Inspection on 28/10/05 for Medihands Healthcare (2)

This inspection was carried out on 28th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Medihands Healthcare (2) 17/10/06

Medihands Healthcare (2) 21/12/05

Medihands Healthcare (2) 21/03/05

Medihands Healthcare (2) 09/12/04

Medihands Healthcare (2) 28/02/04

Medihands Healthcare (2) 30/10/03

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 Medihands Healthcare (2) 2 Westbury Road New Malden Surrey KT3 5BE Lead Inspector David Pennells Unannounced Inspection 28th October 2005 11:00 Medihands Healthcare (2) DS0000013435.V254383.R01.S.doc Version 5.0 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 Medihands Healthcare (2) DS0000013435.V254383.R01.S.doc Version 5.0 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. Medihands Healthcare (2) DS0000013435.V254383.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Medihands Healthcare (2) Address 2 Westbury Road New Malden Surrey KT3 5BE 020 8404 4108 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Jayashree Sawmynaden Mrs Jayashree Sawmynaden Care Home 3 Category(ies) of Learning disability (3), Mental disorder, registration, with number excluding learning disability or dementia (3) of places Medihands Healthcare (2) DS0000013435.V254383.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21/03/05 Brief Description of the Service: 2, Westbury Road is owned and managed by Medihands Care Services and is a small care home for three people and is situated in a residential area, on a busy main road close to local amenities and shops. The house is in keeping with the neighbouring properties and is not identifiable as a care home. Accommodation comprises a bedroom for each of the three service users, with a bathroom and toilet upstairs, and the lounge, a conservatory and kitchen are provided on the ground floor. There is a small rear garden with a patio. The accommodation is of generally good quality. The home provides long term care for a small number (three maximum) of people with severe and enduring mental illness. The home aims to support service users in becoming independent through providing support to each individual service user. The manager is well organised in supporting the needs of both service users and staff. She is also the manager of another small unit a couple of roads away, and a proprietor of a larger home for people with mental health needs and also a nursing home for older people. Medihands Healthcare (2) DS0000013435.V254383.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a few hours over a late morning / lunchtime visit - when fortunately two of the three service users were present at the home. The inspector was able to spend some considerable time speaking to both these residents in private, as well as meeting with the proprietor / manager and the staff member on duty that day. The premises were inspected throughout, excepting the room belonging to the service user who was absent at that time. The inspector was able to review the outcomes from requirements and recommendations from the last inspection visit, and also to inspect essential documentation relating to the health and safety aspects of maintenance and servicing at the home – ensuring that the environment was safe to occupy for both service users and staff. The inspector also spent time with the manager reviewing information provided within the pre-inspection questionnaire that had been completed and returned to the Commission. The Inspector is grateful to service users, the staff and manager of the home for the cooperation, and the hospitality shown, during the inspection process. What the service does well: What has improved since the last inspection? The bathroom has been refurbished with new fittings, a new shower and bathroom furniture. The kitchen ceiling has been redecorated. The rest of the accommodation has been maintained to a reasonable level. The proprietor / manager has updated the Complaints Procedure and modified the home’s Abuse (Vulnerable adults) Policy. Medication Guidance Profiles with regard to ‘when required’ medication has been enhanced. Medihands Healthcare (2) DS0000013435.V254383.R01.S.doc Version 5.0 Page 6 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. Medihands Healthcare (2) DS0000013435.V254383.R01.S.doc Version 5.0 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 Medihands Healthcare (2) DS0000013435.V254383.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None inspected this time. Prospective service users can expect to have their needs assessed and to be provided with adequate information concerning life at the home prior to being admitted. The small size of the home enables prospective service users to visit and ‘test drive’ the service - if there is a vacancy. Service users are provided with written terms and conditions of occupancy, enabling them to understand their rights whilst living at the home. EVIDENCE: None of the above standards were formally assessed at this inspection visit, as the population of the home was the same as at the last two inspection visits. One service user has been resident at the home since 1994, the other two arriving in November 2002 and January 2003. There has been no movement since then. All standards were previously inspected in the 2004 / 2005 cycle of inspections and found to be met at these previous visits. Medihands Healthcare (2) DS0000013435.V254383.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 & 9. The home maintains care plans and assessment documents designed to ensure that the needs of individual service users are realistically met in a focused and individual way. Service users can be assured that their rights to individuality and selfexpression are protected, whilst acknowledging the community aspect of living at the home. Consultation and sharing of information will involve, and take into account, the wishes and aspirations of the single service user as an individual, as well as being a member of the home’s community. Service users can be assured that risk-taking will be an integral part of the support / protection plans put in place by the home and the placing authority. EVIDENCE: Care Plans are held on each service user’s files – these stemming from the regularly reviewed enhanced Care Programme Approach documents that are revised at regular CPA meetings. The Plan gives a detailed assessment of needs concerning health and social care, and describes how the care is delivered - and by whom. Medihands Healthcare (2) DS0000013435.V254383.R01.S.doc Version 5.0 Page 10 The client-centred approach adopted by the home involves the service user all of whom sign their own CPA documentation. Daily diary notes and other appropriate records are kept to monitor progress and to inform assessments. It was clear to the inspector that service users (exemplified by the two he met on site) were quite self-determined - and generally able to speak up for themselves; it was good also, on the day of the visit, to note a good level of ‘bonhomie’ and rapport between them. Service users have their own meetings at the home; these meeting’s records are kept. However - being a small home - many decisions are individually focused; the level of ‘engagement’ with the community is to an extent, voluntary – and as some service users spend substantial periods of time out of the home, this is at their own preference. All service users manage their own finances; these aspects of service user need being entirely independent of the home. A notice close to the washing machine stated: “Only staff to put powder in washing machine not residents.” The inspector hopes that such negative messaging is not carried into practice elsewhere. While it is appreciated that such tasks have to be completed appropriately to avoid damage to equipment, the ‘tenor’ of such notices is inappropriate. Service users should be encouraged to participate and learn - by example and practice - appropriate conduct within the home. It is clear that risk assessments are integral to the care at the home; the enhanced Care Programme Approach used by care managers at individual service user reviews ensures that all three service users are encouraged – within a risk framework - to maintain as much independence as is practicable and appropriate for them. The home will alter and / or amend risk assessments as issues arise; usually these are undertaken in collaboration with care management staff as are precipitated by ‘reportable’ incidents. Medihands Healthcare (2) DS0000013435.V254383.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 16 & 17. Service users can be assured that the home provides opportunities for them to engage in activities both within and outside the home, and to adopt a lifestyle suited to their individual needs and preferences, whilst respecting a service user’s own choices and decision-making. Service users can expect to be provided with nutritious and wholesome food from the home’s menu, whilst acknowledging the right to their own stated choice. EVIDENCE: The standards were explored with the proprietor and continued to be clearly met - this evidenced from the care plans and daily notes kept for the individual service users - and from the broad knowledge the proprietor and care staff showed of each individual. One service user gave the inspector the benefit of a short ‘life history’ thumb sketch, and demonstrated how the home was providing a safe and supportive environment for him to progress in attaining skills and confidence out in the wider community. Medihands Healthcare (2) DS0000013435.V254383.R01.S.doc Version 5.0 Page 12 This service user had undertaken a bakery course – passed with distinction – and had recently undertaken a work placement. He was now seeking longerterm employment close to the home, or to engage with a voluntary organisation offering his undoubted skills. Staff support and help was acknowledged throughout these processes. The local Community Mental Health Team provides support, encouragement and direct assistance to all the individuals resident at the home. There is a link between the Westbury Road and the nearby other care home provided by the same provider in Kingston Road; friends interlink and visit each other from these two locations. The presence of the (very local) mental health Resource Centre – just under the railway bridge – also provides another locale for meeting and accessing both mental health specific and social activity services. General leisure activities engaged in by service users include cinema, leisure centres (swimming is favoured) and visiting the local pubs with friends. In discussion with service users (and subsequently staff), an apparent misapprehension about a ‘curfew’ at the house was discussed; service users commented that they felt that they were not at liberty to use the communal areas at all times within the home – especially later on in the evening. The manager explained that the only ‘condition’ of occupancy was with regard to ensuring that service users were around at the times when they need their medication. Planned absences enabled the arranging of ‘TTOs’ (medicines to take away) – so service users could take their medication with them. This was regularly arranged, for instance, when a service user visited his parents at a distance away and spent the night in a bed and breakfast hotel. The inspector recommends that the issue be opened in discussion with all service users at a Residents Meeting. Service users all have their own bedroom and front door keys - and mail is given, unopened, directly to them. The homes’ ethos is one of fostering independence, building on strengths and promoting choice. There is a policy on smoking in the home and a policy on the use of drugs and alcohol. All service users have their own tea/coffee making facilities and are encouraged to help themselves to breakfast and lunchtime food. The kitchen is accessible at all times. Whilst the general standard of food provided at the home was appreciated and declared to be of an acceptable (if not superior) standard, service users also expressed a wish to have a higher level of choice in such issues as the choice of bread provided at the home; the ‘white sliced’ bread (observed in great quantity in the refrigerator) was disliked by both service users interviewed and the inspector recommends that the manager and staff have a discussion to establish the best preferred foodstuffs to provide. Medihands Healthcare (2) DS0000013435.V254383.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18. 19 & 20. Service users can be assured that their personal, health care and emotional / mental health needs will be recognised and met by the home’s daily service input - and through longer-term monitoring, assessment and care plan programming in conjunction with the mental health team professionals. The systems adopted by the home regarding medication ensure the safety and consistent treatment and support for each service user. EVIDENCE: The Consultant Psychiatrist attends the six monthly reviews held in the home. There is also a fortnightly visit from the community psychiatric nursing (CPN) service. Annual GP checks are undertaken to ensure the physical side of the service user’s life are not neglected. Staff members undertake regular monitoring of weights, etc. Service users currently living at the home do not require direct personal care, though some require prompting at times. Consistency / continuity of care is provided by a staff group who build up relationships and understanding of each service user’s needs - supported by the proprietor / manager. There had been no staff changes since the last inspection visit in March 2005. There is also no set ‘house routine’ as such. Service users actually determine their daily routine themselves. Medihands Healthcare (2) DS0000013435.V254383.R01.S.doc Version 5.0 Page 14 Medication was stored, ordered and disposed of according to the set written house procedures. Photos were present on Medication Administration Record sheets and evidence of recent full medical check ups and reviews of medication were seen. Details concerning ‘prn’ medication (‘when required’) were noted to be full in detail to support staff when having to decide if a discretionary dose was appropriate. This was a recommendation met from the previous inspection report. Staff members receive training in the administration and handling of drugs and are supervised by the manager until assessed as generally proficient. The proprietor has recently accessed accredited staff training by Boots – the supplying pharmacist. The Consultant Pharmacist visits the ‘Medihands’ homes and inspects the systems from time to time. Medihands Healthcare (2) DS0000013435.V254383.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. Service users can be confident that their comments and complaints are responded to, with appropriate action being taken in a timely fashion. The home provides support to service users to ensure that they are protected from harm and any form of abuse. EVIDENCE: Both above standards were inspected, and found met. The Complaints Procedure in the home had been amended in May 2005 as a result of the requirement set after the inspection visit in March 2005; it is now a clear step-by-step procedure, which states the timescales that are tied to the different stages within the process. No formal complaints have been received by the home within the past twelve months. The Abuse policy adopted by the home clearly states the necessary steps to be taken in case of suspicion or the actual discovery of abuse of a service user. A final ‘tweaking’ to the home’s policy will ensure that the home’s document fully reflects the local authority procedure. The manager has a goods concept of the issues around vulnerable adult procedures in general due to an issue arising within one of her other establishments. Medihands Healthcare (2) DS0000013435.V254383.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 – 30. Service users can expect to live in a clean, warm and comfortable environment - designed to meet their individual needs - and providing adequate services and domestic facilities. Service users can be assured that, generally, the home is maintained as a safe environment, in which they may live without unnecessary risk or danger. EVIDENCE: The home is ideally situated, just off a principal arterial road leading to Kingston, within a short walk of local shops, other amenities and public transport. The premises again appeared to be well maintained and provide a comfortable and homely environment for all service users. There is a good standard of decoration throughout the home, with the furniture and fittings being of good quality. The home has access to regular maintenance staff, ensuring all repairs can be dealt with swiftly. All service users have their own single rooms - which are the principal rooms of the house. The dining / sitting area to the rear of the house is ample in size for three, especially bearing in mind the fact that service users tend to use Medihands Healthcare (2) DS0000013435.V254383.R01.S.doc Version 5.0 Page 17 their rooms as ‘bedsits’. The conservatory off the lounge is also popular serving as the designated smoking area. All rooms seen were personalised and decorated to the service user’s individual taste and preferences. Each room has a wash hand basin and a lockable space for personal / valuable possessions. Service users are also provided with tea and coffee making facilities in their rooms. There is one bathroom (newly and well refurbished - with a new bathroom suite of suitable type and new shower), and two toilets available to service users, this is sufficient to meet their needs. Staff members are provided with a lockable space in the sleeping-in room – which is the ‘box room’ on the first floor. The home appeared to be well maintained - and is kept clean generally without odour. Cleaning is a shared task - service users are expected to clean their own private space and are encouraged to help with keeping the rest of the house clean and tidy. The laundry area is located in the conservatory at the rear of the house - this appears to be quite sufficient for the three service users resident at the house. Maintenance and service certificates for the premises were inspected and are covered below under Standard 42 – the health & safety standard. Medihands Healthcare (2) DS0000013435.V254383.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36. Service users can be assured that they will be supported at all times by staff who are trained and competent in their work, staff being provided in sufficient numbers to meet service user’s identified needs. Service users can expect to be provided a service that ensures their safety and protection from abuse through thorough recruitment processes, and ongoing staff support arrangements. EVIDENCE: Staff details in general are securely held at the main Medihands (149) home by the proprietor. The recruitment standard was inspected at the last visit to the home, when current staff members were noted to have references, criminal records bureau checks, the original application forms - with copies of identity confirmation and past employee references. Staff supervision notes were also seem at the last announced inspection visit. Discussion revealed that four of the six staff members working at the home are undertaking NVQ training in care - so that hopefully the home will exceed the target of a minimum of 50 care staff being trained by the end of 2005. It is hoped that all staff working at the home will be at least thus qualified - if not to a level higher than Level 2 - as they are working independently on their own initiative at the home on a generally unsupervised basis, except when Mrs Sawmynaden, as manager, is also at the house. Medihands Healthcare (2) DS0000013435.V254383.R01.S.doc Version 5.0 Page 19 The duty roster again confirmed that there is one staff member on duty at all times at the home and one staff member sleeps-in at night. The manager’s time is shared with the other Medihands 3-bedded home (“Medihands Villa”) nearby. Staff training is an ongoing project for both the proprietor and also Mr Sawmynaden – who is currently piloting an NVQ-related training programme in mental health services with the ‘Medihands’ group of homes. Other in-house training has also included Adult Abuse Awareness and Food Hygiene / Fire / Medication alongside the ongoing NVQ training programme. Only three staff members were indicated to have First Aid training – there is a need (and it is a regulatory requirement) to ensure that all staff working at the home have a First Aid qualification – as they will, without doubt, find themselves working independently at the home - and need to call upon such skills in an accident emergency. The inspector also observed that the proprietor continues to be very much ‘hands-on’, providing additional support and guidance to service users and staff – and, at most, seemingly being just a mobile phone call away. Medihands Healthcare (2) DS0000013435.V254383.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 40, 41 & 42. The home generally operates systems to ensure service users benefit from a well-run and safe environment. Service users can be assured that their welfare, health and safety is safeguarded through the home’s adherence to appropriate guidance and regulations concerning best safety practice. Service users can be assured that generally their rights and interests are well served and protected through the home’s approach to record keeping, policies & procedures, and through the day-to-day conduct of the home. EVIDENCE: The proprietor / manager – who manages a second ‘small home’ nearby - is almost always available to the home, if any problems arise. On the day of the inspection, the manager had been called at the inspector’s arrival, and she was at the home within a few minutes. Mrs Sawmynaden (‘Mrs Sammy’) evidenced a good level of management competence during the inspection visit and – in the words of the previous inspector: “appears to have created a skilled, positive and enthusiastic workforce.” She has many years’ experience working with this client group and showed good insight into relevant issues. Medihands Healthcare (2) DS0000013435.V254383.R01.S.doc Version 5.0 Page 21 The inspector has been shown a format devised by the proprietor for surveying service users, their relatives and professional carers; this was currently being implemented. There are also mechanisms available for assessing quality in the home and, the inspector was told, a business and financial plan. Policies and procedure sets are now totally held in each ‘Medihands’ home, as each is a separately registered care home. All policies and procedures held must, however, be dated and signed by the proprietor, to ensure that staff are reading the most up-to-date document – and are also using the documents specifically sanctioned by the proprietor. This issue was a requirement outstanding from the last inspection visit; the manager admitted that work had not been completed on this aspect yet. The manager has previously confirmed that staff members sign to state that they have read and understood policies and procedures. The proprietor also stated that service users have access to, and are supplied with, the homes policies and procedures - where appropriate. The home’s health and safety checks included: regular testing of the smoke alarms throughout the building, Fire Drill records (a recommendation is made relating to their frequency) and COSHH data sheets. The Landlord’s Gas Safety & Servicing Certificate was available and the electrical wiring and portable appliances were also within date. First Aid boxes are checked monthly. The current Legionella sample-testing certificate was seen. All service users have been risk assessed regarding the use of hot water; the proprietor assured the inspector that thermostatic control valves are now fitted to all hot water taps at baths & hand-basins throughout the building. Hot water temperatures are tested weekly. The home was reasonably well organised - this taking little effort, bearing in mind its size; staff seemed comfortably aware of keeping the environment safe. Medihands Healthcare (2) DS0000013435.V254383.R01.S.doc Version 5.0 Page 22 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Medihands Healthcare (2) Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X X 2 3 3 X DS0000013435.V254383.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? YES – one. 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 YA35 Regulation 13(4) Requirement First Aid training must be provided to all staff members who work at the home – as they will, without doubt, find themselves working independently at the home - and need to call upon such skills in an accident emergency. All policies and procedures held must be dated and signed by the proprietor, to ensure that staff are reading the most up-to-date document – and are also using the documents specifically sanctioned by the proprietor. Previous timescale of 30/04/05 not met. Timescale for action 01/03/06 2 YA40 17 & 18(1) 20/12/05 Medihands Healthcare (2) DS0000013435.V254383.R01.S.doc Version 5.0 Page 24 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 YA8 Good Practice Recommendations Service users should be engaged in domestic activities such as clothes washing with staff support - such that notices of a ‘staff only’ nature should not be necessary within the home. That service users be reassured that they can use the communal areas of the house at any time of the day or night – with no imposition of ‘curfews’ or such conditions. That service users be consulted more closely with regard to their preferred foodstuffs, such as providing brown or wholemeal bread rather than the ‘white sliced’ observed in the fridge at the home on the day of the visit. All care staff should be trained minimally to NVQ level 2 in care by 2005; the home should aim to train staff at 2, Westbury Road to a higher level, due to their need to operate autonomously. The manager of the home should evidence her competency against the NVQ Level 4 Registered Manager’s Award framework – this competency evidence should be in place by the end of December 2005, or supplementary training be committed to, by this date. Fire drills should be conducted sufficiently frequently to ensure that all staff members have undergone such training on a minimally yearly basis. 2 YA16 3 YA17 4 YA32 5 YA37 6 YA40 Medihands Healthcare (2) DS0000013435.V254383.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Medihands Healthcare (2) DS0000013435.V254383.R01.S.doc Version 5.0 Page 26 - 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!