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Inspection on 06/10/06 for MI CASA

Also see our care home review for MI CASA for more information

This inspection was carried out on 6th October 2006.

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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

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 managers and staff are working hard to try to meet the needs of all the service users that live in this new home as and when they move in. This is especially important because all the people living at the home have recently moved from somewhere else. The new staff group are getting along well with each other and, as key workers, are working hard to develop good quality relationships with the service users. The current service users are relatively young and are enjoying exercising their rights as adults and learning to exercise their responsibilities as adults as well. The home is very well decorated and equipped and the service users very much enjoy having their own rooms that include their own bath/ shower and toilet facilities.

What has improved since the last inspection?

This is the home`s first inspection.

What the care home could do better:

This new home is working hard to make sure it meets the needs of service users well. Improvements are required to assist this process in the following areas: clarifying the financial contributions required from one service user with their referring authority to avoid the possibility of the service user running up an avoidable debt, ensuring service users have free access to all the communal areas of the building unless it is clearly agreed otherwise and a particular record relating to staff recruitment.

CARE HOME ADULTS 18-65 MI CASA 15 Duckett Road London N4 1BJ Lead Inspector Peter Illes Key Announced Inspection 6th October 2006 10:30 MI CASA DS0000067230.V310265.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 MI CASA DS0000067230.V310265.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. MI CASA DS0000067230.V310265.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service MI CASA Address 15 Duckett Road London N4 1BJ 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) 020 8340 2447 020 8967 3021 Precious Homes Ltd Mr Simon Keith Atkins Care Home 5 Category(ies) of Learning disability (5) registration, with number of places MI CASA DS0000067230.V310265.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection N/A Brief Description of the Service: MiCasa (which the provider states means “My House”) is owned by Precious Homes Ltd and is registered to provide residential care for five younger adults with a learning disability. The home will specialise in supporting service users with challenging behaviour. The home is situated next to another registered care home owned by Precious Homes Ltd. Both homes are self-contained and have their own separate staff groups. The current manager however is the registered manager for both homes. MiCasa is a large three storey terraced house that has been substantially and sympathetically converted for use as a residential care home. The communal space is accommodated on the ground and lower ground floors. The lower ground floor consists of: kitchen/ dining room, laundry room, staff/ duty office, an activities/ quiet room and a storeroom; there is a small and well kept rear garden accessible from this floor. The ground floor consists of; the main entrance hall, lounge and manager’s/ staff office that also contains the medication storage cupboard and a separate toilet with wash had basin. The five service user bedrooms all have full en-suite facilities and are spread across four sub landings along with additional toilet and shower facilities. The home is within easy access to local shops, restaurants, pubs, and public transport and near to Wood Green shopping city, Finsbury Park and Alexandra Park. The registered manager stated that the home charges from £950 per week depending on the service user’s assessed needs. The registered manager also stated that that CSCI inspection reports would be made available, including to prospective service users and their representatives on request. The stated objectives of the home include to promote: the service users right to social inclusion; their needs, aspirations and cultural values; their right to autonomy and self determination and their rights relating to leading their own life safely, positively and with dignity. MI CASA DS0000067230.V310265.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the home’s first key inspection since it was registered and the inspection was announced. It took approximately six hours with the registered manager and team leader being present or available throughout. There were three service users accommodated at the time of the inspection and two vacancies. The inspection included: meeting and speaking to all three users, two of them in more depth and independently; discussion with the provider organisation’s managing director and director of operations who attended for the beginning of the inspection; discussion with the registered manager and team leader and also independent discussion with two care staff. Further information was obtained from a tour of the premises, a pre-inspection questionnaire, a number of feedback cards received from various people that have contact with the home and a range of documentation kept at the home. What the service does well: The managers and staff are working hard to try to meet the needs of all the service users that live in this new home as and when they move in. This is especially important because all the people living at the home have recently moved from somewhere else. The new staff group are getting along well with each other and, as key workers, are working hard to develop good quality relationships with the service users. The current service users are relatively young and are enjoying exercising their rights as adults and learning to exercise their responsibilities as adults as well. The home is very well decorated and equipped and the service users very much enjoy having their own rooms that include their own bath/ shower and toilet facilities. MI CASA DS0000067230.V310265.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. MI CASA DS0000067230.V310265.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection MI CASA DS0000067230.V310265.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users needs and wishes are assessed and this information made available to the home prior to starting the admission process to ensure that it can meet each service user’s needs and positively address their wishes and preferences. EVIDENCE: Three service users were accommodated at the home. Four in total had been admitted over a period of months since the home was first registered in June 2006 although one has subsequently moved on. The registered manager informed the inspector that enquiries had been made regarding two new potential service users and that he would be starting the assessment process regarding these two shortly. The files for each of the three service users accommodated were inspected. Each file contained detailed multi-disciplinary assessment information from their respective referring authorities. Where appropriate previous assessment information contained information in the looked after children format for those who had previously been accommodated in local authority care as children. It was noted that they were all young being aged between 18 years and 21 years. It was also noted that each were significantly vulnerable in a range of areas, had varying and complex needs and had undergone significant changes leading up to their transition to being supported by adult social care services. MI CASA DS0000067230.V310265.R01.S.doc Version 5.2 Page 9 Evidence was seen on the files that this assessment information had been made available to the home before the service user was accommodated. There was also evidence that the three service users had been assessed by the home. This included evidence of visits and overnight stays as part of the assessment and admission process. Evidence was seen on the files that subsequent review meetings with service users and the respective referring authorities had either taken place or were planned to take place. These were to review progress before the individual placements were confirmed as being long term at the home. Evidence was also seen that service users had received the home’s accessible service user guide and other written information where appropriate. This included information on staying safe generally and staying safe with regard to sexual relationships. The Commission had also received information prior to this inspection that during a trial period for another service user the home had reached the decision that it could not fully meet the needs of that person. This resulted in the placement being terminated by the home. The home had received a range of assessment information from the referring authority and staff from the home had undertaken significant assessment work themselves regarding this person’s needs as part of the admission process. The inspector was informed that not continuing with the placement for this person was a difficult decision for the home to make. The inspector supports the decision made however as in the end it is not appropriate for a service user to remain accommodated in a home if, despite best efforts, the home finds it cannot adequately meet their ongoing needs. As part of the ongoing assessment process for the three service users accommodated evidence was seen of pen pictures of service users and of personal planning books. The personal planning books were being used as an additional tool with the service users involvement to further understand the individual’s wishes and preferences. The registered manager stated that the aspiration was that these would eventually be used to contribute to a person centred plan (PCP) for each service user as the service developed. One of the service users spoken to indicated that they felt the process of moving into the home went better that they thought it might have and said that they really enjoyed living there now they had settled in. MI CASA DS0000067230.V310265.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. 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. Service users assessed needs, wishes and preferences are well documented and meaningful care plans are being developed to assist the home’s staff and relevant others in meeting these needs. Service users are supported to make as many age related decisions for themselves as they can to promote their independence. Service users are also supported to take appropriate risks in their lives to assist them to safely achieve their aspirations. EVIDENCE: The three service user files inspected all contained the essential components for developing a care plan. This included clear assessment information, detailed risk assessments and clear guidance to staff on how to support the service user. The registered manager stated that given the relatively short time the service users had been accommodated work was still in hand to further refine the documentation into the provider organisation’s agreed care plan format. As stated in the Choice of Home section of this report evidence was seen that work had started with all three service users to develop a person centred planning (PCP) approach way of working with them. This by definition MI CASA DS0000067230.V310265.R01.S.doc Version 5.2 Page 11 was still in the early stages of development given the length of time they had been accommodated. Evidence was also gained that the home had allocated key workers to each service user. This was from clear recording of key worker sessions and discussion with some of the service users and staff involved. Evidence was obtained that the home was working hard to encourage the service users to exercise their rights as adults and at the same time take appropriate adult responsibilities for their actions. Specific areas for this included: management of their finances, developing personal relationships as well as developing the necessary skills and having the necessary support and information to keep safe in these relationships and to generally develop appropriate assertiveness as adults. The impression that the inspector gained from discussion with service users and staff was that service users were still exploring boundaries in a number of areas. Staff were in the process of developing individual strategies to support service users achieve this in a planned way and at a pace that suited the individual service user. Service users are supported to remain as independent as they can with regard to their personal finances. Records were sampled of the money held by the home for service users and were satisfactory. One service user had received their first job seekers allowance payment on the day of the inspection and was very excited about this. The registered manager had identified that the job seeker allowance needed to be included in the referring authority’s financial assessment for this service user. Evidence was seen that the home had contacted the service user’s social worker regarding the service users benefits and their assessed contribution but was still waiting for a response. However, given that the service user was clearly of the opinion that the job seeker benefit was theirs to spend as they wanted a requirement is made regarding this. The home must ensure that the benefits and contribution arrangements for this service user are clarified and recorded with the referring authority without delay to avoid a potential debt situation arising for the service user. There were clear and detailed risk assessments in place for each service user that identified potential risks and gave detailed guidance for staff on how to minimise the risk. Risk assessments seen included potential risks involving their health, diet, medication management, sexual vulnerability, financial vulnerability, aggression, community access and emotional distress. Evidence was seen that service users had been involved in the risk assessment process including signing the documentation as appropriate. Evidence was also seen that the risk assessments were being monitored and refined over time as individual service users were settling into their new home and becoming more familiar and comfortable with exercising their rights and responsibilities in this setting. MI CASA DS0000067230.V310265.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users enjoy appropriate activities including within the local and wider community that meet their needs and preferences. Appropriate contact with relatives and friends is promoted and encouraged in accordance with the service users wishes and assessed needs. Service users rights are responsibilities are respected and promoted within their daily lives although unrestricted access to all of the communal areas of the home needs reviewing. Service users also enjoy balanced and varied meals that meet their needs and preferences. EVIDENCE: One service user attends a local day service three days a week and another has successfully enrolled at a local college of further education for one half day per week. The service user who has enrolled at the college indicated that they would have liked more sessions although none were available at the present time. The third service user told the inspector that they had finished their full time education in the summer and were “thinking about what next”. The service user indicated they might be interested in exploring paid employment. MI CASA DS0000067230.V310265.R01.S.doc Version 5.2 Page 13 Staff confirmed that they would be exploring what appropriate options may be open to the service user in the near future. One service user speaks Spanish as well as English and key phrases in Spanish were recorded in that service users file to assist staff in their communication with the person. None of the service users have particular cultural or religious needs identified. All three service users are exploring the local community and its resources. Evidence was seen that service users have visited a local swimming pool, bowling alley, cinema and gym. Service users spoken to stated that they enjoyed these trips. The registered manager stated the home were in the process of refining the support service users needed for these type of activities. This included agreeing when service users could be supported individually and when in small groups and the amount of staff input needed. Two of the service users can travel independently within the local community with one of these two travelling further a field to familiar destinations. The third service user needs staff support in the community. Evidence was also seen of trips to central London that service users had enjoyed. The registered manager stated that service users would be able to participate in annual holidays organised by the provider organisation. Service users enjoy a range of electronic entertainment in the home. This includes television, DVD’s and CD’s that are available in the communal areas of the home with service users also having a range of equipment in their bedrooms. The home has a large basement room that has had significant resources spent on it when the building was converted for use as a care home. This included structurally raising the height of the ceiling. The room has the capacity to become a relaxation room or an additional activity room. The registered manager stated that the use of the room would be further refined when the home was fully occupied to meet the therapeutic, recreational and/ or recreational needs of the service users accommodated. In any event the inspector’s view was that this was a very useful space that will contribute to service users quality of life. All three service users have contact with relatives to the extent that they wish. Some contact is managed according to the individual needs of the service users and where this is the case this has been agreed on a multi-disciplinary basis and with the service user involved. All three service users are young adults and evidence was seen from files and discussion with key workers and service users that they are being actively supported to keep safe in respect of their sexuality. Service users have keys to their bedrooms and were seen to use these during the inspection. Staff were seen to interact appropriately with service users promoting the service users status as adults in an adult environment. Individual service users were observed testing boundaries on two occasions with staff during the inspection. The inspector was impressed with the way that these situations were dealt with by staff that was both clear and reinforced the concept that service users have responsibilities as well as rights. Where service MI CASA DS0000067230.V310265.R01.S.doc Version 5.2 Page 14 users have identified needs with their interpersonal behaviour this was clearly recorded in their files. Staff spoken to were clear about these needs and were able to give examples of the way that they worked with service users to assist support them in identified areas. It was noted that one of the communal toilets were locked at the start of the inspection and staff did not seem clear as to why. Although service users each have access to their en-suite facilities in their rooms a requirement is made that all communal areas of the building are accessible to service users unless there is an appropriate reason that is validated by a risk assessment. The inspector was shown the kitchen and the menu for the home by one of the service users who showed the inspector around the home. The four week menu showed a variety of healthful meals. The service user confirmed that the menu was discussed at service user meetings and that service users could say what they liked and did not like. The service user went on to say that they and another service user took it in turns to cook many of the meals. The registered manager confirmed that meals were monitored by staff to ensure that they met individual service users needs. Issues relating to individual dietary requirements were seen in the service users files inspected. The kitchen was well equipped, clean and tidy. The home had a sufficient supply of food that was appropriately stored and matched the menu. MI CASA DS0000067230.V310265.R01.S.doc Version 5.2 Page 15 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive appropriate support with their personal care needs in accordance with their wishes and preferences. Their healthcare needs are met through registration with and referrals to a range of community based health professionals and actively involving service user in promoting their good health. Service users are also protected by appropriate medication policies and procedures that staff are aware of. EVIDENCE: The two of the three service users are relatively independent regarding their personal care although may need some verbal prompting at times. The third service user needs some more direct staff support with their personal care and this is appropriately recorded with guidance for staff regarding this. Service users spoken to indicated that they were comfortable with the support they received from staff in this area. The three service users are all now registered with a G.P. Evidence was seen on files inspected that service users have been supported by the home to register and attend a range of appointments with other relevant healthcare MI CASA DS0000067230.V310265.R01.S.doc Version 5.2 Page 16 professionals as required. Healthcare appointments recorded included with their: G.P, dentist, optician and an outpatient appointment for one service user via their GP. The inspector was pleased to see that the home had started working with service users to develop individual written health action plans with targets to maintain and promote good health. Where appropriate these targets were included into overall care plan objectives for individuals such as going swimming and/ or participating in other methods of exercise. The home has a satisfactory medication policy that was seen along with an attached list of signatures to evidence that staff had read and understood it. Evidence was also seen that staff had undergone training in safe administration of medication and two of the staff spoken to independently confirmed this. Medication is appropriately stored in the registered manager’s office. The medication and medication records for the three service users were inspected and were satisfactory. MI CASA DS0000067230.V310265.R01.S.doc Version 5.2 Page 17 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are able to express their views and concerns and have these appropriately dealt with by the home. Service users are also protected by satisfactory adult protection policies and procedures that staff are aware of. EVIDENCE: The home has a clear and satisfactory complaints procedure. A summary of the procedure is displayed in the entrance hall to the home that includes details of the Commission. The procedure is also included in an accessible pictorial format in the service user guide, a copy of which had been given to each service user. Service users told the inspector independently that they felt able to discuss issues and raise concerns with staff including their key worker and the registered manager. The record of one complaint from a referring authority was sampled. This complaint had also been bought to the attention of the Commission and evidence was seen that it had been dealt with effectively and was not upheld. The home had a copy of the London Borough of Haringey’s adult protection procedure and a clear in-house policy with guidance for staff on action to take if an allegation or disclosure of abuse is bought to their attention. It was also noted that there was a flow chart on the wall in the staff office reinforcing action to be taken if allegations or disclosures of abuse came to light. Evidence was seen that adult protection was covered in staff’s induction training and had been discussed in staff meetings and staff spoken to MI CASA DS0000067230.V310265.R01.S.doc Version 5.2 Page 18 confirmed this. No allegations or disclosures of abuse had been received by the home. MI CASA DS0000067230.V310265.R01.S.doc Version 5.2 Page 19 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a home that is comfortable, well decorated and which meets the current service users needs. The home was clean and tidy throughout creating a pleasant environment for service users, staff and visitors. EVIDENCE: The home is a large three storey terraced house that has been substantially and sympathetically converted for use as a residential care home. The communal space is accommodated on the ground and lower ground floors. The lower ground floor consists of: kitchen/ dining room, laundry room, staff/ duty office, an activities/ quiet room and a storeroom; there is a small and well kept rear garden accessible from this floor. The ground floor consists of; the main entrance hall, lounge and managers/ staff office that also contains the medication storage cupboard and a separate toilet with wash had basin. The five service user bedrooms all have full en-suite facilities and are spread across four sub landings. On the first landing there is one bedroom and an additional visitors toilet; on the second landing two bedrooms; on the third landing one MI CASA DS0000067230.V310265.R01.S.doc Version 5.2 Page 20 bedroom and an additional shower room and a further bedroom on the fourth landing. Two service users showed the inspector their bedrooms that are well equipped, well decorated and personalised to the service users taste. The inspector was shown around the home by one of the service users and found the whole home to be comfortable, well equipped, well decorated and although not accessible to people with mobility difficulties met the needs of the current service users well. The home’s laundry facilities and included a new commercial washing machine and dryer, sink and new floor. Staff spoken to confirmed that infection control was covered in their induction to the home and that this was included in planned core training. The home was clean and tidy throughout. MI CASA DS0000067230.V310265.R01.S.doc Version 5.2 Page 21 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An effective staff team is able to competently address the needs of the current service users. The home’s recruitment practises robustly contribute towards service users protection although an identified improvement in recording in this area would further assist to evidence this. Service users are supported by staff who have access to training in areas relevant to service users needs and who are supervised to assist them further in meeting service users needs and in their own personal development. EVIDENCE: The registered manager, one team leader and six care staff were employed at the home, four of the care staff full time and two half time. The team manager and one care staff were undertaking national vocational qualification (NVQ) level 3 in care with another care staff having completed this. Two other care staff had completed NVQ level 2 in care. Three care staff were undertaking or had completed the Learning Difficulty Award Framework (LDAF) as part of their professional development. A satisfactory staff rota was seen that showed two staff working during the morning and evening shifts and one sleeping-in overnight. The registered manager works in addition to this and there is an on call system available out MI CASA DS0000067230.V310265.R01.S.doc Version 5.2 Page 22 of office hours for advice or assistance. The home is aware that it must keep the staffing levels under review as new referrals are made to the home to ensure that it can continue to meet the assessed needs of all service users accommodated. Two staff files were inspected at random. These files contained, a satisfactory application form, two references, proof of identity with a photograph and evidence of entitlement to work where appropriate. The home also had a list supplied by the provider organisation to evidence that criminal records bureau (CRB) clearances and protection of vulnerable adults (POVA) checks had been taken out by the provider organisation prior to the staff member starting work. The list contained the reference numbers of the individual checks but not the date that these were received. A requirement is made regarding this so that the home can more easily evidence that the checks were received before the member of staff started working with service users. The registered manager was clear about the importance of operating a robust recruitment procedure to assist protect service users. Evidence was seen from documentation and from discussion with staff that they had benefited from satisfactory induction training. This included protection of vulnerable adults, health and safety, infection control and signing to evidence that they had read and understood these and other key policies in the home. Evidence was seen that staff are issued with the General Social Care Council (GSCC) code of conduct. Evidence was also seen that the home had organised a range of further training in core subjects as required by the national minimum standards. Staff spoken to stated that they received regular formal supervision and evidence of this was seen on one of the staff files sampled. Staff stated that this supervision was useful, that the home held regular staff meetings and that they also received informal supervision as required on a day-to-day basis. MI CASA DS0000067230.V310265.R01.S.doc Version 5.2 Page 23 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, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and staff benefit from the home being effectively managed by the registered manager. Service users will also benefit from the provider organisation’s quality assurance system that is being introduced to the home and will incorporate their views on the service. Effective health and safety procedures contribute to protecting service users, staff and visitors to the home. EVIDENCE: The home has an effective registered manager who is also the registered manager for an adjacent care home run by the provider organisation. He has significant management experience and knowledge of the needs of vulnerable adults. The registered manager is currently undertaking his registered managers award. The inspector also met both the provider organisation’s managing director and the director of operations who attended for the first part of the inspection. Both of these managers presented as being knowledgeable about the developing service at the home and of the need to MI CASA DS0000067230.V310265.R01.S.doc Version 5.2 Page 24 provide appropriate strategic guidance and support to the registered manager and his staff. The provider organisation operates a formal quality assurance system that includes annual surveys of service users and other stakeholders. The registered manager stated that this will be introduced in due course at this home. The home is currently operating a key worker system and is endeavouring to develop good working relationships with other stakeholders including care managers. This should assist with the implementation of the quality assurance system. The operations manager visits the home regularly and undertakes monthly management and quality audits, copies of these reports are sent to the Commission. The reports are comprehensive, detailed and provide a clear overview of the home’s strengths and any areas it needs to address from that visit. A range of satisfactory health and safety documentation was inspected that included: a gas safety certificate, electrical installation certificate and installation of the home’s fire fighting equipment. Evidence was seen that the fire officer had visited the home following its conversion and prior to registration and that the fire precaution systems at the home were satisfactory. Evidence was also seen that of an environmental health visit to the home in September 2006 that was also satisfactory. No other health and safety issues were identified at this inspection. MI CASA DS0000067230.V310265.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X MI CASA DS0000067230.V310265.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? N/A 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 YA7 Regulation 12(2) Requirement The registered persons must ensure that the statutory financial benefits and assessed contribution arrangements for an identified service user are clarified and recorded with the referring authority without delay to avoid a potential debt situation arising for the service user. The registered persons must ensure that all communal areas of the building, including communal toilets, are accessible to service users unless there is an appropriate reason that is validated by a risk assessment. The registered persons must keep a record in the home of the date that the provider organisation receives a CRB/ POVA clearance for a member of staff as well as the clearance reference number. This is to evidence that the clearance has been received before the member of staff commences work with service users. Timescale for action 31/10/06 2 YA16 12(2) 31/10/06 3 YA34 19(5) 31/10/06 MI CASA DS0000067230.V310265.R01.S.doc Version 5.2 Page 27 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 MI CASA DS0000067230.V310265.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 MI CASA DS0000067230.V310265.R01.S.doc Version 5.2 Page 29 - 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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