Inspection on 28/11/05 for Mokattam

This inspection was carried out on 28th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Mokattam 11/05/07

Mokattam 28/07/05

Mokattam 27/01/05

Mokattam 24/08/04

Mokattam 06/01/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Mokattam Altwood Bailey Maidenhead Berkshire SL6 4PQ Lead Inspector Susan Burton Unannounced Inspection 28th November 2005 10:00 Mokattam DS0000011293.V264295.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Mokattam DS0000011293.V264295.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Mokattam DS0000011293.V264295.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Mokattam Address Altwood Bailey Maidenhead Berkshire SL6 4PQ 01628 626070 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) Turnstone Support Limited Mrs Monica El Morabet Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Mokattam DS0000011293.V264295.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th July 2005 Brief Description of the Service: Turnstone Support Ltd, an independent agency, is registered to provide personal care, support and accommodation in Mokattam for up to six younger adults who have learning disabilities. Mokattam is a large detached property situated in a quiet residential road on the outskirts of Maidenhead. There are local shops and facilities within walking distance and a large range of leisure and recreational centres in the local area. The house has a secluded rear garden that has seating, shade and room for leisure activities. There is limited off road car parking available at the front of the house where the residents transport vehicle is kept. Mokattam DS0000011293.V264295.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection on Monday the 28th of November 2005, the inspection commenced at 10 a.m. This was a most positive inspection, which focused on equality and diversity issues, communication and other care practices. The inspector took the opportunity during the visit to ask (with the assistance of staff) one non-verbal resident for feedback on CSCIs information leaflets. What the service does well: What has improved since the last inspection? What they could do better: The manager needs commence the Registered Managers Award/NVQ 4. Mokattam DS0000011293.V264295.R01.S.doc Version 5.0 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. Mokattam DS0000011293.V264295.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Mokattam DS0000011293.V264295.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The ethnic social and cultural for needs for one individual are recognised and met. The home is able to demonstrate that staff can communicate effectively with the residents. EVIDENCE: From observation and discussion with existing residents, they know that the home that they have chosen continues to meets their needs and aspirations. The ethnic needs of one resident are acknowledged and recognised. Issues around privacy and dignity are addressed and same gender care is always provided. Diet and clothing are culturally appropriate. The inspector observed staff members communicating most effectively to some of the residents by sign language, which was understood and responded to. Mokattam DS0000011293.V264295.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 The residents individual care plans documented in detail their assessed and changing needs, personal goals and aspirations. Residents are enabled to make decisions about their lives with the assistance and support of the staff in the home. Individuals are consulted and are enabled to participate in all aspects of life in the home and outside of the home. EVIDENCE: The care plan of one individual was examined in detail. The plan provided a photograph of the individual, details of her link worker and her likes and dislikes and how to communicate with her. The plan provided detailed information on personal care needs relevant to her ethnic background and also information and guidance for staff on how her high dependency needs were to be met. District nurses visit on a regular basis to support the staff in maintaining her dietary needs and written guidance for staff was on file. The inspector observed a member of staff communicating and discussing with an individual what she wanted to do, whether she wished to go shopping or Mokattam DS0000011293.V264295.R01.S.doc Version 5.0 Page 10 stay at home. The resident was given options and choices and enabled to make a decision for herself. Residents were seen to be encouraged by the staff to participate in all aspects of life in the home, whether this was housework, shopping, menu selections or what activities were wanted. Staff were seen at all times to ask the residents individually what they wanted to do and encouraged and supported them to make appropriate choices. The staff team also recognised when residents needed personal space and time for themselves. Mokattam DS0000011293.V264295.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13, 14, 15, 17 The residents are enabled to be part of and participate in the local community. The residents have opportunities to engage in appropriate leisure activities. Personal and family relationships are supported and maintained with staff assistance. Residents are enabled to select suitable menu choices, which meet their dietary, personal and cultural, needs. EVIDENCE: The manager and staff team have made use of the local community cultural centre, library and other resources to ensure that one individuals religious and cultural needs were provided for, which is good practice. One resident particularly enjoys a specific service at a local church and staff will take him whenever he wishes to attend. The manager made contact with the local vicar who now visits the home every week to have a cup of tea and chat with the residents. He has been very supportive for one individual following her mothers death. Mokattam DS0000011293.V264295.R01.S.doc Version 5.0 Page 12 The inspector was able to see photographs of leisure activities and entertainments that have taken place recently in the home. The homes notice board provided a calendar of events and activities. The residents enjoy parties in the house and recently decided on a Wild West theme, photographs and comments from a resident supported that this had been much enjoyed by everyone. Two other residents sat and showed the inspector the work they had been doing to raise funds for their activities. With the assistance of staff the residents have been making decorative individualised Christmas cards, which they then sell for a small sum to friends, relations and staff. The notice board provided photographs of the friends and family members who had attended the recent party. The manager advised the inspector that these events are usually well supported by the residents immediate families. Invitations are sent to those people chosen by the residents. One individual had a boyfriend at the time that was invited to attend any events that were provided. Residents are encouraged and supported by staff to maintain contact with friends and relations living further away. The home displays a pictorial menu for the residents. The manager advised the inspector that residents are shown pictures of various meal choices to help them decide what they would like to eat; these are then selected for the week and attached to the weekly menu. One resident has specific dietary needs and assistance is given to maintain her nutritional status. District nurses visit on a regular basis to ensure that staff are trained and knowledgeable in how the feed is to be given and how to maintain the hygiene requirements for the equipment. The kitchen cupboards have pictures on them to assist the residents in finding crockery or cooking utensils. The kitchen has a large pine dining table, which is the main focus of life in the house, residents were seen to enjoy sitting round the table enjoying a leisurely breakfast and chatting to each other and the staff. Mokattam DS0000011293.V264295.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20, 21 Staff provided sensitive and flexible support in varying degrees to each individual resident. Residents physical and emotional health needs are recognised, documented and met. Medication is dispensed to the residents in an appropriate manner. The ageing, illness and death of family members and the residents themselves are sensitively handled, acknowledged and documented. EVIDENCE: The manager and staff on duty during the inspection were seen to provide sensitive and flexible support in various ways to residents with very differing needs. One resident with high dependency needs was enabled to have a day in bed and she was feeling off-colour. A resident who was physically very able but had higher emotional needs was cared for and supported in a most sensitive way and her need for individual rituals and routines recognised. Care plans and documents in the home evidence that the health care needs of the residents are assessed and recognised and that appropriate support is sought and given by a range of health care professionals such as district Mokattam DS0000011293.V264295.R01.S.doc Version 5.0 Page 14 nurses, physiotherapists, occupational therapists, podiatrists, dentists, dieticians and the local GP. The inspector observed the medication administration practices of one member of staff to one particular resident, this was seen to be sensitive to the abilities of the individual. Medication administration sheets were seen to be correctly filled in and completed. The manager discussed with the inspector her efforts to ensure that issues around death and dying were acknowledged and documented. She had begun to work with one individual who was struggling to cope with the death of her mother. Consideration has been given to the legal and financial aspects of the residents aging families and their own individual needs in regard to aging, illness and death. The inspector was able to see that the manager had awareness and foresight of issues that may occur in the future and how important it was the residents legal and financial rights were protected in regard to family bequests. Care plans and records were seen being updated on an individual basis to ensure all relevant information was documented. The manager is commended for her efforts in this area. Mokattam DS0000011293.V264295.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were inspected at this time. EVIDENCE: Mokattam DS0000011293.V264295.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 The residents live in a homely and comfortable environment. EVIDENCE: The premises had been decorated recently both internally and externally and new carpeting provided. The premises were seen to be comfortable, bright, cheerful, airy, clean and free from any odours. Mokattam DS0000011293.V264295.R01.S.doc Version 5.0 Page 17 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 The residents in the home were supported by a competent and qualified staff. The home was seen to provide an effective and supportive staff team. The residents are protected by the homes recruitment policies and practices. The organisation provides a range of training opportunities for the staff. EVIDENCE: The manager advised the inspector that all members of staff employed on a permanent bases are able to sign. One member of staff has recently had training in supporting people with autistic spectrum conditions. The home has eight permanent care staff of which three have NVQ level 3, one has NVQ level 2, and one has NVQ level 3 equivalent qualifications. The inspector was able to see an appropriate number of staff on duty to support the needs of the residents. The home employs 3 staff for the morning and 3 for the afternoon shift, there is 1 waking staff and 1 sleeping staff for the night shift. Extra staff are bought in for parties and escorting residents. Currently there is only one male carer employed at the home, the organisation is actively seeking to recruit another male carer to ensure an appropriate gender balance for the male and female residents in the home. The home very rarely uses agency staff. Mokattam DS0000011293.V264295.R01.S.doc Version 5.0 Page 18 The inspector reviewed the recruitment records of one new member of staff. Information as required by regulation and schedule were seen in place. The organisation is providing a training course in January 2006 with a validated external trainer to ensure that communication skills are maintained and improved. The home has a training profile, which was seen by the inspector and evidenced a wide range of training opportunities provided for staff. The staff team have accessed medication training, positive communication, health and safety, emergency aid, fire, and protection of vulnerable adults. Mokattam DS0000011293.V264295.R01.S.doc Version 5.0 Page 19 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, 40, 41 The residents benefit from a well-run home. The residents and their families views are actively sought and reviewed. The home has a wide range of appropriate policies and procedures. The residence rights and best interests are safeguarded by the homes recordkeeping, policies and procedures. EVIDENCE: The home has a competent Registered Manager who advised the inspector that she would commence her Registered Managers Award in December 2005. Residents meetings take place regularly, and documents evidenced that the manager and staff seek the views and opinions of the residents in regard to the service. The staff team also record non-verbal communication. Residents were consulted about activities, menu choices, Christmas events and what the residents wanted in regard to the recruitment of a new member of staff. Mokattam DS0000011293.V264295.R01.S.doc Version 5.0 Page 20 The home has been actively seeking feedback from families and residents representatives; copies of the survey sent out were reviewed. Feedback was given on the quality of the service, what the home could do better and if there were any concerns or issues. The inspector was able to see complimentary and positive comments received from the survey. One recorded that a family felt that one individual had received exceptional care and the change was amazing. Where an issue had been raised this was followed up by the manager with a meeting and the issue resolved. Four of the residents expressed their happiness and satisfaction with the care and service they received to the inspector. A staff member assisted the inspector to sign with a resident to ask for feedback on how helpful she found the CSCI information leaflet and cassette tape that can be provided for residents at each inspection. She was happy to feedback her thoughts and comments which will be passed on to the relevant department at CSCI. Discussion took place with the manager in regard to the homes policies and procedures and the recommendations as set out in appendix 2/3 of the National Minimum Standards. The organisation provides the home with a large policy and procedure file that is accessible and updated as necessary. Records required by regulation for the protection of residents and for the effective and efficient running of the business were maintained, were up to date and accurate. Residents have access to their records and information held by the home. Records were seen to be kept securely in a cabinet and locked in the office. The office has a computer, which has access to the organisations database and allows the manager to source information and records as necessary. Mokattam DS0000011293.V264295.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X 3 X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Mokattam Score 3 3 3 4 Standard No 37 38 39 40 41 42 43 Score 2 X 3 3 3 X X DS0000011293.V264295.R01.S.doc Version 5.0 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 Mokattam DS0000011293.V264295.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA 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 Mokattam DS0000011293.V264295.R01.S.doc Version 5.0 Page 24 - 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!