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Inspection on 17/02/09 for Northampton Road (65)

Also see our care home review for Northampton Road (65) for more information

This inspection was carried out on 17th February 2009.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

This registered service is also the private residence of the owners on the ground floor, and the two women who use the service currently live within what is very much an extended family type setting. These two people have the benefit of their own separate kitchenette, their own bathroom and a lounge diner area upstairs, on their level within the house. This provides them with good opportunities for maintaining an independent lifestyle, as far as is practicable. People are encouraged to take responsibility for their home; to further develop independent living skills such as cooking, domestic tasks and organising their personal leisure activities. As both current people living there are quite independent, this also permits the proprietors some space to themselves with their children, whilst still being available / on call at all times. Due to the very small scale nature of the home, there is significant flexibility in the homes routines, and people using the service appear much involved in the day to day decision making processes. We spoke to both people who used the service and they commented positively about their lifestyle, including the social activities and support provided by both Mr, and particularly, Mrs Dabadeen. The homeowners continue to support the users of the service to develop social networks, activities and their own friendships. Regular access to community activities such as pub visits, other meals out, beauty treatments and shopping are much enjoyed. Both women are supported to spend time with their families, as they so elect. As this is a family focused service, the surroundings are generally homely and comfortable, indeed, quite ordinary for all the people who live there. The standard of decor and furnishings is reasonably well maintained, with a very lived in feel.

What has improved since the last inspection?

Records seen showed that staff members who are used at the home are now given formal supervision time. All staff have also undergone Adult Protection / Safeguarding training. Small electrical appliances used throughout the home have been checked this year, ensuring the basic health and safety of the premises. Since previous visits, the medication records have been improved, with profiles now being kept in place for each person using the service. Only one person currently receives medication, the person having medication now signs for receipt of their medication, which they are self administering this emphasising their joint responsibility in this area.

What the care home could do better:

The premises, the kitchenette in particular, would benefit from redecoration or finishing, as the decor looked worn and tired. Although the people living at the home seem content with their living space, a redecoration or refurbishment project wouldbenefit and modernise the premises. This would be particularly appropriate if the service is to transfer to an independent living concept, but in all respects the premises would benefit from an overhaul. Recording, such as day to day notes could be improved, through the staff making a daily entry, instead of just recording significant events when they happen. Such increased focus may well help the house to consider the content of each day and significant activity. The Person Centred Planning approach should be focused on to build up a more client centred picture and holistic plan of care.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Northampton Road (65) 65 Northampton Road Croydon Surrey CR0 7HD     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: David Pennells     Date: 1 7 0 2 2 0 0 9 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 30 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Northampton Road (65) 65 Northampton Road Croydon Surrey CR0 7HD 02086551929 F/P02086551929 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Ravesh Dadabeen,Mrs Nandhinee Dabadeen Name of registered manager (if applicable) Mrs Nandhinee Dabadeen Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 3 The registered person may provide the following category of service only: Care Home Only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home Northampton Lodge is registered to provide care for up to three younger adults with learning disabilities, though currently the community operates happily with just two people using the service, living in separate upstairs accommodation, alongside the Dabadeen family. The home is a semi-detached house situated in a residential area not that far from East Croydon, and close to Addiscombe Village centre; it is well situated to access local Care Homes for Adults (18-65 years) Page 4 of 30 care home 3 Over 65 0 3 Brief description of the care home transport services of both trams & busses, and also shops and other community facilities. The accommodation available for people using the service comprises: three single bedrooms, a large reception room, a kitchenette to prepare drinks and snacks, a bathroom and toilet. There is a large garden and grassed area to the rear of the property and parking to the paved front of the property, and on the street (free of charge). The home is also the principal residence of the registered owners, Mr and Mrs Dabadeen - who live there with their two children also. The Dabadeens continue to seek, if possible, to change these registered premises into Supported Living accommodation, with the sanction of the two placing authorities. Care Homes for Adults (18-65 years) Page 5 of 30 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 peterchart Concerns, complaints and protection Environment Staffing Conduct and management of the home Poor Adequate Good Excellent How we did our inspection: We tried to access the service, unannounced, on a number of occasions at varied times of the day prior to the Christmas break in December 2008, but due to various reasons, we actually gained access to the home eventually in the morning on 17th February 2009. This unannounced inspection visit spanned from 9.00am to 11.45am, allowing us to meet the people who used the service and also the proprietors and their children. During this time, the lifestyle of those living there was seen and discussed, with these people offering their own opinions about the service, and the proprietors being amenable to our enquiries and comments. All parts of the care premises on the first floor were seen. Care Homes for Adults (18-65 years) Page 6 of 30 We are grateful we were able to share hospitality with the extended family, and thank them all for the welcome and cooperation during the visit. As very little has changed at the home since the last inspection visit a year or so ago, the personnel being the same in all respects, the following report covers little new ground and recants a significant amount of previous material. What the care home does well: What has improved since the last inspection? What they could do better: The premises, the kitchenette in particular, would benefit from redecoration or finishing, as the decor looked worn and tired. Although the people living at the home seem content with their living space, a redecoration or refurbishment project would Care Homes for Adults (18-65 years) Page 8 of 30 benefit and modernise the premises. This would be particularly appropriate if the service is to transfer to an independent living concept, but in all respects the premises would benefit from an overhaul. Recording, such as day to day notes could be improved, through the staff making a daily entry, instead of just recording significant events when they happen. Such increased focus may well help the house to consider the content of each day and significant activity. The Person Centred Planning approach should be focused on to build up a more client centred picture and holistic plan of care. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 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 10 of 30 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 Statement of Purpose, and Service User Guide provide prospective service users with details of the services the home offers. This enables them to make an informed decision about admission to the home. The home has an assessment of each individual residing at the home, ensuring that aspirations & needs are recognised and will be responded to. The assessment tells the home about them, what they hope for and want to achieve, and the support they need. Evidence: We found that there have been no changes in the homes service provision or category since the last inspection visit, and no new people have been admitted to the service for some time. The brief Statement of Purpose for the home includes the sizes of the rooms and detail about the experiences of those using the service, and the qualifications of the staff Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: employed there. The views of the two people who live there give positive and personal feedback. East Sussex County Council and the London Borough of Croydon currently fund placements at the home. One review occurred the week after the inspection visit and the care manager fed back comments about their view to us. The current scale of charges is set at approximately 500 pounds per person per week, though people can be covered by added value care rates above this level. The cost of toiletries, magazines, holidays are paid by the individual. The two current people resident at the home have been at the home since 2001 and 2004, respectively. Both are women, and are in the approximate age range of 35-45, coming from white, and black Caribbean, backgrounds. Both have individual programmes, and needs identified for them within this plan. When these newcomers first moved to the home, care managers from their placing authorities completed informative comprehensive needs assessments. This is now replaced by annual review documentation, which now forms the bases of the homes care plans, and clearly describe individual social, physical, emotional and cultural needs. We found that service user plans had been reviewed at regular intervals, and updated accordingly to reflect any changes, also containing detailed guidelines to follow in order to meet the individuals identified personal, social and healthcare needs. Signed contracts were in place on file for both people resident at the home. Care Homes for Adults (18-65 years) Page 12 of 30 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. The assessment and care planning process and resulting service user plan supports staff to meet peoples assessed needs and personal goals. Choice and decision making for people using the service is encouraged and promoted to a good standard, enabling their active involvement in, and opportunities to contribute to, the culture and operation of the home. Individuals are supported to take risks as part of an independent, preferred lifestyle, through risk plans being formulated and reviewed, fully safeguarding individuals from potential harm. Evidence: We found that the manager had developed care plans for the two persons who use the service. Each has a written plan of care that describes their needs, strengths and Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: wants, and states when they require support from staff. As a small home, the proprietor retains the main keyworker role, this ensuring a generally constant overview of their particular cases. We found that another staff member continued to maintain progress records for the service users which highlighted progress, achievements and any activities participated in during their shifts, but some gaps of days at a time were noted, principally when Mrs Dabadeen was on duty alongside her having her family duties. One month, for instance, had eleven entries in it about one of the people. It is again recommended that these progress notes be regularised to a minimum of a daily entry. The manager and her husband have previously undertaken training in person centred planning, and this was evidenced by the preamble to the care plans seen on the day of the inspection. This had been introduced with the intention to make the care plans even more accessible and meaningful to each individual, beyond the current practice of them currently signing their agreement to their plans. Not a lot of progress was noted in this development, however. Support profiles were seen, alongside a weekly planner and a list of strengths, needs and wants. The risk plans were countersigned annually, presumable at the time fo the persons review. We once again found that those living at the home considered that they were being sufficiently consulted about the running of the home, and did not wish to be further involved in decision-making. One service user chooses to go out locally, shopping and buying her toiletries and other requisites, whilst the second prefers to be more organised by staff, structured in her approach and assisted in gaining personal items and other requirements. We found that risk plans covered a variety of situations, from accessing community activities and travelling independently, to learning skills within the home. Risk assessments have also been put in place to safeguard people when the home is occasionally left un-staffed. We found that records evidenced that those who use the service are supported to take risks as part of an independent everyday lifestyle. Care Homes for Adults (18-65 years) Page 14 of 30 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 care home is responsive to their diversity needs. Users of the service access activities inside and outside the home in the local community regularly, and are supported to continue appropriate activities, in order to maximise both fulfilment and achievement in their lives. 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. Friends and relatives of people living at the home can expect to be welcomed, and encouraged to keep in touch with those who live at Northampton Road. Food provision reflects a wide variety and provides choice, whilst seeking to maintain a Care Homes for Adults (18-65 years) Page 15 of 30 Judgement: healthy lifestyle, for those resident at the home. Evidence: We found that there is a lot of flexibility in the daily routines due to the small scale nature of the home, and people are very much involved in the day to day decisionmaking processes. Both of those living at the home were consulted about lifestyles and feel positively about the activities provided. We found that the general domestic life at the home is clearly enjoyed by both of those who live with Mr & Mrs Dabadeen; videos, letter writing, books, TV, DVDs and personal items being in evidence. The homeowners support the people using the service to continue and develop social networks and they regularly access community activities such as pub visits, meals out and shopping. Service users confirmed that they often go out, both with the proprietors and the one staff member who is employed at the home. Social needs are clearly described within the care plans taking into account individual preferences. Both service users discussed their social lifestyle and activities and commented positively about the opportunities provided. Family involvement is encouraged as appropriate and friends are welcome at the house. A bereavement recently has challenged one person to reconsider family relationships, the proprietors supporting her in her decision making. One person at the home is more independent outside the home and is well known in the local community; the second needs company and encouragement. Swimming is certainly enjoyed, once the person gets out. Pubs, clubs, restaurants and bars are popular and frequented, the library, post office and beauty treatments such as manicures, facials and waxing at a local beauticians are also popular. Day care opportunities have been rejected by the women on the basis of a perception of the offer of inappropriate and demeaning activities. Again, no specific cultural or religious needs have been identified for either of those currently living with the Dabadeens. A number of significant trips abroad and to locations in this country continue; had accompanied the Dabadeens with their family on holiday to Dubai; both had been to Jersey for an enjoyable holiday, and more recently a trip to Devon in October had been enjoyed, and a weeks winter break in Malaga. Receipts were seen for these activities. Due to the small size of the home, meals are planned on a daily basis. Those resident are consulted about their preferred meals - and menus are revised to include / respond to their preferred choice. People using the service said they like the meals and Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: enjoy going out shopping to the supermarket to help get in the provisions - if they want. On the day of the inspection a decision to go out to a favoured Chinese Restaurant was deferred to the end of the week, whilst a shopping list was created for a trip that would become that afternoons activity. Care Homes for Adults (18-65 years) Page 17 of 30 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 using the service can be confident they will be supported in personal care issues according to their own preferences and assessed needs. Those using the service may be assured that their welfare is closely monitored to ensure that their physical and emotional needs are met - and will receive care support through the intervention of allied professionals (including any prescribed medication) in an appropriate way. The home manages the administration of medication well, within the context of policy and good record keeping. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home will support them with it in a safe way. Evidence: Those using the service continue to clearly choose their own clothes and initiate their own activities of choice; they are supported in both activities and day-to-day routines by staff. Care and support provided by the home appeared to be appropriate and Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: sensitive to the needs of the two individual service users. Within the home, routines are flexible, and guidance and support is second nature to the proprietor, who lives alongside the people, whilst integrating support and assistance. Dental and GP inputs are available at local surgeries, and visits by psychologists / counsellors are arranged as appropriate. The right of either individual to refuse treatment is also acknowledged. Medication records were examined and found generally well kept. Medication profiles are kept up to date, mapping any changes to the prescriptions. People who use the service who self medicate are encouraged to sign for receipt of their medication, this emphasising their responsibility and providing a written audit trail for the drugs. Care Homes for Adults (18-65 years) Page 19 of 30 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. Those using the service and their advocates can be assured that comments or complaints will be taken notice of, investigated and acted upon within the homes stated procedural timescales. The home provides support to people at the home to ensure that they are protected from harm, neglect and forms of abuse. Staff members need to have a better understanding of identifying and preventing abuse - through attending local authority training provided for such elements. Evidence: We found the home has a complaints policy and procedure summarised within the Service User Guide, and this is also available in picture format - and a log sheet is available for recording complaints, though there were none. Those using the service are provided with a list of emergency telephone numbers, including relevant care managers, and the Commission. Both people using the service are aware of whom to contact should they wish to complain. No complaints had been made about the home since the last inspection. Procedures for alleged abuse is in place at the home, alongside the London Borough of Croydon adult protection / safeguarding procedure. Staff have attended the Croydon Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: authority training on Adult Protection & Safeguarding, as required at the last inspection visit. Care Homes for Adults (18-65 years) Page 21 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides space and facilities for people to lead the life they choose. The home is generally decorated and furnished to a reasonable standard, but appears worn and tired and would benefit from redecoration or finishing. People, however, generally live in safe reasonably comfortable surroundings. Peoples private space feels like their own, is comfortable and people feel safe and secure when they use it. People have enough privacy when using toilets and bathrooms. Evidence: The house is in a good community-based location, in the middle of an ordinary street in Addiscombe, close to shops, trams, busses and local civic amenities. The centre of Croydon with the attraction of bars and clubs is a short drive or a bus or tram journey away. The home clearly suits the needs and lifestyles of the two service users who currently live there. With the benefit of their separate kitchenette and lounge, they are supported to develop their independent daily living skills and hope to progress towards a more independent lifestyle. The users of the service are supported to do their own Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: housework and arrange their rooms as they wish. General hygiene practices are observed, and the home appeared reasonably clean and tidy, and odour-free. Refurbishment a few years ago saw active involvement of the people living there being involved in the decoration of their rooms. One individual said she was still very pleased with her bedroom and that had been repainted and furnished with items of her choice, including a new dressing table. She had chosen pictures for her wall and selected the paint colour. Despite these improvements, the kitchenette and the hallway and landing appeared worn and tired, the former not being completed, and would benefit from brightening up through redecoration or refurbishment. There is a general planned maintenance book. Maintenance and servicing checks to ensure the safety of people living at the home had been completed, with the small electrical equipment checks completed in June 2008, this alongside the electrical mains testing in June 2008, and fire alarm system and emergency lighting checks in January 2009. Care Homes for Adults (18-65 years) Page 23 of 30 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 are supported by a staff team who understand and do what is expected of them, and staff members are given supervision support by the manager, discussing progress and exchanging ideas. Training for staff members results in a skilled workforce to meet peoples needs and homes aims and objectives. Overall, recruitment practices are managed appropriately to ensure protection and safety or service users. Evidence: We found that the two people using the service are supported within a family type environment and staffing context. The owners, Mr and Mrs Dabadeen, and just one part time care worker currently staff the home. The occasional use, when necessary, of an external agency worker has happened. People using the service were content with this small staff team, and gave the clear impression that they are treated as part of the family. The home has an induction pack that covers key learning objectives and an Orientation Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: to the Service process. Staff files previously seen included a completed induction record for current & past staff and records of training. Training opportunities are made available; courses being accessed through an independent training consultant used by the home. Staff members had previously undergone in-house training on Food Hygiene and Abuse Awareness, and the current staff member is studying for their Level 2 NVQ in Care qualification, which includes training in First Aid. The two homeowners have previously attended a course on understanding mental illness and more recently on Safeguarding and Adult Protection (September 2008). The sole additional staff member underwent training in Safeguarding in 2008, and is qualified at NVQ level 2 in Care (2007). Staff files previously inspected contained most of the necessary documentation as required in the Care Homes Regulations 2001 including a completed CRB and a PoVA First check. Certification of the staff members identity and clarification of unrestricted permission to work was also evidenced. Staff have a contract of employment. Staff supervision, identified as a staffing deficit in the last inspection, has started since then, records of supervision sessions being kept and being countersigned by the staff member and the manager. Care Homes for Adults (18-65 years) Page 25 of 30 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 have confidence in the care home because it is generally run and managed appropriately. The opinions of people using the service are central to how the home develops and reviews their practice; the quality assurance system development seeks to ensure that the quality of care is monitored. Overall, health and safety practices are in place to ensure that service users live in a safe environment. Evidence: The Manager, Mrs Dabadeen, has a nursing background and has experience of working with people with learning disabilities. She has been undertaking the CMS at Croydon College and already currently holds the NVQ in Care, Level 3. Throughout the visit we found that Mrs Dabadeen had a good knowledge about both Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: resident peoples needs and showed a general competence in managing the home. The managers husband provides extra support for those who use the service, going on outings or to other activities in the community, as appropriate. As a small home, the input to Quality Assurance functions at a micro-level when compared to larger organisations, and current provision ensures that those who use the service are involved in day-to-day decisions - their views being sought regularly through discussion with the homeowners. Both people using the service have completed Service Monitoring Records, as a satisfaction questionnaire, in November 2008. Both commented that they regarded Northampton Lodge, the service, as their family. One mentioned they are happy and the other stated that the staff understand them well. A Quality Plan was developed in 2006. This appeared not been so well kept up to date, but this is difficult to apply in such a small premises. The individual people who use the service handle their finances independently, having their own benefit books, and managing their own bank accounts and financial affairs. A full and comprehensive Fire Risk Assessment has been completed for the home with fully illustrated documentation. All accidents and incidents are recorded, and safety notices are displayed, appropriately. Other servicing and maintenance records for the home were checked and were completed, as well as fire equipment and fire system checks. The manager continues to complete a health & safety check on the homes environment every month, and also risk assessments covering safe working practices for the premises were available. Care Homes for Adults (18-65 years) Page 27 of 30 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 28 of 30 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 1 6 Recording, such as day to day notes could be improved, through the staff making a daily entry, instead of just recording significant events when they happen. The Person Centred Planning approach should be focused on to build up a more client centred picture and holistic plan of care. The premises, the kitchenette, the hallway and landings in particular, would benefit from redecoration or finishing, as the decor looked worn and tired. 2 6 3 24 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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. 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