Inspection on 27/06/07 for Micado Homes Ltd

This inspection was carried out on 27th 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Micado Homes Ltd 38 St Marys Road Hayes Middlesex UB3 2JP Lead Inspector Susan Woolnough-Singh Unannounced Inspection 27th June 2007 10:30 Micado Homes Ltd DS0000068190.V335507.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 Micado Homes Ltd DS0000068190.V335507.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. Micado Homes Ltd DS0000068190.V335507.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Micado Homes Ltd Address 38 St Marys Road Hayes Middlesex UB3 2JP 020 8573 1134 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) Micado Home Ltd Evelyn Adoma Adu Care Home 4 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (4) of places Micado Homes Ltd DS0000068190.V335507.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: No Conditions of Registration. Date of last inspection No previous inspection. Brief Description of the Service: Micado is set in a quiet location close to Hayes Town Centre. Micado is a four bedroom detached house with a substantial back garden and a patio area to the front for parking. There is ample communal space and the home has been renovated and decorated to a very high standard. The home caters for people who have enduring mental health problems and require help with the activities of daily living. Micado Homes Ltd DS0000068190.V335507.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection of Micado. The home was registered in November 2006. At the time of the Inspection the home had one person resident. The inspection took place between 10.30 and 5pm. All the Key Standards for Younger Adults were assessed. The Inspector took a tour of the building and had lunch with one person using the service and staff. The Registered Manager was able to demonstrate how she had prepared to meet the National Minimum Standards for Younger Adults. The Inspector looked at policies and procedures and the care file related to the person using the service. What the service does well: What has improved since the last inspection? What they could do better: Preparation needs to be made for the mandatory training of staff in health and safety; a Quality Assurance system needs to be developed for future use. Micado Homes Ltd DS0000068190.V335507.R01.S.doc Version 5.2 Page 6 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. Micado Homes Ltd DS0000068190.V335507.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 Micado Homes Ltd DS0000068190.V335507.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. JUDGEMENT – we looked at outcomes for the following standard(s): All of the above 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 required information on moving into the home and the services provided is available. There is a planned admission process, which includes an induction to the home for the person moving in. EVIDENCE: The home has a Statement of Purpose and Service Users Guide. These give prospective service users the information they need to make an informed choice about the home. The Inspector was able to see an example of a Needs Led Assessment completed by a commissioning Local Authority. This contained the necessary information with regard to the needs of the person using the service. The Registered Manager has a system in place for introducing people to the home. This includes a checklist of the procedures and meetings that should take place prior to the person entering the home. A date is set for a trail visit. The Registered Manager aims to attend a ward round and discuss the needs of the person before admission. The home ensures that the hospital provides a Micado Homes Ltd DS0000068190.V335507.R01.S.doc Version 5.2 Page 9 detailed discharge summary. A twelve-week assessment period takes place when the person enters the home. A statement of Terms and Conditions is available. This contains the required information and is signed by the person using the service or a relative/advocate. Micado Homes Ltd DS0000068190.V335507.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. JUDGEMENT – we looked at outcomes for the following standard(s): All of the above 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 care plan, which is based on the individual needs of the person using the service. The care plan indicates the level of decision making and risk taking appropriate, in the best interests of the person using the service. EVIDENCE: The Inspector was able to examine in detail the file held for the person living in the home. The care plan established all the areas of care and support to be offered by the home. The care plan covers physical and emotional well being, areas of risk and plans for encouraging participation and the building of confidence. A risk assessment of mental stability with management strategies also forms part of the care plan. Decision making and participation form part Micado Homes Ltd DS0000068190.V335507.R01.S.doc Version 5.2 Page 11 of the care plan. The aim of the home is to offer a residential placement to people who have used mental health services for a substantial number of years, rehabilitation is not part of the care plan. The emphasis is to encourage participation in daily living, this is set out in the activity schedule. (Please see standard 11 and 12). A full set of policies and procedures have been produced, confidentiality is included. The policy manual contains guidance on how all the National Minimum Standards for Younger Adults will be met. Micado Homes Ltd DS0000068190.V335507.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A weekly schedule is provided which includes the persons’ assessed needs. The schedule sets out how the home will promote the persons development in all areas. The weekly schedule sets out people’s strengths and weaknesses in a social setting. EVIDENCE: A weekly schedule for the person living in the home, at the time of the inspection was seen. The Inspector also discussed with the Registered Manager plans for meeting the lifestyle standards for other people who will eventually move into the home. The aim of the home is to promote and build confidence in the areas of personal care, participation and social inclusion. This will be done in small steps and will be based on mental health assessments and the medical Micado Homes Ltd DS0000068190.V335507.R01.S.doc Version 5.2 Page 13 person’s history. The schedule seen for one person set out a weekly routine that covered steps to be taken to participate in very basic household tasks, contact with staff, and interests. The Registered Manager said the home would ensure that the schedule is followed and this was in evidence on the day of the inspection. The Inspector had lunch with the person living at the home and a member of staff. The person using the service had been encouraged to participate in the preparation of this. A set menu is available, this included breakfast a cooked lunch and light snack for the evening meal. Micado Homes Ltd DS0000068190.V335507.R01.S.doc Version 5.2 Page 14 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): All the above standards were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Provision is made in the care plans as to how people’s social and healthcare needs will be met. There was evidence in the records examined that the home was meeting this standard. Clear policy and guidance is available for the handling of medication. EVIDENCE: The personal support required by people using the service will be included in the care plan. The person using the service at the time of the inspection did not require support in this area. There was evidence in the care plan that the physical well being of the person using the service was being monitored. A list of health care appointments was available, this indicated care in the areas of chiropody, dental and opticians appointments. A weight chart was being kept. As the person had only lived at the home for one month there was no particular reference to mental health reviews with other professionals, apart from the information that formed part Micado Homes Ltd DS0000068190.V335507.R01.S.doc Version 5.2 Page 15 of the initial assessment. People who use the service will be monitored by their General Practitioner, Social Worker, Community Psychiatric Nurse and as an outpatient. The staff at the home have a contact for consultation at a local mental health centre. There is a medication policy and clear guidance for staff on the administration of medication. A local dispensing chemist provides medication in blister pack form. The Medication Cabinet and Medication Administration record were examined and found to be in order. The Registered Manager was able to evidence the systems she had put in place for the monitoring and return of unused medication. The Inspector noted from the policy manual that there is policy and guidance on how staff are to work with aging and death. Micado Homes Ltd DS0000068190.V335507.R01.S.doc Version 5.2 Page 16 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): All of the above standards were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clear procedures are in place for complaints management and the protection of vulnerable adults. EVIDENCE: There had been no concerns or complaints at the time of the inspection. The home has a Complaints Procedure. This is well set out and includes the stages of the complaints investigation and gives contact details of external organisations such as the West London and Central London CSCI offices. There is clear guidance on the Protection of vulnerable adults; this includes definition of abuse and action to be taken in the event of alleged abuse. A Whistle Blowing policy is available for staff, which gives external contact details for reporting including Hillingdon Social Services and CSCI. This is kept in the Policy Manual. It is to be recommended that staff receive a personal copy of this. Training in the protection of vulnerable adults for the staff team had been booked with London Borough of Hillingdon for 17th July 2007. The Registered Manager said the home does not plan to be involved with the management of service users finances. If the person has been assessed as needing substantial help with financial management further risk assessments will be put in place. In preparation for this, the Registered Manager had prepared a form for recording transactions. Micado Homes Ltd DS0000068190.V335507.R01.S.doc Version 5.2 Page 17 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 of the above standards were assessed. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Micado home offers people a homely comfortable and safe environment. The space meets the required standard and the level to which the home is fitted, decorated and furnished exceeds the standard. EVIDENCE: The Inspector took a tour of the building with the Registered Manager. The home met the environmental standards as required by the Central Registration Team and was registered in November 2006. The home is decorated and furnished to a very high standard. The home has been completely refurbished in preparation for registration. New bathrooms and a new kitchen had been fitted. Hygiene standards in the home were of an excellent standard. There is a garden to the rear of the property, which offers Micado Homes Ltd DS0000068190.V335507.R01.S.doc Version 5.2 Page 18 seclusion and is well maintained. Although the home is in a built up residential area, the home is detached and offers privacy and seclusion. The accommodation consists of a large lounge/dining room, utility room, games room (not completed yet) and four single bedrooms. There are plans to register the home for five people once an en-suite bathroom has been installed in the fifth bedroom. The home has one bath, one shower and three toilets. The Inspector talked with the Registered Manager with regard to maintaining the very high standards once the home was full. The Registered Manager said she believed that it is very important to offer a good environment and that people would be helped to respect this. She said plans for continual maintenance would be put in place. Micado Homes Ltd DS0000068190.V335507.R01.S.doc Version 5.2 Page 19 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 of the above 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 Registered Manager was able to demonstrate her competence in the recruitment of staff and the required procedures for the protection of vulnerable adults. At the present time the staff team is able to meet the needs of the one service user. Training for staff is at the preparation stage. A more comprehensive picture of how the home intends to meet training and supervision standards will be established when the home is operating at full capacity and further staff have been employed. EVIDENCE: At the time of the Inspection the staff team consisted of The Registered Manager, a Partner in the Company who is a Registered Nurse, and two members of staff. The Registered Manager was in the process of recruiting three staff and was waiting for the results of POVA First checks and Criminal Records Bureau Checks. The rota indicates that there is a minimum of one Micado Homes Ltd DS0000068190.V335507.R01.S.doc Version 5.2 Page 20 member of staff on duty during waking hours at the present time. One member of staff is on the premises for waking night duty. The personnel files of the two members of staff were examined, these contained all the required information in the form of recruitment checks. There was evidence of completed application forms, references, identity checks and CRB information. Staff also had offer letters and terms and conditions of service. On both files the ‘Skills for Care’ induction booklet had been started. Staff had signed statements to confirm that they were willing to work above forty-five hours per week. Mandatory training had not taken place for all staff. The Registered Manager said that this would be arranged. The Registered Manager said that some training had taken place within other care settings with previous employers but it was not always possible to obtain copy certificates. She had made phone calls where necessary to confirm this. The Inspector discussed with the Registered Manager the importance of being able to evidence training, particularly mandatory training in health and safety. A checklist for recording individual training was provided. The Registered Manager was aware of the need for one to one supervision and had made preparation for this. The staff had been in post for approximately one month and formal supervision had not commenced. This will need to be addressed once the staff team is established. Micado Homes Ltd DS0000068190.V335507.R01.S.doc Version 5.2 Page 21 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): All of the above 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 Registered Manager was able to demonstrate her knowledge of the client group provided for and an understanding of the National Minimum Standards for Younger Adults. Systems are in place for monitoring health and safety in the home. Quality Control systems will need to be implemented as the home progresses and is offering a full service. EVIDENCE: Micado Homes Ltd DS0000068190.V335507.R01.S.doc Version 5.2 Page 22 The Registered Manager and Company Partner own and work within the home and are Registered Mental Nurses. Once the home is established the Registered Manager will need to consider undertaking the Registered Manager Award. The Ethos of the home was discussed throughout the inspection. The aims and objectives of the home are clear; to provide a comfortable environment were people can be encouraged to maintain a level of self care that takes into account their medical history and assessed needs. At this stage a Quality Assurance system had not been instigated, although the Inspector was able to see the questionnaire completed by the person living in the home and his/her feedback on the service. It is to be recommended that a quality audit method be considered for future inspections. The Inspector did not expect to see a business plan identifying areas for improvement due to the short period the home had been operating. The Insurance Certificate and Registration Certificate were displayed. The home has the required policies and procedures. The Registered Manager had been proactive in the field of health and safety. A consultant had carried out a health and safety audit and risks had been identified. A full fire risk assessment was in place. Fire Procedures were in place as were COSHH procedures. The Registered Manager had applied for information on any cleaning chemicals in use. An Environmental Health inspection had taken place on 14th June 2004 by a London Borough of Hillingdon environmental health officer. The report for this was seen by the Inspector. Standards were found to be ‘excellent’ and one recommendation was made. Certificates to evidence that three staff have completed health and safety mandatory training were forwarded to the Insector. Micado Homes Ltd DS0000068190.V335507.R01.S.doc Version 5.2 Page 23 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 4 25 4 26 4 27 4 28 4 29 N/A 30 4 STAFFING Standard No Score 31 3 32 2 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 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 33 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 3 3 3 3 Micado Homes Ltd DS0000068190.V335507.R01.S.doc Version 5.2 Page 24 Not Applicable. Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA42 Regulation 12 (a) Requirement The Registered Manager must ensure that preparation is made for new staff to receive mandatory training in health and safety or to evidence that this training has taken place with previous employers. Timescale for action 01/02/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA23 YA39 Good Practice Recommendations The Whistle Blowing policy should be issued to all staff. An effective system for monitoring the quality of the service should be arranged, this should be linked to an annual development plan. Micado Homes Ltd DS0000068190.V335507.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 Micado Homes Ltd DS0000068190.V335507.R01.S.doc Version 5.2 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. 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