the care plan and the placement on a regular basis ensures that changes in the needs of residents are identified and can be addressed. The residents’ right to exercise choice in their daily lives respected. Staff support residents to take responsible risks so that residents can enjoy an independent lifestyle. Keeping risk assessments under review assures residents that changes in needs are identified and met. EVIDENCE: The case files of the 2 residents that were living in the home when the last key inspection took place were case tracked. Both of the 2 files contained a care plan and evidence of a review of the care plan and placement by the funding Matthew Residential Care Home DS0000059266.V354781.R01.S.doc Version 5.2 Page 12 authority in 2007. An assessment of need had been carried out in preparation for the home’s internal review meeting and these are now due. Each resident has a key worker and one resident named her favourite members of staff. Residents liked to ask who would be on duty each day and it is recommended that some daily record with photographs could be on display. Residents received a personal allowance and a resident said that they could choose what they wanted to buy. All residents needed help in managing money. Records were available and were up to date and complete with balances. Receipts are obtained when money is spent. Passbooks demonstrated that savings accounts were in place, where appropriate. When 2 of the residents had moved from previous placements to Milton Ave an advocate had supported them. Case files contained risk assessments. There was a general risk assessment and then risk assessments tailored to the individual needs of the resident. When a resident was recently admitted t the home a copy of the risk assessment for the previous placement was forwarded. Risk assessments included risk management strategies. Some risk assessments were recent and there was evidence that risk assessments in place for some time had been reviewed although the date of the last review for one assessment was April 2006. Matthew Residential Care Home DS0000059266.V354781.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, 14, 15, 16, 17 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Taking part in activities, developing new skills and using community resources gives residents the opportunity to enjoy an interesting and stimulating lifestyle. By maintaining contact with their family and friends the resident’s need for company and fellowship is met. Residents are encouraged to become more independent by making decisions and by having their wishes respected. Menus respect the religious, cultural and dietary needs of residents. EVIDENCE: The expert by experience spoke with one of the residents at length and asked the resident for her views about life in the home and the service provided. The comments in his notebook have been used in this group of standards. Matthew Residential Care Home DS0000059266.V354781.R01.S.doc Version 5.2 Page 14 Case files contained a copy of the resident’s weekly activities programme. Each plan included activities both inside and outside the home and one of the residents living in the home attends college on one day per week for a cookery course. On another day each week an art therapist calls to the home and the resident said that she enjoyed the art therapy sessions. The manager and a resident gave examples of the facilities and services in the community that residents used. These included the shops, restaurants, hairdressers and pubs. Residents use taxis; dial a ride or public transport to travel. A discussion took place with the manager regarding an annual holiday. The last holiday had been in 2006 to Blackpool. In 2007 there had been days out to London as one resident did not want to go away this year and another resident’s behaviour required a particular venue. Residents confirmed that outings had taken place and the zoo was given as an example. One of the residents said that she enjoyed watching “the soaps” and usually watched television in the lounge rather than on the portable television in her room. She also enjoyed listening to music in her room. Although visitors to the home are made welcome residents did not have family members that visited often. When visits do take place the resident can entertain her relatives in her room, if the resident wishes. Relatives are invited to attend review meetings, birthday celebrations etc. During the inspection residents moved around the house as they wished and we spoke with one of the residents in her room. The resident said that she was able to use her room when she wanted to and that she liked to spend time there. She had chosen the colour scheme in her room, as had the resident most recently admitted to the home. She also said that she had a lot of choice of when she went out with a support worker. Examples of going out for a Chinese meal, going shopping or to the pub with support workers were given. Residents confirmed that they were able to choose when they got in the morning and when they went to bed. They are able to choose what clothes to wear and they have the choice of using the bath or a shower. Residents enjoyed the addition of the expert by experience during the inspection and at the end of the second visit we were invited by one of the residents to stay for a meal or to return to the home on another occasion to visit them. The resident was demonstrating that this was her home and that she was able to offer invitations to people, as she wished. Residents confirmed that they had choice in what they ate and that meals were taken outside the home, from time to time and that sometimes take away food was ordered. The home has a menu and a varied and wholesome diet is offered to residents. During the visits it was noted that residents were encouraged to choose what they wanted to eat. Food being prepared looked Matthew Residential Care Home DS0000059266.V354781.R01.S.doc Version 5.2 Page 15 and smelt appetising. There is a large dining table in the open plan dining and kitchen area and a small dining table in the open plan dining and lounge area. Matthew Residential Care Home DS0000059266.V354781.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents receive prompting with personal care in a manner, which respects their privacy and dignity. Residents’ health care needs are met through access to health care services in the community. Residents’ general health and well-being is promoted by staff that assist the resident to take prescribed medication in accordance with the instructions of the resident’s GP. EVIDENCE: Residents receive assistance with personal care tasks although they are encouraged to do as much as they can for themselves. The current residents are all female and the staff team is female. Routines are based on the residents’ needs and wishes and vary from day to day e.g. one of the residents prefers to have a lie in at the weekends. Residents are encouraged to choose what clothes to wear each day. The manager gave an example of how the home is supporting a resident to maintain their personal dignity by being Matthew Residential Care Home DS0000059266.V354781.R01.S.doc Version 5.2 Page 17 appropriately dressed in communal areas. Listening monitors are in use for 2 of the residents and it is recommended that there is a risk assessment in place regarding their use. Information on the health care needs and how these are met are contained on the residents’ case files. There was evidence of access to routine health screening and support for out patient appointments at hospitals. There was evidence of regular health checks e.g. by the optician, the dentist and the chiropodist. Residents were able to have a flu jab, if they wished. One of the residents had been referred to the physiotherapist and a copy of the report of the assessment was kept on the case file. When one of the residents had been in hospital recently, for a week, a member of staff was with her during the day, and night, to give her support and comfort. A resident said that she goes to the GP or the GP visits her at Milton Ave if she is ill. The home has a medication policy in place and has a written protocol for the use of PRN medication. Records were inspected and were up to date and complete. Medication had been appropriately administered prior to the inspection, according to the time of day and the day of the week on which the inspection took place. The storage of medication was safe and secure and staff have received medication training in September 2007 from the pharmacy supplying medication to the home. Matthew Residential Care Home DS0000059266.V354781.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. A complaints procedure is in place to protect the interests of residents. Knowledge of the adult protection policy and provision of protection of vulnerable adults training for staff contribute towards the safety of residents. However, failing to carry out the required checks before new members of staff start working in the home puts residents at risk. EVIDENCE: A complaints procedure is in place in the home and a copy of this is pinned on the notice board in the office. It includes each stage of the process, with timescales attached. There is a user-friendly complaints procedure for residents to use. The manager said that no complaints have been recorded since the last inspection. No complaints have been made directly to the Commission for Social Care Inspection about the home. A resident said that she would tell some-one if there was something that she was unhappy with and there was a good rapport between residents and members of staff. A protection of vulnerable adults (pova) procedure is in place in the home. A copy of the multi agency protection of vulnerable adults guidelines was present on one of the residents’ case files examined and a copy of the guidelines leaflet Matthew Residential Care Home DS0000059266.V354781.R01.S.doc Version 5.2 Page 19 was pinned on the notice board in the office. The manager confirmed that all members of staff have undertaken protection of vulnerable adults training and training in supporting residents with challenging behaviour. Attendance certificates for pova training were included in staff personnel files. The manager has recently attended a refresher pova training session. No allegations or incidents of abuse have been recorded since the last key inspection. Two residents said that they felt “very safe” living in the home. Staff records were incomplete and not all files included the checks and references required. (Please refer to Standard 34). Matthew Residential Care Home DS0000059266.V354781.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home offers pleasant communal and private facilities, providing residents a comfortable and “homely” environment in which to relax. Residents benefit from living in a home where standards of cleanliness are good. EVIDENCE: During the inspection a tour of the building took place. Although it was December it was warm in the most areas in the home and levels of lighting were sufficient. However the bedroom at the back of the house, on the first floor felt cold. The building is in a good state of repair and is comfortably furnished and decorated and provides residents with a homely environment. Photographs of residents, maybe some of residents taking part in activities outside the home, are lacking in the communal areas and it is recommended Matthew Residential Care Home DS0000059266.V354781.R01.S.doc Version 5.2 Page 21 that if residents wish, photographs could be displayed. Each resident has their own single bedroom with a wash hand basin and one of the bedrooms has an ensuite bath and toilet. Residents said that they were happy with their rooms and while residents are encouraged to personalise their rooms one bedroom contained only the basic furniture. The manager said that the resident occupying this room threw things out of the window. Work on the damp course in the kitchen has been done recently and the plasterwork is still drying out, which has prevented redecorating and making good in the kitchen and in the bedroom adjacent. There is level access to the front of the home but at the back of the house there is a step down from the dining area through doors to the patio. There is also a step down from the kitchen door to the patio. A resident said that the garden is in use in the summer and that there is patio furniture so that they are able to sit out on the patio. There is stair lift in the home to help residents that may have difficulty climbing up or down the stairs but the space left between the banister and the tracking for the stair lift, for people using the stairs independently, is restricted. During the tour of the building it was noted that all areas were clean and tidy and there were no offensive odours. However the bathroom on the first floor did not have any soap, toilet paper, paper hand towels, a plug for the wash hand basin or a lock on the bathroom door. The manager said that one of the residents accommodated on this floor throws things out of the window or down the toilet and has broken the lock on the bathroom door. The utility room leads off the kitchen but although laundry is carried through the kitchen the manager said that the home does not service incontinent laundry. Laundry facilities are sufficient for the number of residents and include a washing machine (no sluicing cycle) and a tumble drier. There is a wash hand basin in the utility room. The home has an infection control procedure and the manager said that staff have previously undertaken infection control training. Matthew Residential Care Home DS0000059266.V354781.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, 36 People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. NVQ training enhances the general skills and knowledge of carers and contributes towards the quality of service that the residents receive. The rota demonstrated that there were sufficient members of staff on duty to support the residents and to meet their needs. Recruitment practices, where checks and references were lacking, failed to protect the welfare and safety of residents. Training and supervision records failed to clearly demonstrate opportunities for staff development that would ensure residents benefit from a service based on current best practice and guidance. EVIDENCE: There are 7 names of carers on the rota and the manager confirmed that 6 of the carers have completed their NVQ level 2 or level 3 training and that the newest member of staff has started their NVQ level 2 studies. A resident said that all the members of staff were friendly and it was noted that all members of staff on duty interacted well with residents. Matthew Residential Care Home DS0000059266.V354781.R01.S.doc Version 5.2 Page 23 A discussion took place with the manager regarding staffing levels. A copy of the rota for week commencing the 17th December was seen. Each day there are 2 members of staff on duty. At night there is one member of staff on waking night duties and 1 member of staff sleeping on the premises, but on call in the event of an emergency. These were the staffing levels seen on the day of the inspection and are sufficient to meet the needs of the current residents. The names of 5 carers were chosen and their files requested. Three files were provided and the manager said that the file of the 4th member of staff was at the company’s other care home. (This member of staff works shifts in both of the company’s homes). The file was not produced later in the day, during the second visit. The manager said that the 5th member of staff did not have a personnel file as there were no records. A letter of serious concerns was sent to the home following the inspection regarding the lack of staff records and the failure to demonstrate that the home screened out unsuitable applicants during the recruitment process. The manager has since informed that CSCI that the 5th member of staff was suspended from duties the day after the inspection and will not work in the home until satisfactory checks and a disclosure have been received. The 3 staff files examined contained evidence that an enhanced CRB disclosure had been obtained, passport details, and 2 satisfactory references. The right to reside and to work in the UK had been established. A copy of the training schedule was provided but it did not indicate the period it covered. However, it included dates for training taking place between September and December 2007. More detail is necessary to identify whether the sessions form part of the home’s core training programme of whether the sessions are refresher training. Although there were attendance certificates on file an individual training profile is needed for the member of staff to highlight any gaps in training provided and to highlight when refresher training is needed to meet the recommended frequencies for updating knowledge. One of the 3 staff files examined contained a Sector Skills Council’s “Common Induction Standards – Progress Log”. Minutes of individual supervision sessions for members of staff working in the home are kept but did not demonstrate that they take place at least every 2 months even though this had been identified as a requirement in the previous key inspection. The manager said that in a home with a small number of residents and with a small staff team informal supervision and support can be given on a daily basis. The manager has the opportunity to observe and to monitor the care practice of each member of staff. Matthew Residential Care Home DS0000059266.V354781.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. Undertaking periodic training to update her skills and knowledge helps the manager to organise a service that is based on an understanding of the needs of the residents. Failing to follow the home’s policies and procedures puts residents at risk. Using annual quality assurance questionnaires for relatives and social workers would help to monitor the quality of the service provided to residents and contribute towards the development of the service. Regular servicing and checking of equipment used in the home ensures that items are in working order and safe to use. EVIDENCE: Matthew Residential Care Home DS0000059266.V354781.R01.S.doc Version 5.2 Page 25 A copy of the manager’s NVQ level 4 for Registered Manager’s (Adult services) certificate has been seen. The manager has previously said that she qualified as a mental health nurse. Since the last key inspection the manager has attended Mental Capacity Act training and refresher training for the protection of vulnerable adults. Both residents and staff have a good rapport with the manager and both have said that she is approachable and that if they had a problem they would talk with her. An admission by the manager that there were no records kept for one member of staff and that the file of another member of staff was in the company’s other care home is contrary to the company’s recruitment and selection procedure and contrary to safe working practices. (Please refer to Standard 34). The manager has responded appropriately to the letter of serious concerns sent to the home, following the inspection, by suspending the first member of staff until the necessary checks and references have been received and by ensuring that there are basic records in both of the homes where the other member of staff works. This is a small residential care home that is registered to accommodate up to 4 residents. One of the 3 current residents is unable to give any verbal feedback. Members of staff study the facial expressions and body language of residents in the absence of verbal feedback or when the resident has limited verbal communication skills to understand the wishes of the resident. One resident can give verbal feedback and appears to be comfortable in giving her opinions. There was a quality assurance survey form (with illustrations and pictures to assist completion) on their case file but no date to confirm when it was used. The manager spends time with residents, on an individual basis, to monitor their wellbeing and one resident likes to sit in the office when the manager is working there. The home has not sent a quality assurance questionnaire to relatives or social workers in 2007. Certificates for servicing, checking or inspecting equipment and systems in the home were shown. These included valid certificates for the portable electrical appliances, the Landlord’s Gas Safety Record and the electrical installation. Records for the weekly testing of the fire alarm system were up to date. There were some boxes in one of the bedrooms and these could restrict movement and present a hazard. It is recommended that storage facilities in the home be reviewed. There was a door guard on the lounge door so that it could be held open to allow easy movement but would close automatically in the event of a fire. It is recommended that one be used on the ground floor bedroom door as this was propped open. (The door could be closed when the resident wants privacy). Matthew Residential Care Home DS0000059266.V354781.R01.S.doc Version 5.2 Page 26 Matthew Residential Care Home DS0000059266.V354781.R01.S.doc Version 5.2 Page 27 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 4 3 X 4 X 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 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 1 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X 2 X 2 X X 3 X Matthew Residential Care Home DS0000059266.V354781.R01.S.doc Version 5.2 Page 28 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 Risk assessments must be subject to regular reviews (which are recorded) to assure residents that changes are identified and met so that there safety is maintained. Making good and redecorating the area where damp course work has taken place in the kitchen and adjoining ground floor bedroom will assure residents of comfortable and smart surroundings. Installing a lock on the door of the first floor bathroom ensures that the privacy of people using this facility is protected. Staff records must be kept on site and available for inspection to demonstrate that all necessary checks and references have been obtained to assure residents that unsuitable persons are not employed. All necessary and satisfactory checks and references must be obtained prior to a member of staff starting to work in the home to protect the safety and DS0000059266.V354781.R01.S.doc Timescale for action 01/04/08 2 YA24 23(2) 01/05/08 3 YA30 12(4) 01/03/08 4 YA34 17(2)S(4) 07/01/08 5 YA34 19(1) 07/01/08 Matthew Residential Care Home Version 5.2 Page 29 welfare of the residents. 6 YA35 18(1) The training programme must include sufficient detail to differentiate between core and refresher training so that it demonstrates that ways of working in the home are based on best practice. Each member of staff must have an individual training profile with attendance certificates so that any gaps in knowledge can be identified and addressed. Regular, recorded supervision must take place so that members of staff are supported and residents are assured of a service where standards are monitored. (Timescale of the 30th May 2007 not met). Each person working in the home must follow the policies and procedures in place so that residents are assured of a quality service. An annual quality assurance questionnaire must be sent to relatives, social workers and professional visitors to the home to assure residents that as the service develops it will continue to meet their needs. 01/04/08 7 YA35 18(1) 01/04/08 8 YA36 18(2) 01/04/08 9 YA37 12(1) 01/04/08 10 YA39 24(1) 01/04/08 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 Refer to Standard YA6 YA18 Good Practice Recommendations That there is a daily record (with photographs) on display of which members of staff are on duty. That the use of a listening monitor in a resident’s bedroom at night is subject to a risk assessment, agreed by all DS0000059266.V354781.R01.S.doc Version 5.2 Page 30 Matthew Residential Care Home 3 YA24 4 5 6 YA24 YA24 YA30 7 8 9 10 11 YA35 YA36 YA39 YA42 YA42 parties concerned (including the funding authority) and is reviewed when the care plan review takes place. That a thermometer is kept in the bedroom at the back of the house to monitor the temperature in this room to ensure that it does not fall below a safe and comfortable temperature during the day and the night. That subject to the residents’ wishes, photographs of residents are displayed in communal areas as part of the creation of a homely atmosphere in Milton Ave. That a portable wooden ramp is kept for use in the home is visitors or residents are unable to negotiate the step down from kitchen or dining area onto the patio. That a review is carried out regarding the provision of toilet paper, paper towels and soap in the first floor bathroom so that residents, members of staff and visitors have access to these as necessary. That the training programme for the home is dated. That individual supervision sessions with members of staff are held at least every 2 months. That quality assurance questionnaires are dated. That a review of storage facilities in the home is carried out to avoid boxes restricting movement in a resident’s bedroom. That a door guard is fitted to the door of the ground floor bedroom so that it can be open to allow easy movement but closed for privacy and in the event of a fire. Matthew Residential Care Home DS0000059266.V354781.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Matthew Residential Care Home DS0000059266.V354781.R01.S.doc Version 5.2 Page 32 - 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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