Inspection on 02/08/07 for Northbrook Care Home

This inspection was carried out on 2nd August 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Northbrook Care Home 27/04/08

Northbrook Care Home 26/01/07

Northbrook Care Home 06/07/06

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 Northbrook Care Home 63 Northbrook Road Ilford Essex IG1 3BP Lead Inspector Jackie Date Key Unannounced Inspection 2nd August 2007 10:00 Northbrook Care Home DS0000066343.V347351.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 Northbrook Care Home DS0000066343.V347351.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. Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Northbrook Care Home Address 63 Northbrook Road Ilford Essex IG1 3BP 020 8911 9110 020 8911 4900 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) Northbrook Homes Limited ** Post Vacant *** Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th January 2007 Brief Description of the Service: Northbrook Care Home opened in March 2006. It is a home for 4 adults with learning disabilities. The 2-storey house is in Ilford close to bus routes, the station, shops and leisure facilities. The home is not accessible to wheelchair users and the service will not be accepting residents who are wheelchair dependent. There are four single bedrooms, each with ensuite toilet, shower, and wash hand basin. In addition there is also a communal bathroom. There is a small lounge upstairs and a dining room downstairs. At the time of the visit three women were living at the home. Residents do not attend formal day services but are supported by the staff team to do activities. The scale of charges is £1177 to £1400 per week. The manager provided this information at the time of this inspection. Information about the service provided is contained in the service users guide. Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 10:00 am. It took place over 6 hours. This was a key inspection and all of the key inspection standards were tested. Staff were asked about the care that residents receive, and were also observed carrying out their duties. Where possible residents were asked to give their views on the service and their experience of living in the home. All of the shared areas and bedrooms were seen. Staff, care and other records were checked. Relatives, social workers and healthcare professionals were contacted and asked for their opinions of the service. At the time of writing this report feedback had been received from one relative and two social workers. Any feedback subsequently received will be taken into account for future inspections. Staff supported the one resident who is able to express an opinion to complete a feedback forms. Services are now required to complete an AQAA (Annual Quality Assurance Assessment) and the completed form was received on 20th July 2007. Information provided in this document also formed part of the overall inspection The inspector would like to thank the residents and staff for their input during the inspection. What the service does well: There is a small staff team and most of these have been at the home since it opened in March last year. Staff therefore know the residents well. Residents appear happy and relaxed in the company of staff and one resident said that she liked the staff. The bedrooms are all of a good size and have ensuite showers and toilets. They have been redecorated. One relative said, “I am happy with the placement, my daughter is happy and the staff look after her well.” A social worker said “my client has progressed well since moving into the home, I think that it is the right placement for her. I have had positive reports from other professionals that have visited the placement.” Another social worker said, “it is a good home”. Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: 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. Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. Appropriate information is gathered on a prospective resident prior to their moving into the home and this gives staff a picture of the individual’s needs and how to meet these. Prospective residents and their relatives can spend time in the home to find out what it would be like to live there and to enable the resident to make a choice about living in the home, within their capacity to do so. The Service User Guide is being simplified to help them with this. Residents now have contracts/statement of terms and conditions and therefore have information about the service that they are entitled to. EVIDENCE: The manager is still in the process of making the Service Users Guide more user friendly by including pictures and symbols. A simplified guide will assist residents to find out about the home and it is recommended that this piece of work be finished. The manager has translated the guide into Urdu and put this on tape for one of the residents. This is good practice. Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 9 There have not been any new admissions to the home since the last inspection. The newest resident moved into the home in December. At the time of the last inspection the paperwork with regard to this individual was examined. It contained an assessment by the placing authority, a referral form and also an assessment that the manager of the home had carried out. A care plan was also in place. This contained an assessment profile. Therefore sufficient information was gathered on a prospective service user to enable their needs to be identified and for a decision to be made about the home’s capacity to meet their assessed needs. There was also evidence that a prospective resident visited the home on occasions and had met the other residents. Therefore, when possible, prospective residents are given the opportunity to visit the service and to meet staff and residents before they decide if they want to live there. Residents have been issued with contracts/terms and conditions. These were in individual files. Therefore residents have information about the service that they are entitled to. Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 & 10. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. Residents’ care plans and risk assessments contain sufficient information to enable staff to safely meet their needs. Residents are consulted about what happens in the home as far as they are able. Residents’ personal information is safely stored to maintain confidentiality. EVIDENCE: All of the residents have plans which give details of how they need/like to be supported. Areas covered included health, personal care, communication, behaviour, sexuality and cultural and religious needs. The care plan of the newest resident includes “when I am happy I smile”, “uses facial expressions and eye contact to communicate”. Also “speak to me in a quiet calm voice.” A selection of care plans were examined during the visit and the information contained in them was relevant. They also indicate what individuals like and dislike. For example one residents’ care plan states that she likes the park but Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 11 not the garden. Staff review care plans monthly to ensure that they are up to date and reviews are due to be held in September and October to which the resident, their relatives and representatives will be invited. Residents’ plans contain sufficient and current information so that staff can meet their needs. Daily recordings are made about what each person has done and support that they have been given. These recordings are broken down into various areas including night care, personal hygiene, communication, socialisation and meals. Therefore there is information about each individual, which can be used as part of the review process and to identify ongoing and changing needs. There are risk assessments in place. These identify risks for the residents’ and staff and indicate ways in which the risks can be reduced to enable the residents’ needs to be met as safely as possible. Risk assessments have been extended further to cover all areas of risk as required by the previous inspection. They are also relevant to each person. For example one resident smokes, the others do not. Residents meetings are now held each month and a record is kept of these. One of the residents can and does express her views about what she wants to do and what she likes. This resident confirmed that she chose the colour for her bedroom and also that she was asked when she wanted it to be decorated. This resident also said that she had talked to the manager about possible new residents and had indicated that she would like this person to be able to speak and to do more things with her. The manager had previously stated that she was hoping that any new resident would be more independent and have similar needs to this person. The minutes of the residents meetings indicate that staff use direct questions to assist them to find out what another resident wants and then she is able to sign yes or no in response. During the course of the visit it was noted that staff asked residents what they wanted to do and then supported them to do this. Therefore the residents are involved in the running of the home as far as they are able. They are encouraged to make decisions about what happens as far as they are able. Residents’ records and other information are stored in a lockable cabinet in the office and staff are aware of issues of confidentiality. Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17. People using the service experience adequate quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. Although the residents are encouraged to take part in activities and to be part of the local community this needs to be developed further particularly for the youngest resident who has a sensory impairment. The residents are supported to keep in contact with their relatives. The residents are supported and encouraged to have a diet that is healthy and meets their need. This includes health and cultural needs. EVIDENCE: One resident said that she makes drinks for herself and that she likes to make drinks for the staff as well. She also that she goes out a lot. She likes to go the cinema, to the shops, the local café, the park to feed the ducks and swimming. She said that she goes out every day. On the day of the Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 13 inspection she went to the local café for lunch. Since the last inspection this resident has become more independent and no longer needs staff support all the time. She travels independently to visit her mother at the weekend. She also goes to the local shops to buy things like bread and milk. A social service representative said that this resident had “improved tremendously.” At the time of the last inspection activities were still being developed for the other two residents and this is still an ongoing process. Both residents do go out with staff most days. They both need to use wheelchairs when out in the community and staff said that these residents like to go out, especially for lunch and to the park. One of these two residents is being introduced to an independent day service and will be attending for two days per week. This resident’s social worker said that her client has progressed well since moving into the home and that she has received positive reports from other professionals who had been working with this person. The third resident has quite complex needs and in addition to her learning disability and behaviour problems is unable to see. Staff spoken to said that this individual needed more input from other professionals and that she would benefit from a more specialised day service. The manager said that this would be discussed with the social worker at the next review. The mother of this resident said that she was happy with the placement. The social worker of this resident said that it is a good home and meets most of the individual concerned needs. However this person has complex needs due to her challenging behaviour and the social worker has made a referral to the learning disability team with regard to specific input. A requirement has therefore not been made at this stage and this will be monitored during future visits. Two of the residents have regular contact with their families who visit the home. Families are invited to celebrations at the home and one resident talked about her birthday later this month. Celebrations were also held for Eid and Sabaarat and for Christmas. Therefore residents are supported to keep in contact with their family and relatives are welcomed at the home. Staff were observed to knock on a residents bedroom door and wait for reply before opening it. Therefore residents’ privacy is respected. The most independent resident has a key to the front door and is able to use this. One of the resident’s can and does choose what she wants to eat and also assists with shopping and cooking. This resident has diabetes and staff support her to eat appropriately. Meals for the other residents are based on their likes and dislikes. One resident is provided with Halal meat to meet her cultural needs. Prior to moving into Northbrook this resident had a very limited diet but based on advice from the GP staff have been gradually introducing different foods into her diet and she does now eat some fruit and vegetables. There had been concerns about the weight loss of the newest resident but since moving into the home in December she has gained weight and as a result of having a much healthier diet aspects of her health have also improved and she not require as much medication as she used to. This Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 14 resident is of Caribbean descent and a Caribbean take away meal is purchasd once a week for her. Residents receive a nutritious diet that meets their individual needs. Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 15 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. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. Residents receive personal care that meets their individual needs and the staff team support them to get the healthcare that they need. Residents are given regular prescribed medication safely. Guidelines need to be developed to ensure that “as required” medication is appropriately administered. EVIDENCE: Two residents require a lot of support with their personal care and the help that they need is in their individual plans. At present there is a small consistent staff team and staff were aware of how to support these residents. It is recommended that the information in the care plans be more detailed so that it clearly states how the personal care needs to be provided. For example that two staff are needed, when pads need to be changed during the night. The manager said that one resident does not like to have a bath but this is not clear in her care plan. The plans also contain information on how to recognise Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 16 how a person is feeling. For example “when I am happy I smile”. The other resident does not need a lot of support in terms of personal care and staff give her the help that she needs. Staff help this resident to dye her hair and she said that she is happy about this. Therefore her personal care needs are being met. On the day of the visit residents looked clean and appropriately dressed. One resident wears the traditional clothing of her culture. Another resident is of Caribbean descent and staff took her to a Caribbean hairdresser and also purchased oils for her hair. Therefore residents’ personal care needs are being met. All of the residents go to the local doctor and specialist help is received when needed. Staff take residents to all of their medical appointments. Residents’ files have details of health care issues and show that residents have regular access to health care professionals. None of the residents are able to self medicate and medication is administered by staff that have received training for this. Medication is administered from the Boots monitored dosage system and staff have received training from Boots. In addition the manager has also assessed the competency of staff to administer medication. Medication is now securely stored in an appropriate lockable cabinet in the office. The medication file contained photographs of each individual and a record of any allergies. There was also a list of staff that are able to administer medication and also the their signatures. All of the residents have had medication reviews. This is good practice. Examination of the MAR (Medication Administration Record) found that there were some gaps in recording when medication had been administered. The MAR (Medication Administration Record) must be completed by the person administering medication at the time of administration. This is to safeguard residents and also for accountability. In addition all staff have a responsibility to highlight any gaps or discrepancies in the MAR (Medication Administration Record) so that this can be checked and addressed as soon as possible. One resident take PRN (when required) medication and guidelines/protocols are needed so that staff are clear as to when and how to administer this medication. This requirement remains outstanding from the previous inspection and must be addressed. The newest resident was prescribed rectal Valium for epilepsy but this was discontinued at her medication review. Therefore it is no longer necessary for staff to receive training in the administration of this. The medication policy/procedure has been amended to include the action to be taken in the event of an error being made. This will ensure that the correct action is taken in that event. Medication administration is satisfactory and meeting the above requirements will help to ensure that residents are safeguarded and that any medication is appropriately administered. Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 17 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. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. There is a complaints procedure that would be followed in the event of any complaints being made. Staff have received adult protection training to ensure that they are clear about what constitutes abuse and what to do if abuse is seen or suspected. However residents’ bank accounts are not being adequately monitored and this does not robustly safeguard them from the risk of financial abuse. EVIDENCE: The home does have a complaints procedure, which is displayed. One resident living at the home would be able to say if she was not happy about anything. She also has access to an advocate from Goodmayes hospital. The other two residents would be reliant on other people to raise concerns on their behalf. One social worker said that her client appeared to be happy there and had progressed well. One resident said that she liked the staff. The two other residents were observed to respond positively, by smiling, to staff and seemed happy and relaxed in their company. The local authority’s adult protection procedure is available in the home and staff have read this. The manager was aware of the action to be taken in the event of a suspicion or allegation of abuse. The staff team have received protection of vulnerable adults training and are aware of adult protection issues. A safeguarding adults issue has arisen since the last inspection. This Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 18 was reported directly to the Commission and the proprietor worked in conjunction with the learning disabilities team on this. At the time of this inspection this issue has not been fully concluded. However the mother of the resident involved in the safeguarding issue said that she was happy with the placement and that staff looked after her daughter well. She also said that her daughter is happy there and is happy to go back after visits to the family. Staff spoken to said that they did not have any concerns about the care of residents. At the time of the visit the service was only dealing with the finances of one resident. The manager knows the PIN number for the persons account and withdraws money each week. The resident usually accompanies her. The resident’s finances were checked and cash amounts held agreed with records. Receipts were on file. A running record is kept of the amount of cash held and any withdrawals are recorded in this. The monthly monitoring report indicates that the recording system for residents’ monies is good but there is no indication of exactly what is checked or that the person carrying out the visit actually counts cash and checks statements. A system still needs to be in place to monitor the amount in the accounts. This should be checked as part of the monthly monitoring. This will offer more robust safeguards for residents from financial abuse. These requirements remain outstanding from the previous inspection and further guidance was given to the manager about this during the course of the visit. Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 19 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, 26, 27, 28, 29 & 30. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. The residents live in a home that is suitable for their needs and improvements have been made so that the environment is a satisfactory standard. EVIDENCE: The home is a 2-storey house in Ilford close to bus routes, the station, shops and leisure facilities. The home is not accessible to wheelchair users. However, there are two ground floor bedrooms. There are four single bedrooms, each with ensuite toilet, shower, and wash hand basin. In addition there is also a communal bathroom. There is a small lounge upstairs and a dining room downstairs. The home opened almost a year ago and with the exception of the kitchen was totally refurbished. The bedrooms are a good size. Since the last inspection most of the home has been redecorated and looks much brighter. New curtains have been purchased and also some new Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 20 furniture. The communal areas are quite small and since the redecoration the staff are gradually making these more homely and this is an ongoing process. The kitchen has been refurbished and there is now room for the fridge and freezer to be kept in there. Previously these were in the dining room. New crockery and utensils have been purchased as required by the previous inspection. The residents living at the home do not require any aids or adaptations although two of them require wheelchairs to go out in the community. However to assist residents an additional handrail has been fitted on the stairs. There is a garden at the rear of the building and the large concrete slab has been removed and a grass lawn laid. Some garden furniture has been purchased and on the day of the visit some of the residents spent time in the garden. Overall there have been a lot of improvements to the environment since the last inspection and it is a lot more welcoming and homely for the residents. However there are not any facilities for staff to change or to store personal belongings. This is of concern to staff particularly as one of the service users has been known to look in staff bags for cigarettes. The registered person must provide suitable facilities for staff for the purpose of changing and for storage. At the time to visit the home appeared to be clean and hygienic and received a satisfactory food hygiene report in July 2006. Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 21 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 & 36. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. Staffing levels are sufficient, and staff receive the necessary training, supervision and support, in order to meet residents’ current needs and provide an appropriate service for them. Residents are supported and protected by the homes recruitment practice. EVIDENCE: There is a small female staff team in post and the intention is that the home will only provide a service for female residents. Some staff have been working at the home since it opened in March 2006 and with the exception of one newly recruited night staff there has not been any staff changes since the last inspection. Therefore a consistent staff team supports residents. From discussions with staff it was evident that they know the residents very well and are able to understand the non-verbal communication of two of the residents. However feedback from staff was of low pay and poor conditions, for example no additional pay for working on bank holidays. Staff also said that they have had to pay for some of their training. This has affected staff morale and is Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 22 likely to have an adverse affect on staff retention and the recruitment of experienced and qualified staff. This in turn will affect the quality of service provided to the residents. The registered person is reminded that it is his responsibility to ensure that persons employed at the home receive training appropriate to the work that they are to perform and that they are given suitable assistance for the purpose of obtaining further qualifications appropriate to such work. This will be monitored during the course of future inspections. The staff team have undertaken a lot of training to assist them to carry out their duties. This has included structured induction training, working with people with challenging behaviour, managing difficult situations, medication administration, first aid, infection control and food hygiene and POVA (Protection of Vulnerable Adults). With the exception of the newest employee all staff have either completed NVQ 2 or are in the process of doing this. In addition two staff have just completed NVQ 3. The staff team have had the training that they need to provide an appropriate and safe service for the residents. The staffing ratio is two staff on each shift, with the manager as an additional person during the daytime. Feedback from staff was that staffing levels are sufficient to meet residents’ needs. Two staff are also on duty at night. There are not any facilities for staff to sleep in at night and at the time of the last inspection it was evident that both staff were not awake all night and one appeared to be sleeping in the lounge. Also staff were on the rota as working at night and then on duty the next day. From examination of the rota and discussions with staff and the manager this no longer happens and both staff are awake at night. An additional member of staff has been employed and she works mainly on night duty. Staffing levels are adequate to meet residents’ current needs. A selection of staff files were examined at the time of the last inspection and found to contain the necessary information and checks. On this occasion the file of the newly recruited member of staff was checked. This contained a copy of the application form, the interview test, references, confirmation of identity, CRB (Criminal Records Bureau) check and other required details. The person started work after the CRB (Criminal Records Bureau) check had been received. Therefore an appropriate recruitment process is now in place, as required by the previous inspection. This helps to safeguard residents. Staff are receiving regular supervision and staff meetings are being held each month. This gives staff the opportunity both collectively and individually to discuss work practice, any concerns and the development of the service. As most staff have now been in post for a year or more the manager stated that she is in the process of introducing staff appraisals. The experienced person that is contracted to provide supervision for the manager and to carry out monitoring visits will support her. Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 23 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, 38, 39 & 42. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. The residents are benefiting from the management and development of the home. The registered provider monitors the service to check the quality of the service provided to residents. The residents are living in a safe environment. EVIDENCE: The manager started at the home in September 2006. She has a lot of experience of working with people with learning disabilities and of managing residential services. She has successfully completed the RMA (Registered Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 24 Managers Award) and NVQ 4 in care. The manager therefore has the necessary experience and qualifications to manage the service. At the time of the last inspection the manager said that she had obtained a CRB check via the Commission but had not started the registration process. The situation remains the same. The manager said that for personal reasons the application had not been made. However these issues have been resolved and the manager undertook to submit the application within a week of the inspection. An application must be submitted to the Commission for the manager’s registration within the required timescale. The service continues to develop and improve and most of the requirements from the previous inspection have been addressed. Feedback from staff was that the service to the residents continues to get better and the residents are happy. Staff also said that they receive the supervision and support that they need from the manager to carry out their duties. Monthly monitoring visits are carried out by an experienced person on behalf of the proprietor. The reports received are detailed and cover the necessary areas. They also indicate any action that is needed. Therefore the home is being adequately monitored and residents are being safeguarded. The most recent report highlight that the manager needs to send out quality assurance questionnaires to obtain feedback on the service provided and this is due to happen in the near future. Therefore at this stage no requirement has been made and this will be monitored during the course of future inspections. The staff team carries all of the necessary health and safety checks out regularly. For example fire call points are tested weekly, as are hot water temperatures. Fridge and freezer temperatures are tested daily. Regular fire drills take place and these are recorded. Appropriate servicing is carried out on the fire system and fire equipment. The working practices in the home are safe and there have not been any preventable accidents. Records show that there are very few accidents and staff confirmed this. A safe environment is provided for the residents. Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 2 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 3 3 X X 3 X Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 26 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 YA20 Regulation 13 Requirement The MAR (Medication Administration Record) must be completed, by the person administering medication, at the time of administration. This is to safeguard residents and also for accountability. Protocols/guidelines must be in place for any PRN (as required) medication. Staff will then be clear as to when, how and why to administer this medication. (Previous target of 15/03/07 not met). A system must be in place to reconcile and monitor residents’ bank/building society or post office accounts. (Previous target of 31/03/07 not met). The registered person must provide suitable facilities for staff for the purpose of changing and for storage. An application must be submitted to the Commission for the manager’s registration. (Previous target of 31/03/07 not met). Timescale for action 15/08/07 2 YA20 13 31/08/07 3 YA23 13 30/09/07 4 YA28 23 30/11/07 5 YA37 8 31/08/07 Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA1 YA18 Good Practice Recommendations It is recommend that a simplified user-friendly Service User guide be developed to assist residents to find out about the home. It is recommended that the information in the care plans be more detailed so that it clearly states how personal care needs to be provided. Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Northbrook Care Home DS0000066343.V347351.R01.S.doc Version 5.2 Page 29 - 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. 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