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Inspection on 20/11/06 for Median Road Resource Centre

Also see our care home review for Median Road Resource Centre for more information

This inspection was carried out on 20th November 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service continues to offer service users a very high quality of care. All service users undergo an assessment of need prior to admission, except in emergency situations when the assessment is completed shortly after admission. The registered manager and the senior staff team are very well qualified and experienced perform their duties and the staff group are well established and committed to quality care. All four distinct services are managed well and effectively meet service users` identified needs and placement objectives. The home`s premises are impressively well maintained and it is clear that time and effort is taken in making the home`s environment very pleasant and homely. Service users who were interviewed spoke very positively about services provided by the home, the caring efforts of managers and the staff group as a whole, recreational activities, meals etc.

What has improved since the last inspection?

The standard of care evident during the inspection is similar to the quality of care observed during the previous inspection. It was the inspectors view however that the continued development of some of the home`s newer services (intermediate and interim programmes) had brought the quality of care to be on par with the standard of care of the long-term service. All services at this point were highly functional and facilitating excellent outcomes for service users.

What the care home could do better:

The inspector noted that while documentation seen on service user files were good, improvements could be made to contain more comprehensive information. On care plans for example, information seen was adequate, but the inspector felt that in some instances, staff could have elaborated more fully in case recordings and key documents.

CARE HOMES FOR OLDER PEOPLE Median Road Median Road 25 Median Road Hackney London E5 0PE Lead Inspector Unannounced Inspection 20th November 2006 11:00 X10015.doc Version 1.40 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 Median Road DS0000033815.V319916.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 Older People. 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. Median Road DS0000033815.V319916.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Median Road Address Median Road 25 Median Road Hackney London E5 0PE 020 8356 4768 020 8985 3960 cbarrett@gw.hackney.gov.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) London Borough of Hackney Cecile Barrett Care Home 37 Category(ies) of Dementia (28), Old age, not falling within any registration, with number other category (28), Physical disability (9) of places Median Road DS0000033815.V319916.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th March 2006 Brief Description of the Service: 25 Median Road Resource Centre is a local authority run home for elders who do not require nursing care. The home offers support, personal care and accommodation for a maximum of 37 service users. It offers four distinct services; long term residential care, intermediate care, respite care and services to those recently discharged from hospital and assessed as having no immediate need for hospital care (Delayed Discharge Programme). The home is in the process of reducing its long term residential care provision in order to offer more beds to service users admitted via the delayed discharge policy. It is the service’s long term plan to eventually phase out long term provision and offer services to slightly younger elders than the registration category currently permits. A variation to the home’s current services will need to be applied for. The home is situated in Clapton within the London Borough of Hackney, in very close proximity to the local general hospital. Bus links are good and local shops and amenities are located nearby. Fees are payable for respite and interim care services are £64.65p for seven nights; no charges are made for intermediate services. Fees payable for the remaining long-term beds are based upon individual financial assessments. Median Road DS0000033815.V319916.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection of Median Road Resource Centre took place on November 20th 2006 for the duration of eight hours. Assisting the inspector with the process was one of the home’s deputy managers; the inspector had the opportunity to meet with the registered manager towards the end of the inspection. The purpose of the inspection was to assess the home against key National Minimum Standards; the home had no requirements outstanding from the previous inspection. The focus of the inspection was the review of the home’s intermediate (rehabilitation) service and its interim (delayed discharge) service. The inspection process included private interviews with six service users, a group discussion with unit staff on shift during the inspection, discussion with managers, an accompanied tour of the home’s premises and the review of four service users files. As a result of the inspection one recommendation only was made and the home is commended for its consistent high standard of quality care. The inspector would like to thank all service users and staff who co-operated and contributed to the inspection process. What the service does well: The service continues to offer service users a very high quality of care. All service users undergo an assessment of need prior to admission, except in emergency situations when the assessment is completed shortly after admission. The registered manager and the senior staff team are very well qualified and experienced perform their duties and the staff group are well established and committed to quality care. All four distinct services are managed well and effectively meet service users’ identified needs and placement objectives. The home’s premises are impressively well maintained and it is clear that time and effort is taken in making the home’s environment very pleasant and homely. Service users who were interviewed spoke very positively about services provided by the home, the caring efforts of managers and the staff group as a whole, recreational activities, meals etc. Median Road DS0000033815.V319916.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Median Road DS0000033815.V319916.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Median Road DS0000033815.V319916.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The deputy manager assisting with the inspection process commented that all service users underwent needs assessments prior to admission to the home. The exception to this was emergency admission, which did occur infrequently. In such cases, representatives of Social Services or the hospital had generally completed assessments of need. The inspector reviewed the individual case files for four service users and was satisfied that in each case, needs assessments were documented. The deputy manager gave good examples of how service users accessing the home via the intermediate care service were proactively encouraged by staff of the home and other involved professionals to maximise their independence in order to return home or move to alternative placements. Occupational/psysiotherapist establish short and log term goals to support service users maintain and increase their independence in order for them to move on to permanent Median Road DS0000033815.V319916.R01.S.doc Version 5.2 Page 9 placements or back to their own homes. So for example for service users initially requiring total support, the long term goals of the service would be to work towards minimising the input of carers. Staff of the home were jointly responsible for executing the short and long-term plans established by occupational/physio-therapists. The deputy manager commented that often the task of moving service users on to greater independence required a fair amount of persuasion; she indicated that she felt that the staff group had a good skill mix and that staff’s aptitude in encouraging service users to work towards greater independence varied. An attempt was made, the deputy commented, to match the skills of individual staff with service user needs. Work was embarked upon with the understanding and consent of service users. The inspector met with a service user who had fractured her arm during a fall at a relative’s home, she was receiving intermediate care at the home. The service user commented, “I like making my own bed and keeping things tidy, but staff are always here to help me……I could spend the rest of my days here, but I know I have to go home” . Median Road DS0000033815.V319916.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The deputy manager assisting with the inspection process commented that documented care plans were in place for all service users. Review of four service users files, confirmed this to be the case. The inspector noted that some files contained care plans devised by the local authority prior to the service user’s admission to the home. These were very comprehensive detailing well all aspects of the service user’s lives. The care plans devised by staff of the home were fairly well documented, by it was the inspector’s view that care plan documentation could be improved upon to include more extensive service user information. Care plans seen were fairly basic in content, but nonetheless adequate. With regard to health care needs, the deputy manager gave good illustration of the types of healthcare and medical conditions that service users’ presented with upon admission. These were wide ranging and included pain management, bone fractures, diabetic conditions, renal failure, obesity, and issues associated with mental health support needs. Files reviewed outlined Median Road DS0000033815.V319916.R01.S.doc Version 5.2 Page 11 well the medical and health care needs of service users, particularly via the care planning process. The deputy manager informed the inspector that service users had good access to GP services, either via their own registered GP, or the GP practice assigned to the home. On call GP services were also available. The home has an excellent working relationship with the local university hospital, which is the source of many referrals for both interim and intermediate care services. With regard to medication, the deputy manager commented that where appropriate, service users were encouraged to manage their own medication. Where this was not possible, staff were responsible for the administration of medication. The inspector saw on file comprehensive information pertaining to the medication and medication regimes of individual service users. Dosett boxes containing daily medication was available to service users, making easy the management of their own medication One service user who met with the inspector indicated that he was responsible for his own medication as he had been while at home, despite his continued failing health. The deputy manager shared that the home’s duty managers and senior staff were responsible for the weekly monitoring of MAR (Medication Action Record) sheets and that most staff had received medication training via an external pharmacist. Newly recruited staff were paired with experienced staff to observe medication practices. New staff were only responsible for administering service users’ medication once their competency in this aspect of their work had been assessed. The deputy manager gave good examples that indicated that service users’ rights were promoted and that privacy was respected. So, for example it was standard practice for staff to knock on bedroom doors before entering and seeking out service users’ permission to enter their rooms for cleaning if they were elsewhere on the premises. Staff were encouraged to readily consult staff over a host of issues and respect the wishes of those who preferred their own company. All service users who met with the inspector spoke very positively about staff respecting their wishes and need for privacy. One service user commented; “I think the home is lovely, you get a lot of privacy, the girls (staff) don’t fob you off. It couldn’t be nicer”. Another service user interviewed said, “Staff listen to me and assist when I want them to”. Median Road DS0000033815.V319916.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users who spoke with the inspector indicated that they were very satisfied with their lifestyle while at the home and that their individual needs and interests were very well met. One service user accessing services via the interim care service commented; “It’s not like a home, you do your own thing, there are people here to help you if you need it” Another service user, whose mobility was significantly restricted told the inspector of some of the activities organised by the home that he enjoyed participating in, “I have nothing to complain about. I join in the games, happy hour, parties, I watch TV and listen to the radio. This place offers enough things to do”. The deputy manager in discussing the home’s activities said that there was a fair range of recreational activities that services users could participate in if Median Road DS0000033815.V319916.R01.S.doc Version 5.2 Page 13 they so wished. These included a ‘coffee morning’ on one of the units that discussed current affairs, nostalgia, service users personal interests, personal events and life experiences. Guest speakers also occasionally featured. Two church services (Methodist and Seventh Day Adventist) were conducted in the home on a monthly basis and other activities such as bingo, board games, knitting, art and baking also featured on the units. Musical therapy was a twice-weekly activity that was popular in the home and at the request of some residents; Gospel music is played on some the units on a Sunday morning. The deputy indicated that new or developing service users interests could be introduced as requested. Friends and family members of service users were encouraged to visit Median Road Resource Centre and during the inspection, the inspector saw a number of visitors on the premises. Visiting times are flexible and private and communal areas are available for service users to entertain their guests. The home encouraged frequent telephone contact especially with friends and relatives of service users who did not live locally. Advocates were informed and invited to review meetings as per the request of service users. One service user said “I go to see my sister in Walthamstow, my family also visit me here, they like it” Another service user informed the inspector of ongoing relationship difficulties she was experiencing with her son and her appreciation of staff respecting her wish that he not allowed to enter the home’s premises under any circumstances. There was a consent form in place to this effect. The service user said, “The best thing about here is the peace of mind. They monitor visitors. I don’t have to see anyone I don’t want to see”. Service users also spoke of the control and freedom they enjoyed at the home. One service user said, “I can go and have a cigarette upstairs anytime I want”. Another service user indicated that she was not keen on group activities and enjoyed the freedom to go shopping locally on almost a daily basis on her own. Other service users spoke about being responsible for their own medication (as explored earlier in this report) and made decisions to participate or not in tasks such as assisting to tidy their rooms. Residents meetings were regularly held on each unit. This was an opportunity for service users to explore service provision and delivery. All service users interviewed were extremely positive about the home’s meals. The deputy manager explained that meal plans were largely based on the Median Road DS0000033815.V319916.R01.S.doc Version 5.2 Page 14 expressed preferences of service users and took into account cultural and religious considerations. Meal times were flexible and served where service users preferred to eat. The home’s cook frequently asked service users about their preferences and satisfaction with the quality of meals provided. Traditional English and West Indian meals featured on unit menus and the deputy explained that Kosher meals were provided via a catering company that also offered catering services to the neighbouring hospital. Asked about the home’s menu service users said the following; “Meals here are perfect!” “Meals are good – you get a good choice” Meals are marvellous; they cook in front of you so you can see what you’re eating. You can help (cook) if you want to. It couldn’t be nicer” “The meals are very good” One service user commented that she felt at times the home had offered, “too much chicken”. The deputy manager informed the inspector that she was aware of this complaint and said that the home had tried to amend its menu some time ago to offer a wider variety of meat, fish and vegetarian foods. Median Road DS0000033815.V319916.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector reviewed the home’s complaints log and was satisfied that complaints made were appropriately handled in accordance with the home’s complaints procedure, which had been reviewed at a previous inspection. The recording of complaints was clear, as were the outcomes of complaint investigations. Service users interviewed by the inspector largely commented that they had no reason to complaint but were aware (to varying degrees) of the home’s complaint procedure. The deputy manager commented that there had been no instances of an adult protection nature since the last inspection and that senior staff had completed POVA training, which had been cascaded down to other staff. The deputy manager also said that staff has received adult protection training via NVQ 2 training, which most staff had completed. Median Road DS0000033815.V319916.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18 & 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector participated on an accompanied tour of the home’s premises and observed all units. Beds in the home are allocated as follows; nine beds were designated intermediate care, sixteen beds were allocated to the interim care service; seven beds remained for permanent long term residents, while a further five beds were allocated for respite service. The inspector was aware of the home’s operating CCTV that covered the immediate external surroundings of the home and internal front entrance, thereby enhancing the safety and security of service users and staff. The home was maintained impeccably clean, domestic staff were seen conducting their duties at the time of the inspection. The deputy manager pointed out new carpeting through the home and a small area on the top floor Median Road DS0000033815.V319916.R01.S.doc Version 5.2 Page 17 that had been recently plastered. Some units had been re-decorated since the last inspection and the kitchen area in one unit had new flooring. The inspector was struck by the time and effort staff had applied to making the sure the home was pleasant, very comfortable with a warm atmosphere. The inspector was encouraged to observe artwork, (including those produced by service users), throughout the building. There were many positive images (photographs, posters art prints maps etc), of numerous cultures. The inspector had no doubt that residents from all areas of the world would feel welcome at the home. The communal large dining area had collages of miniatures dresses on the wall that had been made by service users. This same area of the home also had multiple maps from numerous countries on display. Fresh flowers were evident throughout the home as were celebratory photographs of service users and staff. Individual service user bedrooms were very personalised and contained good evidence of the different personal effects of residents. Service users who spoke with the inspector were very complimentary about the home’s environment. Service users said; “The home is lovely, I think my room is superb” “My room is Ok, but there are too may corridors” “It’s very, very clean here” “Median Road is OK. I like living here, my bedroom is alright, it has everything I need” “My room is huge!” The deputy manager said that most of the residents’ beds had been changed to electric beds, which were more comfortable and promoted good posture. One service user said of her new bed, “I got a new electric bed two days ago – it’s much better than the one I had before”. The registered manager informed the inspector that it was the responsibility of all staff to maintain the home’s welcoming atmosphere and it had become a matter of routine, for example that fresh flowers were purchased at the beginning of the week. The registered manager indicated that it was time for the home’s décor to be changed and that it was her intention to swap pictures and posters around the home and purchase new ones. Median Road DS0000033815.V319916.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager informed the inspector that staff recruitment interviews were being held on the day of the inspection. These were to cover a number of staff vacancies and positions currently held by agency staff. The registered manager said that she had recently audited staff personnel files to ensure all required information was evident. She was satisfied, following the auditing process that this was the case. The inspector had previously reviewed staff personnel records and had been satisfied that staff vetting and recruitment processes were sufficiently robust. No new staff members had been recruited since the last inspection The registered manager informed the inspector that staff of the home had access to ’statutory’ departmental training that was offered as part of a rolling programme. Staff meetings also frequently focused on training issues. Key (external) training provided to staff in recent months had included manual handling, risk management and stress management training and ongoing NVQ courses at varying levels. The registered manager had recently attended a (refresher) management course and the management of violence and aggression. Fire risk assessment, POVA training, dementia care and training focused on dual diagnosis had been provided to staff, while two senior staff members were completing management training. Training opportunities for staff had developed significantly over the past 12 months. Median Road DS0000033815.V319916.R01.S.doc Version 5.2 Page 19 Managers of the home indicated that they were satisfied with the competency levels of the staff group. The work force was well established, some staff members having worked at Median Road for several years. The inspector attended the afternoon hand over meeting for staff. Discussions were as expected, user focused. Senior staff informed the inspector that the staff group as a whole had recently been awarded Social Services Team of the Year 2006 in recognition of Customer Care excellence and effective team working. The staff group were proud of this achievement and acknowledged the need to continue to maintain the home’s very impressive high standards. In interviewing service users, the inspector asked for their view in relation to the home’s staff. Responses were extremely encouraging; Staff are very kind and gentle. They listen” “Everyone of the staff are good” “…I have no complaint, the staff pamper me” “You have everything you need and staff will help you” During the course of the inspection, the inspector discretely observed staff interact with service users. Staff at all levels, domestic staff, the ’handy person’, support and senior staff all with great ease, addressed service users with sensitivity and care. In the corridor (where the inspector could not be observed) domestic staff were heard asking service users if they could be of assistance. Staff habitually spoke with service users routinely about what they wanted and verbalised what action would occur next, this was particularly true around meal times. In passing staff would openly greet service users and have conversation. The inspector got the impression that service users were constantly readily engaged in interaction and their wellbeing and welfare was paramount. Overall, throughout the inspection the inspector witnessed what one service user had described regarding her relationship with staff; “We just have a laugh and a right carry on” Median Road DS0000033815.V319916.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector continued to be impressed by the effective leadership style of the registered manager and her ability to motivate the staff group to maintain the high standard of care at Median Road Resource Centre. The management of the home is effective primarily due to the competency of the registered manager in her role as manager of the service. Staff appeared to appreciate her directness and keen eye for detail and was particularly impressed by her embracing attitude towards service users and her ‘hands on’ approach to care and management. Not satisfied with existing extensive training, the registered manager, who is also a qualified social worker had recently completed a ‘refresher’ management course. Responsible for a number of projects at Median Road, the registered Median Road DS0000033815.V319916.R01.S.doc Version 5.2 Page 21 manager as for some time been preparing able staff to take on increasing responsibility and has managed to successfully delegate management tasks to senior members of staff, while maintaining overall responsibility for the service. The registered manager spoke with enthusiasm developing projects anticipated at the home to further promote service user independence. The health, safety and welfare of service users and staff are clearly well promoted and protected. The registered manager has implemented keen systems in place to ensure the protection of service users and this contributes to the low number of undesired incidents that occur in the home. Asked to comment on their impression of the registered manager and her abilities, service users were very complimentary, two service users said; “The manager is lovely, very down to earth” “I couldn’t say a wrong thing about the home”. Overall, Median Road Resource Centre is an impressive service that pays keen attention to the needs of people who live and stay there. The service is commended for its continued high quality care in providing four very distinct services for Hackney elders. Median Road DS0000033815.V319916.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 4 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 X X 3 X X 4 Median Road DS0000033815.V319916.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Median Road DS0000033815.V319916.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection East London Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU 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 Median Road DS0000033815.V319916.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!