Inspection on 23/07/07 for Params The (18)

This inspection was carried out on 23rd July 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 no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Params The (18) 05/06/06

Params The (18) 27/01/06

Params The (18) 06/09/05

Params The (18) 04/02/05

Params The (18) 28/09/04

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 Params The (18) 18 Foxley Lane Purley Surrey CR8 3ED Lead Inspector Lee Willis Key Unannounced Inspection 23rd July 2007 10:15 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 Params The (18) DS0000025853.V346414.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. Params The (18) DS0000025853.V346414.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Params The (18) Address 18 Foxley Lane Purley Surrey CR8 3ED 020 8660 7747 020 8763 8615 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) Mr Siva Kandaswami Parameswaran Mrs Isabel Parameswaran Mrs Isabel Parameswaran Care Home 13 Category(ies) of Learning disability (13) registration, with number of places Params The (18) DS0000025853.V346414.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A variation has been granted to allow two specified service user over the age of 65 to be accommodated until such time as the needs of the service users can no longer be met or until such time as the placements cease. 5th June 2006 Date of last inspection Brief Description of the Service: The Params is a privately run service that provides accommodation and personal support for up to 13 generally older adults with moderate learning disabilities. The service continues to be co-owned by Mr and Mrs Parameswaran. Mrs Parameswaran remains in operational day to day control of the service, although the homes relatively new deputy manager who usually operates under the direction of Mrs Parameswaran would be responsible for its day to day running in her absence. This detached Victorian property is perched on a hill in a residential suburb of Purley and is approached by climbing a steep set of winding steps. The home is within ten minutes walk of the centre of town, which is well served by a wide variety of local shops, cafes, restaurants, take-always, pubs, and banks. The home is also on a main line bus route and less than fifteen minutes walk away from a local train station with good links to central Croydon and London. The home comprises of thirteen single occupancy bedrooms, a large entrance hall, main lounge, separate dinning room, conservatory, kitchen, laundry room, office, and top floor games room. The sloping gardens at both the front and rear of the property are well maintained. Service users have all been offered copies of the homes Statement Of Purpose, Residents Guide, and Occupancy Agreements. These documents specify information about services and facilities provided and fees charged currently range from £2,597.04 - £4,494.40 per month. Params The (18) DS0000025853.V346414.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. From all the available evidence gathered during the inspection process the Commission for Social Care Inspection (CSCI) has judged the service as having significantly more strengths than areas of weakness. Key standards are generally met and the management have responded well to problems identified during this site visit regarding staff recruitment checks. This unannounced site visit was carried out on a Monday between 10.15am and 4.30pm. During the course of this six and a quarter hour inspection six people who use the service, both proprietors, the newly appointed deputy manager, and a senior support worker were all spoken with at length. Three people who use the service were selected at random to have the care they receive ‘case tracked’. The remainder of this site visit was spent examining the homes records and touring the premises. The proprietors also returned a completed annual quality assurance (self) assessment form as part of the inspection process. An expert by experience was also invited to take part in the inspection process and visited the service with the inspector. An expert by experience is a person who has a shared experience of using services who can help an inspector get a better picture of what it is like to live in a care home. The expert by experience who visited the service was accompanied by a support worker and spent over two hours engaging with a number of people who live at the Params. Key parts of the report compiled by the expert by experience will be used as evidence to support the judgments I have made about the home throughout this report. What the service does well: Most of the verbal feedback received from the people who use the service was on the whole very complimentary about the standard of care being provided at the home. It was evident from reading the homes records and comments made by several of the people who live there that dietary needs and preferences are well catered. One service user told us ‘the food was the best thing about living at the Params’. The expert by experience also reported that a number of people who live at the Params told her: • People can choose the foods they like- pasta, vegetables, roast dinner and pancakes. • People also have choice over drinks they can have- tea, coffee, water, coke etc. • There is a menu in place that people like. Params The (18) DS0000025853.V346414.R01.S.doc Version 5.2 Page 6 The service also ensures people have various opportunities to develop their independent living skills. This is because staff understand the importance of supporting personal development and actively encourage people to help prepare meals, doing their own laundry, and clean their bedrooms. Several of the people who use the service were observed participating in various household chores during the course of this site visit and one person told us they really enjoyed helping staff peel potatoes. All the staff who were on duty at various times throughout the course of this site visit were observed interacting with service users in an extremely friendly and respectful manner. All the people who use the service who were asked about staff commented very favourably about them. One person told us ‘all the staff were very nice and were good listeners’. The expert by experience reported that she had observed staff interacting with a number of people who use the service and also noted: • • • ‘Staff are nice and polite. The people who use the service like the staff Staff were friendly to the people who use the service’. What has improved since the last inspection? Since the homes last inspection a new care plan format has been introduced. People who use the service are actively encouraged to participate in the process of developing their own care plans and this more person centred approach places a greater emphasis on peoples unique strengths and personal preferences. The new format is also better at reflecting people’s unique life experiences and sets out more clearly how people’s wishes and personal goals are to be met. All the outstanding requirements identified at the homes last inspection were followed up during the site visit. It was positively noted that all the care plans examined had been recently reviewed and up dated accordingly to reflect any changes in provisions. Documentary evidence was also made available on request to show that sufficient numbers of the homes staff team had now received training in recognising, preventing, and reporting abuse. There have been no significant changes made to homes environment in the past twelve months, although it was noticed during a tour of the premises new floor covering had been laid in the main lounge, dinning room, and conservatory. Params The (18) DS0000025853.V346414.R01.S.doc Version 5.2 Page 7 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. Params The (18) DS0000025853.V346414.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 Params The (18) DS0000025853.V346414.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): 1&2 People who use the 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 who use the service are provided with a guide that only contains basic information about the home. The guide must contain far easier to read information about the qualifications and experience of all staff, recent CSCI inspection findings, and the comments and experiences of the people who live at the home. This will enable people who use the service to make more informed judgments about whether or not the service is right for them. People’s needs will be fully assessed prior to admission so the individual, their representatives, and the home can be sure the placement is appropriate. EVIDENCE: Copies of the homes Statement of Purpose and Guide were both looked at. The relatively new deputy manager told us these documents had not been reviewed for well over a year and subsequently did not reflect all the recent changes in provision (e.g. what the experience and qualifications of the new deputy manager were, and who was ‘usually’ responsible for the day-to-day running of the home). Params The (18) DS0000025853.V346414.R01.S.doc Version 5.2 Page 10 Furthermore, as required in the homes last inspection report the homes Guide did not contain any information about how anyone wanting to read the homes most recent inspection could obtain a copy. The good practice of including what the people who use the service think about life at the home has also not been carried out as previously recommended. Finally, the Guide does not contain any information about how the homes job share management arrangements actually work in practice or what qualifications the current staff team has. The expert by experience also told us that ‘they did not think the homes Guide was particularly easy to read or understand’. The new deputy told us the home remained fully occupied and was therefore not accepting any new referrals. He also demonstrated a good understanding of the homes admissions procedures. Params The (18) DS0000025853.V346414.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 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans reflect what is important to the individual, their capabilities, and what support they need to achieve their personal aspirations. The homes arrangements for assessing and managing risk are suitably robust to ensure people using the service are able to take ‘responsible’ risks and develop their independent living skills. EVIDENCE: The individual care plans for the three people selected for case tracking were examined in depth. Since the homes last inspection a new care plan format has been introduced. Where possible care plans are developed with the individual and their representatives. This more person centred approach places a greater emphasis on an individuals strengths and personal preferences. The plans celebrate an individuals life experiences and sets out more clearly how all their Params The (18) DS0000025853.V346414.R01.S.doc Version 5.2 Page 12 current requirements and aspirations are to be met. To help individuals to understand the information contained in their care plan the new format is illustrated with all manner of pictures and is written in plain language. One member of staff met told us the new care plan format was a better working tool that helped them deliver the support the people who used the service needed. This individual was also able to describe how they had helped develop the new care plans and accurately described the plans for one of the people whose care was being case tracked. This knowledge means that service users can be confident that they will get support from people who understand their care needs. The deputy manager told us the process of making electronic versions of the new care plans was almost complete. Followed up requirement identified in the homes last report regarding care plans not being reviewed at least once every six months. Evidence was produced on request to show that the three care plans being case tracked had each been reviewed at least once in 2007 and up dated accordingly to reflect changes in provisions. The deputy told us is was custom and practice to invite service users relatives and care managers to attend care plan reviews. Two people who live at the home told us staff always listened to them and consulted them about all aspects of life at the Params. The expert by experience reported that in discussions with several people who use the service she was told people could choose to attend: • ‘Residents meetings’. A number of risk assessments were included in the two care plans being case tracked, which detailed any action to be taken to prevent and or minimise any identified risks/hazards. These assessments included specific guidance to help staff prevent and deescalate incidents of verbal aggression and moving and handling techniques regarding the homes stair climber. The deputy told us people who use the service are supported to take ‘responsible’ risks in order to enable them to develop their independent living skills. One person who uses the service told us they are actively encouraged to access the wider community and use public transport without any staff support. Params The (18) DS0000025853.V346414.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): 11, 12, 14, 15, 16 & 17 People who use the 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 who use the service have a wide variety of opportunities to develop their social, emotional, communication and independent living skills. This is because staff understand the importance of supporting personal development and helping people participate in suitable leisure activities. Dietary needs and preferences are in the main well catered providing daily variation, choice, and interest for the people who use the service. EVIDENCE: Staff maintain a record of all the activities service users choose to engage each day both at home and in the wider community. The record showed that people who use the service lead relatively active and fulfilling social lives. People who choose to attend religious services are also supported to do so as and when they wish. Params The (18) DS0000025853.V346414.R01.S.doc Version 5.2 Page 14 The expert by experience reported that having spoken with a number of people who use the service they told her: • • • • • • ‘People can play music in their rooms and a couple of them have got stereos in their bedrooms. One man liked to relax at the end of the day and listen to music. People can choose what to watch on TV, and some had TV in their rooms. People use the garden and one individual likes growing potatoes and vegetables. Some of the things people do at the weekends included knitting. Another man likes drawing animals and cartoons’. People can choose when to go out go bowling, cinema, shows/musicals (Sound of Music) and go to Chessington. During the course of this site visit one person who uses the service was observed helping themselves to a drink in the kitchen. The deputy told us that people who are willing and capable of making their own drinks or helping staff to prepare meals are actively encouraged to do so. One service user spoken with at length said they enjoy helping staff peel potatoes and prepare vegetables. This individual also told us their favourite food was chicken pie, which was on the published menu for the week. The deputy told us minutes of weekly menu-planning meetings are not kept, which the service should consider introducing. Another service user asked about meals said they liked curry, which was also advertised on the previous weeks menu. During a tour of the premises it was noted a bowl of fresh fruit was available in the kitchen. Care plans now contain more detailed information about service users food and drink preferences, as well as their dislikes. A record of the food actually consumed by people who use the service at mealtimes is also kept which revealed people have a choice about what they eat. The expert by experience reported that having spoke to a number of people who live at the Params: • • • • People can choose the foods they like- pasta, vegetables, roast dinner and pancakes. People also have choice over drinks they can have- tea, coffee, water, coke etc. There is a menu in place that people like. People can go to the shops to buy food and there is a supermarket nearby. Params The (18) DS0000025853.V346414.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 who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Suitably robust arrangements are in place to ensure the people who use the service receive personal support in the way they prefer and require, and that their unique physical and emotional health care needs are continually recognised and met. In the main the homes policies and procedures for handling medication are relatively robust but will need to be improved to ensure people who use the service are not placed at risk of harm because clear instructions for the use of as required medication are not always available. EVIDENCE: The expert by experience reported that in discussions with a number of people who use the service they told her: • ‘People who use the service have choice over the structure of their day what time to get up and go to bed’. DS0000025853.V346414.R01.S.doc Version 5.2 Page 16 Params The (18) All the people met who use the service were suitably dressed for the season in well-maintained clothes. One person told us they always chose the clothes they wore each day. Since the homes last inspection new health care records have been developed that set out in detail a service users medical history and the outcome of all their appointments with various health care professionals. Like the new care plan format this single bound document is written in plain language to enable it to be better understood by both service users and staff. All the staff spoken with demonstrated a good understanding of each of the service users unique personal and health care needs, including both their emotional and physical requirements. Staff continue to maintain detailed records of all the accidents and incidents involving service users. These records showed that the two accidents and the one incident that had occurred since the homes last inspection had been appropriately dealt with by staff on duty at the time and where necessary reported to the Commission. None of the people who use the service have sustained any major injuries in the past twelve months or been admitted to hospital. No recording errors were noted on medication administration sheets sampled at random where staff had failed to enter the appropriate codes for medicines received, administered, and/or returned. All the medication held by the home on service users behalves is securely stored in a locked metal cabinet. Clear instructions regarding the use of ‘as required’ (PRN) medication prescribed one individual could not be produced on request. Protocols about how much to give, when, and why this type of medication should be administered in the first place must be developed as a matter of urgency. Params The (18) DS0000025853.V346414.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 who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. If people are unhappy with the care home, they or their relatives know how to complain and are confident their complaint will be looked into and action taken to put things right if necessary. People who use the service are also sure the homes arrangements for dealing with suspected or actual abuse are sufficiently robust to protect them, so far as reasonably practicable, from harm or neglect. EVIDENCE: A copy of the homes complaints procedure is included in the service users guide and specifies who deals with them and how long a complainant can realistically expect to wait for a response (i.e. within 28 days). The deputy confirmed that no complaints or concerns had been made about the homes operation in the past twelve months, although he was unable to produce the homes complaints record on request. The new deputy was reminded that this vital record must be kept in the home at all times. The new deputy demonstrated a relatively good understanding of the action he would need to take if an allegation of abuse was made within the home and which external agencies would need to be notified without delay. Params The (18) DS0000025853.V346414.R01.S.doc Version 5.2 Page 18 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, 26, 27 & 30 People who use the 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 who use the service live in a relatively homely and comfortable environment that suits their needs and lifestyles. EVIDENCE: The expert by experience observed during a tour of the premises that the home: • • • ‘Was nice, old Victorian. There were lots of photos on the wall of people who lived at the Params and other stuff. The house was an ok size. It is very clean’. Params The (18) DS0000025853.V346414.R01.S.doc Version 5.2 Page 19 There have been no significant changes made to the physical design or layout of the home since it was last inspected. The deputy told us new carpet has been laid in the main lounge and new laminated flooring put down in the dinning room, and conservatory. The proprietor also told us two bedrooms had recently been redecorated which one person who lived at the home said they were ‘very pleased with’. The individual went onto to say that they ‘had enough space to store all their personal belongings’. The temperature of hot water emanating from a number of the homes water outlets was found to over 43 degrees Celsius when tested around midday. The proprietor assured us that tamper proof thermostatic mixer valves had been fitted in the homes boiler to prevent water temperatures exceeding unsafe levels. The homes maintenance person adjusted the valve at 1.30pm and hot water temperatures returned to a safe 41 degrees Celsius. The home was clean throughout and no offensive odours were detected during a tour of the premises. The homes washing machine is capable of cleaning laundry at appropriate temperatures and has a sluice programme for dealing with foul laundry. The walls and floor of the laundry room are readily cleanable. Params The (18) DS0000025853.V346414.R01.S.doc Version 5.2 Page 20 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 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Overall, sufficient numbers of very experienced and competent staff are employed on a daily basis to support the needs, activities, and aspirations of the people who live at the home. However, more staff still need to receive infection control training to ensure they have the necessary knowledge and skills to effectively manage infection in the home. The homes recruitment procedures are not sufficiently robust to minimise the risk of service users being harmed by people who are ‘unfit’ to work with vulnerable adults. EVIDENCE: The expert by experience reported that she had observed staff interacting with a number of people who use the service and noted: Params The (18) DS0000025853.V346414.R01.S.doc Version 5.2 Page 21 • • • ‘Staff are nice and polite. The people who use the service like the staff Staff were friendly to the people who use the service’. Five members of staff that included the relatively new deputy manager and the homes owner/manager were all on duty on arrival. The deputy told us that at least three members of staff were always on duty during the day. The home has recruited two new support workers in the past six months. The new employees personal files were examined in some depth and found to each contain two written references, proof of their identifies, completed job application forms, Home Office approved work permits, and their induction records. However, only one file contained an up to date Criminal records Bureau (CRB) and Protection of Vulnerable Adults check. The proprietors were able to produce a CRB that was nearly three years old for their newest member of staff and are reminded that since the implementation of the Protection Of Vulnerable Adults scheme CRB portability has been restricted in relation to regulated services for adults. The Care Standards Act requires that new staff are checked against the POVA 1st list prior to them being offered employment. Furthermore, POVA 1st should only be used in ‘exceptional circumstances’ where there is pressure to recruit staff quickly because service users are at being placed at risk as a result of staff shortages. An Immediate Requirement Notice was issued at the time of this inspection for the aforementioned individual to stop working at the home until the proprietors had obtained a clear POVA 1st check for them. The individual is also not permitted to work unsupervised in the home until full and satisfactory CRB has been received. The homes induction programme ensures all new staff are given the right information to be able to do their jobs well. Individualised training plans are in place for each member of staff that not only identifies what skills people have, but also what their training needs are. Records in the form of certificates of attendance were made available on request to show that sufficient numbers of the homes current staff team had received training in fire safety, food hygiene, first aid, person centred care planning, and recognising, preventing and reporting abuse. The deputy told us that despite the requirement being made in the homes last CSCI report only three members of staff team have received any training regarding infection control. This requirement will be repeated for a second and final time in this report with the timescale for action extended to enable the new deputy more time to meet it. Failure to meet the requirement within the new timeframe for action will result in the Commission considering enforcement action to ensure compliance. Params The (18) DS0000025853.V346414.R01.S.doc Version 5.2 Page 22 The deputy confirmed that just over 50 of the homes current staff team had either achieved a National Vocational Qualification in care (level 2 or above) or were enrolled on a suitable course. The deputy is aware that the service should be aiming to have its entire staff NVQ qualified. Progress towards achieving this aim will be assessed at the homes next inspection. Params The (18) DS0000025853.V346414.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, 39, 40 & 42 People who use the 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 homes management arrangements are meeting the needs of the people who live at the Params, although the person who is designated as responsible for its day-to-day operation is not suitably qualified to run a residential care service. People who use the service and their representative do not know that their opinions are central to the homes development because the results of quality assurance surveys undertaken by the proprietors are not published. The homes health and safety, and fire prevention arrangements are sufficiently robust to safeguard the welfare of the people who use the service, their guests, and staff. Params The (18) DS0000025853.V346414.R01.S.doc Version 5.2 Page 24 EVIDENCE: The homes manager has not achieved an NVQ Level 4 in either management or care, but she is a Registered General Nurse with other twenty years experience running this residential care home. The homes new deputy manager has the equivilent of an NVQ level 4 in Management, and told us he was confident about achieving the care component of his NVQ Level 4 training by the end of the year (2008). The homes annual quality assurance assessment (AQAA) states that ‘Mrs Isabel Parameswaran (Registered manager and co-owner of the service) does not intend to complete her NVQ 4, but hopes that this training requirement will be satisfied if another memeber of the homes management team (i.e. the homes deputy) achieve this qualification’. This is accepatable to the Commission providing the person designated in operational day to day control of the home (i.e. the deputy) has achieved an NVQ Level 4 or the equivilent in both management and care. This outstanding requirement will be repeated for a second and final time with the timescale for action extended to enable the new deputy more time to achieve it. Failure to meet the requirement within the new timeframe will result in the Commission considering enforcement action to ensure compliance. The deputy told us that the proprietors are always on hand to offer him advice and support regarding the day-to-day running of the service. Evidence in the form of satisfaction surveys people who use the service as well as their representatives have completed were made available on request. However, the new deputy acknowledged that no attempt had been made to analyses this feedback and publish the results, despite this being identified as a requirement in the homes last CSCI inspection report. This outstanding requirement will be repeated for a second and final time with the timescale for action extended to enable the new deputy more time to achieve it. Failure to meet the requirement within the new timeframe will result in the Commission considering enforcement action to ensure compliance. The proprietors stated in the homes AQAA that none of the services policies and procedures had been reviewed since 2004. The deputy acknowledged that policies and procedures should be reviewed on a more frequent basis and up dated accordingly to reflect changes. Params The (18) DS0000025853.V346414.R01.S.doc Version 5.2 Page 25 The Commissions database confirmed the recent fire the home experienced was reported to us in a timely fashion. The homes fire records revealed that the night staff on duty at the time and the proprietor, who was on call in her own home, responded well to the emergency and managed to evacuate all the service users in a timely fashion and contact the local fire brigade. Other fire records confirmed staff continue to test the fire alarm system every week. Up to date Certificates of worthiness were in place to show that suitably qualified engineers had checked the homes gas (Landlords) installations, portable electrical appliances, stair climber, and fire extinguishers, in the past twelve months. The homes water heating was also last checked for legionalla in September 2006. Params The (18) DS0000025853.V346414.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 2 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 3 28 X 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 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 X 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 2 3 X 3 X Params The (18) DS0000025853.V346414.R01.S.doc Version 5.2 Page 27 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA1 Regulation 5(1)(d) Requirement Timescale for action 01/09/07 2. YA1 4(1)(c), Sch 1.3 and 1.4 3. YA20 13(2) All the people using the service must have a Guide that contains the Commissions findings about how the service is performing. This will ensure people have good information about the quality of the care provided. Previous timescale for action of 1st July 2006 not met. All the people who use the 01/09/07 service must have a Statement of Purpose/Guide that contains detailed information about the homes unique management arrangements and qualifications of staff. This will ensure people have all the information they need to know about the service. When ‘as required’ (PRN) 01/08/07 medication is administered staff authorised to handle it must have clear instructions regarding its appropriate use. This will ensure that people who use the service receive the correct levels of medication when they are supposed too. DS0000025853.V346414.R01.S.doc Version 5.2 Params The (18) Page 28 4. YA34 19(10) (11) 5. YA35 13(3) (6) & 18.1, Sch 2.4 6. YA37 9(2)(b)(i) 7. YA39 24(2) Up to date Criminal Records Bureau and Protection Of Vulnerable Adult checks must be obtained in respect of all new members of staff. This will ensure the safety of people using the service. An Immediate Requirement Notice was issued at the time of this site visit. Infection control training must be provided for all staff that work with people who use the service. Previous timescale for action of 1st December 2006 partially met. The person(s) responsible for the day-to-day management of the home must have achieved an NVQ Level 4 in Care or the equivalent. This will ensure the home is well run by someone who is suitably qualified to manage a care home for vulnerable adults. Previous timescale for action of 1st January 2007 partially met. All the people who use the service must have access to the findings of the homes most recent quality assurance surveys involving the service users and their representatives. Previous timescale for action of 1st October 2006 not met. 27/07/07 01/11/07 01/01/08 01/09/07 Params The (18) DS0000025853.V346414.R01.S.doc Version 5.2 Page 29 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. Refer to Standard YA1 Good Practice Recommendations People who the service should have their views about their experiences of life at the home published and made accessible to all. The proprietors have not carried out this good practice recommendation suggested at the services last inspection. The people who use the service should be able to obtain a Guide to the home that they understand and is ‘easy to read’. The outcome of weekly menu planning meetings should be minuted. NVQ training should be provided for all staff that work with people who use the service. The homes policies and procedures should be reviewed and up dated accordingly more frequently in order to reflect changes. 2. 3. 4. 5. YA1 YA17 YA32 YA40 Params The (18) DS0000025853.V346414.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!