Inspection on 14/06/07 for Meridian Walk

This inspection was carried out on 14th June 2007.

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

Other inspections for this house

Meridian Walk 27/03/09

Meridian Walk 18/05/06

Meridian Walk 21/11/05

Meridian Walk 16/06/05

Meridian Walk 28/10/04

Meridian Walk 06/05/04

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 Meridian Walk 80 Meridian Walk Tottenham London N17 8EH Lead Inspector Tom McKervey Key Unannounced Inspection 14 & 20th June 2007 10:00 th DS0000060937.V336938.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 DS0000060937.V336938.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. DS0000060937.V336938.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meridian Walk Address 80 Meridian Walk Tottenham London N17 8EH 020 8365 0023 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) meridian.walk@heritagecare.co.uk www.heritagecare.co.uk Heritage Care Mr Zaydon Alayasa Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places DS0000060937.V336938.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th May 2006 Brief Description of the Service: Meridian Walk is a purpose built care home in Tottenham, North London owned by Metropolitan Housing. The home is managed by Heritage Care based in, Loughton Essex and has homes in Newham, Norfolk, Westminster and Hertfordshire. Heritage Care took over the care of the home on the 1st April 2004 from Real Life Options. Meridian Walk is registered to provide specialist support to six adults, male and female, with profound learning disabilities, some of whom also have physical disabilities. The home is very spacious and well equipped. It has two floors with a lift for wheelchair users. The residents’ bedrooms are spacious and all have en-suite facilities that are adapted to individual needs. The lounge, kitchen, dining room and sensory area are in one large room, divided into separate areas that are easily identified by residents who have sensory difficulties. The garden area is paved with raised flowerbeds. All areas of the home are accessible by wheelchair users. The home is situated near an industrial site, some of which is being redeveloped for residential use. It is quite a distance away from Edmonton Angel, Tottenham and Wood Green shopping areas. The home has its own transport with a tail lift for residents with mobility problems. The aim of the home is to provide a friendly, warm, relaxing and homely environment striving to preserve and maintain the dignity, individuality and privacy of the residents and remain sensitive to each service user’s changing needs. The residents have access to a range of specialist services geared towards meeting their individual needs. The fees for the service are £1201.89 per week and there are no additional charges. DS0000060937.V336938.R01.S.doc Version 5.2 Page 5 Inspection reports produced by the Commission of Social Care Inspection (CSCI) are available upon request from the registered manager. DS0000060937.V336938.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over two days and was completed in a total of seven hours. The registered manager was on leave on my first visit, which necessitated returning to the home on another day to inspect confidential staff records and to discuss the overall management of the service with the manager. On the first day of the inspection, a senior support worker was in charge, and two support workers were also on duty. Two residents were in the home and three residents were at their day centres on both of my visits. At the time of the inspection there was one vacancy. The inspection process included examining care plans, policies and procedures, a tour of the building, and talking to the manager and staff. I also observed how staff interacted with the residents. There were no visitors during the inspection. On the second visit, I spoke to an aromatherapist who has been coming to the home once a week since the home opened. Due to the residents’ lack of verbal skills, I was unable to communicate effectively with them, but it was evident that the staff were able to understand and support the residents’ needs. The people who live in the home looked well cared for and appeared happy. What the service does well: The home is purpose-built to provide spacious accommodation for six adults with profound physical & learning disabilities. Wheelchair users have access to all areas of the home. There is good information about the service, which is also available in picture format for potential users of the service. No-one is admitted to the home until a full assessment of their needs is carried out, and people can visit the home to enable them to decide about moving in. Each resident has a single bedroom with en-suite facilities and they can personalise their rooms. All the residents have the opportunity to attend a day centre and are supported to go out to shops and leisure facilities in the community on a regular basis. There is a mini bus available for this purpose. DS0000060937.V336938.R01.S.doc Version 5.2 Page 7 Each resident has an individual care plan to guide staff about the best way to support them. The home’s policies and procedures are comprehensive and give clear guidance and advice to staff. All the residents have communication difficulties, but the staff have the ability to effectively communicate with them and support their needs. There are good visiting arrangements for families, and the residents are able to spend time with them at home. The care plans include risk assessments that cover daily living activities in the home and out in the community. The manager and staff have implemented a creative way to record the residents’ lives through digital records on discs, which residents and their relatives can view at any time. The food is very well balanced and nutritious and caters for the varying cultural and dietary needs of the people who use the service. A full range of healthcare screening and treatment is provided for the residents and medication is administered safely. The home deals with complaints quickly and effectively and has good systems for the detection and reporting of abuse. The staff rotas are arranged around when residents’ needs are greatest in the morning and evening. There are good systems in place for the recruitment, training and supervision of staff who enjoy high morale in their work. The manager shows enthusiasm to continuously improve the service for the residents, and runs the service effectively. There is a good system to safeguard residents’ personal finances and to ensure the health and safety of the residents and staff. What has improved since the last inspection? It was evident that the home has complied with all the requirements from the last inspection. There is a procedure for monitoring a specific resident’s care needs during the night. The medication policy includes a section on the covert administration of medicine, should this be necessary. DS0000060937.V336938.R01.S.doc Version 5.2 Page 8 The residents’ ‘My Day & Night’ daily logs are being completed after each shift, and there is guidance for staff about what is to be included in these documents. Induction programmes for new staff are signed and dated when each task is completed. Appointments have been made for health screening for residents, e.g., smear tests, breast and prostate examination. A new lift has been installed to provide access to the upper floor of the home by wheelchair users. A qualified first-aider is designated on each shift rota. A risk assessment for the use of bed rails for a specific service user has been carried out. A care plan has been completed for a resident who was new to the service. A fire risk assessment of the building has been carried out. 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. DS0000060937.V336938.R01.S.doc Version 5.2 Page 9 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 DS0000060937.V336938.R01.S.doc Version 5.2 Page 10 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): 1, 2, 3, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a Statement of Purpose that is specific to the resident group they care for, and the Service User Guide, which is in picture format, details what the service users can expect regarding specialist services. Admissions to the home are not made until a full needs assessment has been undertaken, and prospective service users are given the opportunity to spend time in the home prior to moving in. Service users’ rights of tenancy may be infringed by the landlord by not providing tenancy agreements. EVIDENCE: All the current residents have lived at the home since it opened. They were placed by the local authority and had a comprehensive assessment by care managers and health professionals, at the time of admission. The manager has recently carried out an assessment of a prospective service user who has been referred. I examined the home’s Statement of Purpose, which was an DS0000060937.V336938.R01.S.doc Version 5.2 Page 11 accurate description of the service, and the Service User Guide, which was presented in a pictorial format. The manager said that this document was given to the residents’ relatives at the time of admission. As noted in the summary, the home was purpose-built to accommodate people with physical and learning disabilities. Security is provided by CCTV and a gate that is locked at night. There is a coded key pad for entering and exiting the building. All bedrooms are en-suite and have grab rails, special baths and showers and other adaptations to support people with physical disabilities. The rear garden is paved and there is a raised flower bed to provide access to wheelchair users. The home has its own transport with a tail lift for residents with mobility problems. The manager informed me that a potential new resident has visited the home with their relatives several times to assess its suitability to meet their needs. All the residents were placed by the local authority, with whom the home has a contract. However, none of the residents has a licence or tenancy agreement with the landlord - Metropolitan Housing. A recommendation is made for this matter to be taken up with the landlord. DS0000060937.V336938.R01.S.doc Version 5.2 Page 12 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a comprehensive care plan for each person who lives in the home, which is kept up to date to ensure their needs are still being met. Positive risk assessments are carried out so that residents are able to make use of opportunities to improve their lives. Staff have a thorough understanding of the residents and their needs and support them to make choices about their lives. EVIDENCE: DS0000060937.V336938.R01.S.doc Version 5.2 Page 13 I sampled three residents’ care plans. The manager has introduced comprehensive person-centred care plans, which give a very good picture of individual residents and their needs. The care plans were written as far as possible from the resident’s perspective, with input from their relatives, indicating how they would like to be supported. This covered needs such as; mobility, communication, continence and communication. Each person is allocated a key worker who is responsible for reviewing the care plan each month and writing a summary. Reviews are now taking place annually with the placing authority care managers, which had proved difficult in the past. The manager told me that one person has now been allocated by the local authority to conduct these reviews, and that the residents and their relatives are invited to attend. Each care plan included a comprehensive risk assessment, which was also reviewed regularly. The risk assessments addressed safety issues, in the home and when residents are out in the community. These assessments were positive in aiming at the residents’ potential to achieve a better quality of life. All the people who live in the home have communication difficulties and those residents whom I saw, were non-verbal. Their communication consisted of gestures, body language and facial expression. I was impressed when observing and talking to staff, that were able to interpret these communications and they had a good understanding of individuals’ care and support needs. I noted how a new member of staff was being instructed about how best to support a specific resident at breakfast. Evidence of how residents exercise choice is decided on a daily basis and is recorded in their “Day-Night” book, such as breakfast routines and on how individuals choose what they want to eat, rise and go to bed. Specialists, for example speech and language therapists, had been referred to for advice to assist the staff in supporting the residents. The manager said that all the people who live in the home had chosen the colour scheme for their rooms and described how a resident had been taken to furniture shops to test out various armchairs before purchasing one. DS0000060937.V336938.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14 15 & 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. It is a central objective of the home to promote the individual’s right to live as ordinarily and as meaningful as possible, both in the home and in the community, and to enjoy all the rights and responsibilities of citizenship appropriate to their peer group. Innovative methods are used to enable residents to reflect and build on opportunities for developing their potential. Meals are very well balanced and highly nutritional and cater for varying cultural and dietary needs of the people who use the service. EVIDENCE: DS0000060937.V336938.R01.S.doc Version 5.2 Page 15 I was very impressed when the manager showed me extensive photographic evidence of residents’ activities, which are downloaded on to the home’s computer from a digital camera. He said, “I want to show the real work that goes on with our residents, not just paper records”. He is currently working on a project to provide a lap-top for each resident so that they can have their own personal record of their activities. A CD record will then be kept in each resident’s case file. There was evidence that the relatives’ permission had been obtained for the taking of photographs for this purpose. One of the staff told me that they are expected to take the home’s camera with them when they accompany residents on all outings in the community, for example to shops, so that the activity can be recorded and shown to the resident and their family. This initiative is highly recommended. Activities were also summarised by the key worker in monthly summaries. Activities in the community include going to the cinema, swimming, bowling, the park, restaurants and shopping. Last year, the residents went on a holiday to Centre Parc, and at the time of this inspection, this year’s holiday was being planned. All the people who live in the home attend day centres on various days during the week, where they have various educational and training programmes. These are recorded in their “Day and Night” book. Following the last inspection, the manager has produced guidelines for the staff about what is to be included in the Day/Night books. There is a well-equipped sensory area on the ground floor for people who live in the home to have periods of relaxation. I observed the aroma-therapist working with one of the residents during the inspection. The therapist has been coming to the home for a number of years and spoke highly of the staff and manager, saying that the lives of the residents had greatly improved under this manager’s leadership. The aroma-therapist told me that she was impressed that the staff carry out some of the techniques in her absence, especially simple hand massage, with the oils that she prepares for them. I visited residents’ bedrooms and noted that they had a range of personal belongings and leisure equipment, for example televisions and music centres. It was evident on each case file I examined that family contacts were recorded. Several residents spend weekends with their families. The residents’ ethnic groups are varied and the staff team compliments this. DS0000060937.V336938.R01.S.doc Version 5.2 Page 16 The menus showed that the meals provided by the home are varied, nutritious and balanced. The residents have individual menu plans and some have particular ethnic dishes that are brought in by family members. A record of what each person eats is recorded in their “My Day & Night” daily notes. I noted that “takeaways” are also provided once a week, which are chosen by the residents. DS0000060937.V336938.R01.S.doc Version 5.2 Page 17 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal healthcare needs, including specialist interventions, are clearly recorded in each resident’s plan and give a comprehensive overview of their health needs. Medication records are fully completed, contain required entries and are signed by appropriate staff. However, the medication policy needs to be amended to ensure that authorisation is obtained for medicines to be given covertly, should this become necessary. EVIDENCE: I observed during both days of the inspection, that staff provided personal support to the residents who were in the home, in a manner that respected their privacy, dignity and independence. In discussion with the staff, I was DS0000060937.V336938.R01.S.doc Version 5.2 Page 18 satisfied that they were aware of residents’ preferences about how they liked to be supported, which was also detailed in their care plans. There were good records of the various healthcare appointments attended, for example, the GP, hospital, speech/language therapists, dentists and chiropodists. Following the last inspection, the manager assured me that appointments had been made within the next week, for appropriate breast and prostate screening for the people who live in the home. At the time of the inspection, all residents were said to be in good health. The medication procedure complies generally with pharmaceutical guidance. There is also a separate policy in pictorial format for residents with communication difficulties. I understand that other service users within the organisation devised this, which is excellent practice. The records for the receipt, administration and disposal of medication were satisfactory. The service users are generally protected by the home’s medicines policy and procedures. The staff have receive training in all aspects of handling medication. The medication policy refers to covert medication, but does not mention the need for consent from relatives and/or the GP for the covert administration of medicines, should it become necessary. A requirement is made to address this. DS0000060937.V336938.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home keeps a full record of complaints and this includes details of the investigation and any actions taken. Training of staff in the area of protection is regularly arranged by the Home and they are aware of their responsibilities to report suspected abuse. EVIDENCE: The complaints book contained two complaints that were made in the past year. These were from the parents of a resident regarding activities at the weekends. The response from the manager fully addressed the concerns and the complainant was satisfied with the outcome. The staff records showed that they had all attended training in adult protection procedures, and in discussion with staff, they were able to describe the actions to be taken if there were concerns about abuse. A member of staff was currently suspended while a suspected misappropriation of a resident’s funds was being investigated. The local authority and the Commission for Social Care Inspection had been informed about this matter. DS0000060937.V336938.R01.S.doc Version 5.2 Page 20 DS0000060937.V336938.R01.S.doc Version 5.2 Page 21 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): All these standards were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a physical environment that meets the specific needs of the people who live there. The home is comfortable, and has a programme to improve the decoration, fixtures and fittings. People who live in the home can personalise their rooms. The bathrooms and toilets are fitted with appropriate aids and adaptations to meet the needs of the people who use the service. The home is generally clean and tidy. EVIDENCE: DS0000060937.V336938.R01.S.doc Version 5.2 Page 22 The home is purpose built and is very spacious and well equipped. There are two floors with a lift to the first floor for wheelchair users. The residents’ bedrooms are spacious and have en-suite facilities that are adapted to individual’s needs. The lounge, kitchen, dining room and sensory area are in a large downstairs room, divided into areas that are easily identified by residents who have sensory difficulties. The garden area is paved with a raised flowerbed and small pond. A new housing estate has just been completed on the boundary of the home’s property. The manager told me that the building work had meant that the garden could not be used for a considerable time because of the noise and dust. At the time of the inspection, the garden/patio area appeared rather neglected and the paving stones were uneven in places, which could present a hazard to the residents. The manager told me that Haringey Council had agreed to refurbish this area and provide a sensory garden. A meeting to plan this was due to take place on the 17th of July. A new passenger lift has just been installed, and during the inspection, the estates manager from Metropolitan Housing Association visited the home regarding replacing the fire door by the lift. Subsequent to this inspection, the manager has informed me that all the communal areas in the home have been re-carpeted following the completion of the lift installation. I was concerned about the state of some carpets in the residents’ bedrooms, which were stained and were not properly fitted. However, the manager said that all the bedroom carpets were due to be replaced in the next month, now that the lift was installed. This will be checked at the next inspection. The home’s communal areas, individual bedrooms, sofas, lounge/kitchen flooring and the kitchen units have recently been either redecorated or replaced. There was comfortable seating provided in the lounge, and one resident had their own adjustable armchair. The sensory area was well equipped and had a bed for aromatherapy sessions. The bedrooms were individualised to meet personal styles and tastes, and each bedroom reflected the resident’s interests and their cultural preference. I noted that the toilet seat was missing in one resident’s en-suite, and a requirement is made about this issue. Otherwise, the standard of décor throughout the building was good and the home was clean and tidy at the time of the inspection. DS0000060937.V336938.R01.S.doc Version 5.2 Page 23 DS0000060937.V336938.R01.S.doc Version 5.2 Page 24 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): All these standards were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are consistently enough staff available to meet the needs of the people using the service, with more staff being available at peak times of activity. The staffing structure is based around delivering outcomes for the people using the service, and is not led by staff requirements. The service ensures that all staff receive relevant training that is focussed on delivering improved outcomes for people using the service. The service has a good recruitment procedure that clearly defines the process to be followed. Staff meetings take place regularly. Supervision sessions are regular and staff find them helpful. EVIDENCE: DS0000060937.V336938.R01.S.doc Version 5.2 Page 25 The staff records contained contracts of employment and job descriptions, which clearly described their roles. The staff records showed that all new staff have a written induction in the organisation’s policies and procedures, as well as an induction to the home. The staff I spoke to, confirmed that the induction and training they received, prepared them for their roles as carers. Mandatory health and safety subjects are covered during the induction, which takes place in the first month of employment. Two staff have attained National Vocational Qualification level 2 and two others are currently on the course. One person has NVQ 3. Other courses attended included person-centred planning, epilepsy and administration of medicines. I examined the staff rota and noted that it correctly reflected those on duty, one of whom was a student nurse on placement at the home. This person was supernumerary, and was not included in the staff numbers. The staffs’ shifts are flexible to ensure that sufficient people are on duty at the busiest times of the day when the residents’ support needs are greatest. One person is identified as being in charge in the absence of the manager. One new member of staff had been recruited in the past year. Their records showed that they had attended an interview and had been screened by the Criminal Records Bureau and references had been obtained before they started work. I saw minutes of staff meetings, which are held monthly, and there were records to show that the staff have regular formal supervision. The staff I spoke to stated that they found their supervision to be very important in supporting them in their work and personal development. DS0000060937.V336938.R01.S.doc Version 5.2 Page 26 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, 38, 41 & 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The registered manager has the required qualifications and experience, is enthusiastic about improving outcomes for service users, and is highly competent to run the home and meets its stated aims and objectives. The home has efficient systems to ensure effective safeguarding and management of individual’s money including record keeping. There is evidence of organisational monitoring by corporate providers. There is full and clearly written recording of all safety checks and accidents, including analysis, and there is no evidence of a failure to comply with statutory reporting requirements and other relevant legislation. DS0000060937.V336938.R01.S.doc Version 5.2 Page 27 EVIDENCE: The manager has been in post for about two years and is registered as a fit person to manage the home. He has several years of experience of working within Heritage Healthcare, with this client group. He is currently training for the Registered Managers Award at NVQ level 4. In discussion with him, I was impressed by the manager’s enthusiasm for the job and his plans to constantly develop the service for the benefit of the service users. The staff to whom I spoke, were very complimentary about the manager’s ability and described the positive changes he implemented when he took over the running of the home, resulting in improved outcomes for the residents. They confirmed that he provides clear leadership and sets high standards for the service. There was a relaxed but business-like atmosphere in the home on both my visits, and the staff appeared efficient and caring in the way they supported the residents. The staff reported that there was a good team spirit and they supported each other very well. The majority of the records, policies and procedures in the home are stored on a personal computer in the manager’s office. The accident book contained full descriptions of incidents with details of appropriate follow-up actions being taken. I examined at random, a resident’s personal finance records and saw that receipts had been retained for purchases of personal items. I also was satisfied that the resident’s money matched the recorded balance. Residents’ money and petty cash are stored securely in a safe, which is bolted to the office floor. Copies of senior managers’ monthly monitoring visits reports are sent to the Commission. There is a qualified first aider on each shift, who is clearly indicated on the rota. A fire risk assessment of the building has been carried out and the fire alarms are tested each week. DS0000060937.V336938.R01.S.doc Version 5.2 Page 28 The gas, water, fire and electric systems and appliances have all been tested, and hoists and special equipment have been serviced within the past year. All hazardous substances were safely stored. DS0000060937.V336938.R01.S.doc Version 5.2 Page 29 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 4 12 3 13 3 14 3 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 4 3 X X 3 3 X DS0000060937.V336938.R01.S.doc Version 5.2 Page 30 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard YA24 YA20 Regulation 23(2(b) 13(2) Timescale for action The toilet seat in a specific 31/07/07 resident’s bathroom must be replaced. The medication policy must be 31/08/07 amended to state that authorisation must be obtained for medicines to be given covertly, should this become necessary. Requirement RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA5 Good Practice Recommendations The issue of licence agreements for the residents should be taken up with the landlords. DS0000060937.V336938.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 DS0000060937.V336938.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. 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. 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