Inspection on 20/04/07 for Murree Residential Care Home

This inspection was carried out on 20th April 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Murree Residential Care Home 08/06/09

Murree Residential Care Home 08/09/08

Murree Residential Care Home 07/09/06

Murree Residential Care Home 06/10/05

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Murree Residential Care Home 17 Marquis Close Wembley Middlesex HA0 4HF Lead Inspector Julie Schofield Key Unannounced Inspection 20th April 2007 08:10 Murree Residential Care Home DS0000061675.V336441.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 Murree Residential Care Home DS0000061675.V336441.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. Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Murree Residential Care Home Address 17 Marquis Close Wembley Middlesex HA0 4HF 020 8903 1571 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) murreecarehome@ntlworld.com murreecarehome.co.uk Mrs Shahnaz Abbasi Mrs Shahnaz Abbasi Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users admitted to the home must all be able to manage the stairs without assistance. 7th September 2006 Date of last inspection Brief Description of the Service: Murree House residential care home provides personal care for up to 3 adults with learning disabilities. At the time of the inspection there were 2 residents and 1 vacancy. The property is off a road, which is part of a route linking Ealing Road with the North Circular Road. There is a barrier across this road, close to the home, and so access to the home by vehicle must either be from the North Circular Road or by using a detour around the barrier, if approaching from Ealing Road. There is space to park outside the home on the street and 2 cars could park on the paved area at the front of the house. Inside the home there is a bedroom on the ground floor and 2 bedrooms on the first floor. There are bathing and toilet facilities on both floors. There is a kitchen and an open plan lounge/dining area on the ground floor. The office is on the first floor. The laundry room is in a building in the attractive garden at the rear of the house. Details of the fees charged for the service may be obtained, on request, from the home. Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on a Friday in April 2007. It began at 8.10 am and finished at 12.55 pm. The manager and her husband were on duty during the inspection. The Inspector met and spoke with both residents and with a relative that was visiting one of the residents. Records were examined, a site visit took place and discussions were held with Mr and Ms Abbasi. The Inspector would like to thank everyone for their assistance and for their comments. What the service does well: What has improved since the last inspection? Eight statutory requirements were identified during the previous key inspection in September 2007. Five of these have been met and there is compliance. Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 6 A review the menu has taken place between the manager and residents and adjustments have been made, where necessary. Residents now confirm that they are satisfied with its content. As the manager’s husband has commenced NVQ level 3 training and as he is currently the only member of staff, apart from the manager, the requirement that 50 of carers working in the home achieve an NVQ level 2 or 3 qualification is deemed to be met. Although a person has been appointed to work in the home, they have not commenced duties, as some of the necessary checks are outstanding. People working in the home have undertake training in safe working practice topics i.e. fire safety, manual handling, and infection control procedures. After the last key inspection he home forwarded a copy of a valid certificate for the testing of the portable electrical appliances and for the Landlord’s Gas Safety Record to the CSCI. What they could do better: Of the 8 statutory requirements identified during the previous key inspection 3 remain outstanding. The home must draw up risk assessments for activities carried out as part of daily living e.g. eating lunch out and travelling independently in the community for the resident that was admitted to the home in June 2006. Reference requests must be addressed to the manager or proprietor or personnel department and sent to the business address. (As a record of when and where references had been sent in respect of the person being recruited to work in the home was absent, the home was unable to demonstrate compliance). Formal quality assurance systems, including written feedback from residents, their relatives and the funding authority, is needed so that this information can be used when drafting an annual development plan for the home. In addition 5 statutory requirements were identified during this inspection. Care plans lacked sufficient detail to demonstrate that the support provided by staff met the needs of the resident. Minutes of review meetings must be kept on file so that they are available for reference by staff and to ensure that the support provided helps residents to achieve their goals. Records made during the recruitment process, including copies of documents sent or received, must be kept in the home so that they are available for inspection. A training programme is needed to include all persons in the home ensure that they have the necessary skills, knowledge and understanding to perform their duties and to meet the needs of the residents. Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 7 An annual internal audit is needed to ensure that the quality of care reaches and is maintained at a good standard. 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. Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 8 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 Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 9 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): 2, 4 Quality in this outcome area is good. A comprehensive assessment of the needs of the resident, prior to admission to the home, enables the home to determine whether a service tailored to the individual needs of the resident can be provided. A programme of preadmission visits to the home enables the prospective resident to sample life in the home and to decide whether the service provided is acceptable. This judgement has been made using available evidence including a visit to this service. EVIDENCE: One resident was admitted to the home in September 2006, but after the last key inspection. The case file was examined and it was noted that it contained a copy of the discharge summary and a copy of the funding authority’s mental health assessment form. The registered manager had completed an assessment for a care plan when the resident visited the home, prior to admission. The assessment formed the basis for the development of a care plan. The scope of the care needs assessment was comprehensive and included the identification of cultural and religious needs, general health and medication, personal care and domestic skills, social contact and communication, community skills, leisure and day care, financial Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 10 arrangements, behavioural problems and general attitude and risk management. The resident that had been admitted to the home in September 2006 described the pre-admission process. He said that he had visited the home to “have a look first” and that “it felt good”. He said that he liked his room, which was nicely decorated, and that he got on with the other resident. His preadmission visits had included having a meal in the home and an overnight stay. He said that the home was “a good place” and that he was enjoying living there. There was a record of his pre-admission visits to the home. Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Overall quality in this outcome area is adequate. Evaluating comprehensive care plans on a regular basis ensures that changes in the needs of residents are identified and can be addressed and regular reviews of the placement confirm that the care home continues to be able to meet the individual needs of the resident. The care plans need to be more detailed and minutes of review meetings need to be kept on file. Residents have the opportunity to exercise choice in their daily lives. Responsible risk taking contributes towards the resident leading an independent lifestyle. However one case file lacked any risk assessments. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two case files were examined. Both contained a care plan that had been developed by the home and that was based on the care needs assessment. Care plans need to be more detailed and comprehensive. It was noted that for Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 12 the resident that had been admitted to the home in September 2006 an initial review meeting had taken place in October and an internal review meeting had taken place in February 2007. Copies of the minutes of the meetings were on file and it was noted that a relative of the resident had also been invited to attend. In addition to regular review meetings the files contained copies of a weekly summary of the care plan, which recorded the goals set at review meetings. These were up to date and complete. Although for the other resident the care plan and placement had been reviewed in January 2007, and the social worker had attended, the minutes of the meeting were not on file. In a discussion with the residents they described their lifestyles and confirmed that the content and organisation of these were of their own choosing. One resident manages their own finances although they are encouraged to save and when they are given money by the home for meals out they bring receipts back. Now that the home has helped the other resident to apply for a passport an application has been made by the resident for a building society account. His financial affairs are monitored by the social worker, when they visit the home. Records include details of expenditure and the resident signs to acknowledge receipt of money given to him. Records were satisfactory. A statutory requirement was identified during the previous key inspection that the home draws up risk assessments for activities carried out as part of daily living e.g. eating lunch out and travelling independently in the community. Both case files were examined and it was noted that 1 file contained risk assessments tailored to the individual needs of the resident. The format of the risk assessment included an identification of the risk, assessing the likelihood of occurrence and actions needed to reduce or to minimise the risk. Risk assessments included those for walking in the middle of the road, using sharp instruments and becoming overtired. There were no risk assessments for the other resident although the statutory requirement identified during the previous key inspection had been in respect of their case file. The manager has recently attended risk assessment training. Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 13 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): 12, 13, 14, 15, 16, 17 Quality in this outcome area is good. Taking part in activities, pursuing new interests and using community resources gives residents the opportunity to enjoy an interesting and stimulating lifestyle. Residents are encouraged and supported to maintain contact with their family and friends. Residents are encouraged and supported to become more independent by making decisions and by having their wishes respected. Residents have access to a diet that is varied and wholesome and which meets their personal preferences. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Separate discussions took place with each resident and then with the manager regarding residents’ lifestyles. Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 14 One resident has a day care programme, which he said that he enjoyed. It included attendance at day centre, for numeracy skills and money awareness and for arts and crafts. He also attends college for drama classes and independent living skills training and goes to the library and has swimming sessions. The other resident is continuing their further education and attends college twice a week. He had recently sat a “mock” GCSE and was waiting for the results. On other days he likes to visit a library. He would like employment in the future and has already done some voluntary work. He has had an assessment interview with a member of the Job Centre. Both residents have travelled independently although at the moment, due to health problems, one of the residents has an escort when he goes out. The manager’s husband gives residents a lift to their appointments etc and one of the residents also confirmed that he used public transport, including underground trains and buses. He said that his choice of community resources tended to be London wide rather than concentrated in the borough in which he was living. He previously described himself as “more of a lodger than a resident” although he has joined the owners when they have attended family celebrations or events. Both residents’ names are entered on the electoral roll and the manager said that one of the residents spoke to one of the prospective electoral candidates. Both residents enjoy listening to music when they are in the home and one of the residents likes watching DVD’s. One resident has visited the British Museum and art galleries. There are also walks to the park and meals out at restaurants. Other community resources used include shops, library, cinema, pubs, church and leisure centre. The manager said that it is hoped that as the residents have now settled into the home discussions can take place with the residents, their families and their social workers about a holiday. Residents receive visits from their relatives and friends at Murree House and they also go to visit family and friends, either independently or with the support of staff. Residents make and receive telephone calls so that they can maintain relationships and friendships. Residents have developed their own daily routines, to accommodate their day care programmes, and they confirmed that when they were in their rooms their privacy was respected. It was noted that when the manager went to speak to one of the residents that was relaxing in their room the manager knocked on the partly open door, called out and waited to be invited into the room by the resident. Residents like to listen to music when they are in their rooms relaxing. They have door keys to both their own room and to the front door. The manager confirmed that residents were responsible for keeping their rooms tidy and that they were encouraged to do their laundry and ironing. One of the residents likes to help water the garden. Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 15 A statutory requirement was identified during the previous key inspection that the manager and the resident review the menu and make adjustments, where necessary. A copy of the menu was available and it demonstrated a varied and wholesome diet. The manager said that the copy of the menu becomes the record of meals eaten, as changes are recorded on the sheet. One of the residents confirmed that the menu was to his liking and that he particularly enjoys Japanese food when he eats out. He said that following a healthy eating plan had enabled him to loose some weight and he was pleased with the result. The other resident enjoys African-Caribbean food and the menu included curry, dumpling and salt fish. He said that the food served in the home was good. Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. Residents receive prompting with personal care in a manner, which respects their privacy and dignity. Residents’ health care needs are met through access to health care services in the community. Residents’ general health and well being is promoted by staff that assist the resident to take prescribed medication in accordance with the instructions of the resident’s GP. This judgement has been made using available evidence including a visit to this service. EVIDENCE: One resident attends to his own personal care needs although the other resident requires encouragement and prompting with their personal hygiene. Both residents were clean and tidy and the resident that was going out for an appointment was smartly dressed in a suit. He confirmed that he purchases his own clothing and decides what to wear each day. Residents decide when they go to bed at night and when they get up in the morning. The resident that was staying at home and was expecting a visitor was up later in the Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 17 morning as they had left the hospital in the early hours of the morning. Residents have a male key worker. It was noted that on the case filed there was a record of health care appointments. There was evidence of access to the services of an optician, dentist and GP. A referral had been made to a psychologist. One resident has weekly psychotherapy sessions. Recent concerns about the health of a resident were recorded and there was evidence of early referral to the GP and support for the resident when they needed to go to the hospital. One of the residents had attended the hospital on the evening before the inspection and confirmed that the manager had supported him. The storage of medication is safe and secure. Medication administration record sheets were examined and were up to date and complete. The manager administers the medication and is a qualified nurse. Only 1 resident takes medication as a review in January 2007 confirmed that medication was no longer necessary for the other resident. Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is adequate. Residents are aware of their right to complain if the care that they receive is not satisfactory. An adult protection policy and protection of vulnerable adults training for people working in the home contributes towards the safety of residents. However the home is unable to demonstrate that its recruitment practices protect the safety of residents due to the absence of records for the member of staff that has been appointed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a complaints procedure in place. The procedure includes timescales for resolution of the complaint and advises the complainant of their right to refer to other agencies e.g. the CSCI. The manager said that no complaints have been recorded since the last inspection. The manager said that the procedure is discussed as part of the admission process and that information about the procedure is included in the service users’ guide. The residents were aware of their right to complain if they were not satisfied with the care received. The residents said that they would speak to the manager if they had any concerns and one of the residents said that they would also speak to a person who was independent of the home. Both residents confirmed that they were satisfied with the service being provided. Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 19 Both the manager and her husband that works in the home have enhanced CRB disclosures. There is a comprehensive protection of vulnerable adults policy in place. The policy also includes a whistle blowing procedure. The home has a copy of the local authority’s interagency guidelines. The manager and her husband have both undertaken training in the protection of vulnerable adults. The manual also contains a policy for supporting residents with challenging behaviour. The manager said that there have been no allegations or incidents of abuse since the last inspection. She confirmed that restraint is not practiced in the home. One of the residents said that “no one here is annoying me” and that the felt “in safe hands”. No records were available for the member of staff that has been appointed. The manager said that they have not yet started to work in the home. (See Standard 34). Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 20 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): 24, 25, 27, 28, 30 Quality in this outcome area is good. Residents enjoy a comfortable and “homely” environment with pleasant communal facilities. Single bedrooms provide residents with privacy and a room sufficient in size in which to relax. Residents live in a home where standards of cleanliness are good and where bathing and toilet facilities are appropriately placed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A site inspection took place and, with the permission of the residents, included viewing the bedrooms that are currently in use. The home is kept and maintained to a good standard. The premises were bright and airy. Lighting, heating and ventilation were suitable for the time of year and weather conditions. One of the residents said that they liked the appearance of the home because it “blends in well” and is “discreet”. Both residents enjoyed the Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 21 peaceful atmosphere in the home, as neither liked a lot of noise from other people. Each resident has their own single bedroom. One of the 3 bedrooms is situated on the ground floor at the front of the house and the other 2 bedrooms are situated on the first floor. All 3 bedrooms are above the minimum of 10 square metres and are spacious. Both residents said that they liked their rooms and were satisfied with the facilities. During the inspection one of the residents was relaxing in their room and entertaining a visitor. There are bathing and toilet facilities on both ground and first floor. There is a shower room, containing a toilet and wash hand basin, leading off from the dining area, on the ground floor. There is a bathroom, containing a toilet and wash hand basin, on the first floor. Each of the bedrooms contains a wash hand basin. There is a combined lounge and dining area, which is comfortably furnished and decorated. The kitchen is a separate room. Residents have access to a lovely garden at the rear of the house, which has a patio and lawn area, borders and mature shrubs. There is a combined office and sleeping in room for staff on the first floor. Both residents said that the communal areas were pleasant to use and comfortable. The home was clean and tidy and free from offensive odours. The laundry facilities are situated in a building in the garden and include hand-washing facilities. The washing machine has a sluicing cycle. There is an infection control policy in the home’s policies and procedures manual. The manager has undertaken infection control training while working as a nurse and her husband has also undertaken a training course in infection control procedures. Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 22 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): 32, 33, 34, 35 Quality in this outcome area is adequate. The home has met the target of 50 of its staff competent to an NVQ level 2 standard. The rota demonstrated that there were sufficient staff on duty to support the residents and to meet their needs. A lack of records to demonstrate that the necessary checks are being carried out during the recruitment process puts the welfare and safety of residents at risk. Drawing up a training programme would help the manager to ensure that the changing needs of residents were being met while staff fulfilled the aims of the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A statutory requirement was identified during the previous key inspection that 50 of carers working in the home achieve an NVQ level 2 or 3 qualification by September 2007. Mr Abbasi started NVQ level 3 training in March 2007 and so he is deemed to be already competent to NVQ level 2 standards. With 2 residents accommodated in the home the registered manager and her husband provide the support. Both were on duty during the inspection. There Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 23 is always at least one person on duty when residents are present in the home. Staffing levels are sufficient for the current needs of residents. A statutory requirement was identified during the previous key inspection that staff do not commence duties in the home until all the necessary checks have been carried out. The manager said that she has appointed a member of staff although a starting date has not been arranged. The manager is waiting for the return of the person’s CRB disclosure and references. A statutory requirement was identified during the previous key inspection that reference requests are addressed to the manager or proprietor or personnel department and sent to the business address. However there were no documents available for inspection e.g. proof of identity, statement of health, a record of when and where reference letters had been sent, details and confirmation of right to work (if required) etc. The Inspector was informed that the person had commenced NVQ level 4 training in March and that the assessor had taken the application form. Although this a care home which is registered to accommodate a maximum of 3 residents and therefore will only have a small number of staff working in the home, including the manager, Ms Abbasi has begun to draw up training profiles. However the home lacks a training programme to demonstrate that training undertaken enables people working in the home to perform their duties efficiently and effectively and to meet the needs of the residents. Copies of attendance or achievement certificates have been kept for courses undertaken by the manager or by her husband. A period of induction training is planned for the new member of staff, when they commence their duties. A training and development plan is needed. Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Overall quality in this outcome area is good. The manager demonstrates her competence by continuing to develop her understanding, skills and knowledge through further training. More formal systems need to be in place to gather feedback on the quality of the service provided to enable the service to develop in ways that meet the changing needs of the residents. Training in safe working practice topics enables members of staff to safeguard the health, safety and welfare of the residents and regular servicing and checking of equipment used in the home ensures that items are in working order and safe to use. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 25 The manager is an RGN with 11 years experience of supporting adults with learning disabilities, in a care setting. She has worked in residential and nursing homes and also in a day centre. The manager has completed an RMA course and her certificate was available for inspection. The manager (and her husband) is able to speak and/or understand English, Urdu, Hindi, Punjabi, Arabic and Gujarati. Since the last key inspection the manager has undertaken dementia care training and risk assessment training. A statutory requirement was identified during the previous key inspection that quality assurance systems are in place for obtaining feedback from residents, their representatives, placing authorities etc and that the information generated is used in drafting the first annual development plan for the home. Feedback from residents is obtained on a day-to-day basis and there is an opportunity to record any feedback from residents, their relatives and representatives from the funding authority at review meetings. The manager said that as quality assurance feedback form had not been developed an annual development plan had still not been drafted for the home. An annual internal audit had not taken place. A statutory requirement was identified during the previous key inspection that all staff working in the home undertake training in safe working practice topics i.e. food hygiene, fire safety, manual handling, first aid and infection control procedures. This range of training in safe working practice topics is almost complete. Although the manager is responsible for cooking the meals in the home food hygiene training is planned for her husband. A statutory requirement was identified during the previous key inspection that the home has a valid certificate for the testing of the portable electrical appliances and for the Landlord’s Gas Safety Record and that copies of these certificates are forwarded to the CSCI. These were sent to the CSCI after the inspection and during this inspection there was a Landlord’s Gas Safety Record dated 10/06 and a certificate for the testing of the portable appliances dated 9/06. There were also valid certificates for the testing/servicing of the fire extinguishers, fire alarm system, emergency lighting and the electrical installation. Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 26 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 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 1 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 1 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 27 YES 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 YA6 Regulation 15.1 Requirement Timescale for action 01/09/07 2 YA6 15.2 3 YA9 13.4 Care plans must be comprehensive so that when needs are identified the information about the support required from staff is in sufficient detail to demonstrate that it meets the need of the resident. Copies of the minutes of review 01/06/07 meetings must be kept on file, for reference by staff, to ensure that the care provided supports residents in reaching their goals. That the home draws up risk 01/07/07 assessments for activities carried out as part of daily living e.g. eating lunch and travelling independently in the community. (Previous timescale of the 1st November 2006 not met). Staff files must include a record of all checks and references undertaken as part of the recruitment process to demonstrate that the safety and welfare of residents is promoted and protected. Reference requests must be addressed to the manager or proprietor or personnel DS0000061675.V336441.R01.S.doc 4 YA34 19.1 01/06/07 5 YA34 19.4 01/06/07 Murree Residential Care Home Version 5.2 Page 28 department and sent to the business address to ensure that the system of taking up references is not abused and does not put residents at risk. (Previous timescale of the 1st October 2006 not met). 6 YA35 18.1 The manager needs to draft a 01/09/07 training programme for all persons working in the home to ensure that they have the necessary skills, knowledge and understanding to perform their duties and to meet the needs of the residents. Quality assurance systems are 01/08/07 needed for obtaining feedback from residents, their representatives, placing authorities etc and that the information generated is used in drafting the first annual development plan for the home. This will ensure that the developing service continues to meet the needs of the residents. (Previous timescale of the 1st January 2007 not met). An annual internal audit must 01/08/07 take place so that the manager can review all aspects of the care provided and identify where changes may be needed to ensure that the quality of care reaches and is maintained at a good standard. 7 YA39 24.1 8 YA39 24.1 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 Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 29 1 2 3 YA32 YA35 YA42 That the home notifies the CSCI when the manager’s husband has completed his NVQ level 3 training in care. That a training and development plan is drafted. That all staff working in the home undertake food hygiene training. Murree Residential Care Home DS0000061675.V336441.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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