Inspection on 21/10/08 for MIG House Residential Care Homes Ltd

This inspection was carried out on 21st October 2008.

CSCI found this care home to be providing an Good service.

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

Other inspections for this house

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 13/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: MIG House Residential Care Homes Ltd 42 Clarendon Road Leytonstone London E11 1DA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Caroline Mitchell     Date: 2 9 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: MIG House Residential Care Homes Ltd 42 Clarendon Road Leytonstone London E11 1DA 02085562931 02085562931 mighouse42@gmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : MIG House Residential Home care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 4 The maximum number of service users who may be accommodated is: 4 The registered provider may provide the following category of service only: Care Home with Personal care - Code PC To service users of the following gender: Either Whose primary care needs on admission are within the following category: Learning Disabilities - Code LD Date of last inspection Brief description of the care home Mig House is a registered care home for four people with learning disabilities. The home is a family-type home and fits in well with the other houses in the street. The property is owned by registered provider who runs other, similar homes in the area. The house has four bedrooms, a computer room, sensory room, laundry room, an adapted shower, bathroom, kitchen, dining room, a lounge, an office and a staff room. There is an enclosed garden to the rear. The home is in Leytonstone, close to public transport and the surrounding area has a range of shops, restaurants and cafes, a leisure centre, and public houses. The charge is from £1,600 to £2,100 per week. People using the service pay for their own toiletries, outings, holidays, and clothing. Following Inspecting for Better Lives the provider must make information available Care Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home about the service, including inspection reports, to the people who use the services and other stakeholders. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was done in two visits. We met two of the three people living in the home and some of the staff and managers. We looked at the written records kept in the home and looked around the building. Three young men were living in the home at the time of the inspection. One of the three people communicates mainly by sound and behaviour, because of their disabilities. This means that some of the judgements in this report have to be made based on the views of others, such as staff and on the written records kept by the home. What we saw when staff were working with people has also been used. We looked at care plans and daily records, and compared to the care being provided. We looked at two staff files and talked to the two staff and asked about what support training they had. Care Homes for Adults (18-65 years) Page 6 of 27 The home sent us their annual quality assurance assessment (AQAA) when we asked for it. It was clear and gave us the information we asked for. The AQAA is a form that the home fills in. It tells us how well outcomes are being met for people living there. It gave us useful information and helped us to plan our visit. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has an accurate assessment of peoples needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. Evidence: This home is quite new and the first person moved in, in February 2008. There were three people living there when we did this inspection. When we looked at the files for two of the people living there we found that the home made sure they had lots of information about each person before they moved in. There were good assessments about their needs and lots if information from where they lived before. People had been asked about what they like and dont like and their families and advocates had been involved. People had visited before they moved in and had overnight stays and the staff had kept a good record of how they were when they visited. The line manager Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: for the home said, It is important we do it at the individuals pace. A lot of work was being done to make sure that the information about the home in the service user guide was written in a user friendly way. It was in large print and used words that were easy to read and widget pictures were being put in. Widget is a way of putting pictures into documents to help people with learning disabilities to understand them. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life with support that they need. This is because the staff promote their rights and choices. People are supported to take risks to help them to be as independent as they can. This is because the staff have proper information to base decisions on. People and their families are involved in all aspects of life in the home. This is because the managers and staff offer them opportunities to be involved in making decisions about the way their lives and their home are run. Evidence: The care plans we saw were good as they included peoples strengths and needs and their aims and objectives. The people living in the home and their relatives and advocates had been involved in putting the plans together. People had key workers and they had regular meetings with them to talk about things. The key worker writes the notes of these meetings to help keep a check on how well people are doing with Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: the aims in their care plans. The line manager showed us that the person centred plans (PCP) were all being being improved by having pictures added and we saw that one person had a PCP meeting last week, and that their relatives and advocate were there. At both visits we saw that people living in the home were being given choices and being encouraged to be as independent as they could. We saw very good risk assessments covering all aspects of the risks linked with peoples needs and lifestyles. There were clear written records about any limits placed on peoples freedom and these were being reviewed regularly. There was a key pad on the front door because one person would be at risk if they were able to go out on their own and without the staff knowing they had gone. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person is treated as an individual and the home is responsive to their race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are suitable for their age and culture and are part of their local community. The home supports people to follow their interests and activities. People choose and participate in suitable leisure activities. People are able to keep in touch with family, friends and advocates. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, wellpresented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: We met one of the people living in the home as he was going out shopping with a member of staff. He told us about a Halloween party that he was looking forward to going to, and said that he was going back to college next week. We met another person twice, because he was at home on both of our visits. We looked at his file and saw his weekly planner that showed the activities he was doing. The planner was also on his wardrobe door and had a picture of each activity. He had some activities at home, like cooking, doing laundry, dusting and vacuuming. The activities that he was doing in the community included visiting a stables, trampolining, swimming, going to the shops and MENCAP club. The line manager said that the home was working on developing more daytime activities for him out side of the home. The person has autism and uses Makaton to help him to communicate. The home is and is encouraging the staff and the other people in the home to use Makaton with him. Staff were also being careful to find out what he likes and taking care to make sure that he can do activities that he likes and that are designed to meet his needs. We saw staff working with this person, supporting him to do ordinary household tasks and helping him to make choices. We saw leaflets about social and self-advocacy events being held locally. These were on the wall in the office. We were told that people living in the home went to these events. The line manager told us that a lot of work was being done to widen peoples circle of friends and to get them involved in activities in the local community. We saw lots of family photos in one persons bedroom. Two people have special diets because they cant eat some kinds of food. The home had made sure that all the staff know about this. The menus have pictures to help people to make choices and the home keep a good record of what people actually eat so staff can make sure that they get a balanced diet. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. Where people cannot manage their medicine, the home supports them with it in a safe way. Evidence: As we have already said in this report the risk assessments and care plans were very good. They included information about peoples health care needs and showed that people like psychiatrists and psychologists were involved in checking peoples care. There was guidelines for staff about how to give care and this guidance made sure staff think about peoples dignity, choice and independence. There were good records of peoples health care appointments and any other health care input people had received. We looked at the medication that people are taking. The medication was stored properly in a locked cabinet. People are supervised with their medication and we saw the records of medication that had been given, the medication coming into the house Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: and the medication returned to the chemist. We saw that the management team make sure the medication system is working and that staff are following the proper procedures. The staff had been given training about medication and been tested to make sure they were competent. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. If people have concerns with their care, they or people close to them know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. Evidence: The home has a complaints procedure that is clear and easy for people to understand. It tells people who they should speak to at the home and who to contact outside the home to make a complaint. How to complain was in simple, accessible language and displayed on the wall. We looked at the complaints file and one complaint had been made since the last inspection. The records were good and showed that the complaint had been dealt with properly and in a reasonable timescale. The staff had attended training in safeguarding people from abuse. The organisation has a policy about safeguarding people and preventing abuse. The home has a whistle blowing policy and procedure. Staff have also had training in how to deal with challenging behaviour. This means that people living in the home are supported by staff who have the necessary guidance and training to protect them from potential abuse. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People stay in a safe and well-maintained home that is homely, clean, comfortable and pleasant. The home has enough space and facilities for people to lead the life they choose and to meet their needs. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. Evidence: We were shown around the home and noticed that it was generally clean and well maintained. There were no unpleasant smells. The people living there have been provided with a computer room that is very well equipped. The line manager told us that two people are very keen on computers. They are also keen on football and there were lots of football posters in the computer room. The line manager told us that all three of the people living in the home liked playing the electric piano. There is also a sensory room, which is with special lights and soft furnishings like big bean bags. There is a separate kitchen and dining room and a good sized lounge. We saw one persons bedroom and it was decorated in a way that showed his background and interests. There are enough toilets, baths and showers and a well equipped laundry room. Care Homes for Adults (18-65 years) Page 19 of 27 Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have safe and appropriate support, as there is enough competent, qualified staff on duty. They can have confidence in the staff at the home because checks have been done to make sure that they are suitable. Peoples needs are met and they are supported because staff get very good training, supervision and support from their managers. Evidence: We saw the staff rota and it showed that there is usually a minimum of two staff in the daytime and 1 person sleeping-in and 1 waking night staff at night. We spoke to two of the care staff and both showed a very good understanding of peoples needs. They were informative and positive in their outlook. We were told that there was good teamwork in the home and that the managers were open and supportive. We looked at the staff personnel files for two staff members. These showed that the proper checks had been done on staff before they started work in the home. The staff members had a criminal record bureau check (CRB) and two written references. The staff members file contained proof of their identity and their application form. We saw Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: the records of the 1 to 1 meetings staff have with their managers and these showed that staff were having this kind if supervision regularly, which helps to make sure that staff are supported properly. Overall, we saw good monitoring records of staff supervision and lots of information about the training that staff have had and the training that is planned. The home was also doing well in making sure that staff have training to national vocational qualification (NVQ) level 2 and above. The line manager said the aim is to offer staff 6 different types of training each year. The management team was very responsive. During the inspection we made a recommendation for minor improvements to be made to the application form and the line manager made the changes immediately. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can have confidence in the care home because it is run and managed appropriately. The environment is safe for the people who live there and the staff because health and safety good practise is carried out. People get the right support from the home because the management team run it properly, with an open approach that makes them feel valued and respected. They are safeguarded because the home keeps records appropriately and makes sure staff understand the way things should be done. Evidence: There is a full time manager and she is registered with the Commission. She was ill at the time of this inspection. We met other members of the management team and they came across as very committed and knowledgeable about the needs of the people living in the home. The line manger has been doing lot of work with the home to make sure that written documents for people who live in the home are written in a way that is easier for them to understand, using Widget and pictures. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: We looked at the residents meeting book. This showed that the meetings are held regularly and that people are consulted about things like activities, the house rules, the menu, PCP and personal space. The last set of minutes were written with pictures and large, clear print. Members of the management team speak to peoples relative on almost a daily basis. They were very involved and often asked about their opinion of the service. The line manager told us that there were monthly steering group meetings, which peoples families attend and the home is talking to peoples families about their PCP and getting them involved in the PCP process. In terms of health and safety, in the AQAA the home gave us information about the health and safety checks that had been done and these were up to date. Staff had training in health and safety and some more training was planned, to keep them up to date. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!