Inspection on 27/01/06 for Params The (18)

This inspection was carried out on 27th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Params The (18) 23/07/07

Params The (18) 05/06/06

Params The (18) 06/09/05

Params The (18) 04/02/05

Params The (18) 28/09/04

Similar services:

Ashlong House

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Edenvale

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Chatsworth Care - Dawson House

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Chatsworth Care - Tudor Lodge

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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 Unannounced Inspection 11:15 27 January 2006 th Params The (18) DS0000025853.V271469.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Params The (18) DS0000025853.V271469.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Params The (18) DS0000025853.V271469.R01.S.doc Version 5.0 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.V271469.R01.S.doc Version 5.0 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. 6th September 2005 Date of last inspection Brief Description of the Service: The Params is a privately run residential care home that is registered with the Commission for Social Care Inspection (CSCI) to provide accommodation and personal support for up to thirteen younger adults (18-65) with mild to moderate learning disabilities. All thirteen of the service users currently residing at the home are aged forty and over. There have been no new admissions or significant changes made to the physical environment of the home since it was last inspected in September 2005. Mrs Isabel Parameswaran, who co-owns the Params with her husband Siva, is also the registered manager, although the homes deputy manager tends to be in operational day-to-day control. This detached Victorian house is perched on the top of a hill and is approached up a steep set of winding steps. Located close to the centre of Purley it is well served by a wide variety of local shops, cafes, pubs, and restaurants. The home is also close to numerous main line bus routes and a local train station with excellent links to central Croydon, London and the surrounding areas. Built over three floors each service user has their own single occupancy bedroom. Communal areas include a main lounge with a conservatory attached and a separate dinning room on the ground floor, a small smoking room on the first floor, and a top floor games room. The home also has a separate kitchen, laundry room, and a first floor office. There are sufficient numbers of bathroom and toilet facilities located throughout the home near service users bedrooms and communal areas. The sloping gardens at both the front and rear of the property are extremely well maintained and contain a wide variety of well-established plants, shrubs and trees. Params The (18) DS0000025853.V271469.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and began at 11.15am on the morning of Friday 27th January 2006. It took four hours to complete. Six service users were met during the course of this inspection, two of whom were spoken with at length about the quality of care they received. Since the homes last inspection, undertaken in September 2005, the Commission has received a further four comment cards in respect of this service. A service user’s care manager completed one of these. This particular care manager was also spoken to over the telephone a week after the visit. The rest of the cards had been completed by GP’s representing various doctors surgeries used by the service users. The majority of this inspection was spent talking to the homes deputy manager, two service users, as previously mentioned, and a member of staff on duty at the time. A considerable amount of time was also spent examining the homes records and touring the premises. No additional visits or complaints investigations have been carried out by the CSCI in respect of this service in the past twelve months. What the service does well: What has improved since the last inspection? Half the requirements identified in the homes previous report have been met in full, but there has been some variability in complying with others, which will be discussed in the summary section entitled ‘what the home could do better’. Since the homes last inspection its arrangements for managing identified risks associated with behaviours that challenge have improved to ensure the safety of all the service users and staff. Furthermore, in response to one service users changing needs, which have significantly altered in the past year, a thorough assessment of their physical needs has been undertaken by suitably qualified Params The (18) DS0000025853.V271469.R01.S.doc Version 5.0 Page 6 healthcare professionals and the necessary moving and handling equipment purchased to meet these changing needs. A suitably qualified engineer has also checked the homes water heating system for legionella in the past twelve months in accordance with health and safety regulations. Finally, all staff are now receiving formal supervision sessions on a more regular basis. What they could do better: The positive comments made overleaf notwithstanding, there are still important areas of practice that could be improved in a number of clearly identifiable ways. Firstly, the home still needs to produce a far more service user ‘friendly’ guide, which is separate from its Statement of purpose, that can be distributed to anyone who is interested to learn more about the services and facilities provided by the Params. Secondly, each service users terms and condition of occupancy still need to be updated and specify the exact amount the Params charge for services and facilities provided. Each service users care plan needs to be reviewed at least once every six months and updated to accordingly to reflect any agreed changes. The Commission also needs to be notified without delay about any significant event, which adversely affects the welfare of the service users, including theft. The management and staffing resources are in the main adequate to keep the service users safe and some progress has been made with regard staff attending recognising, preventing and reporting abuse training in the past six months. Nevertheless, there is room for improvement and sufficient numbers of staff still need to improve their existing knowledge and skills and attend National Vocational Qualification in care, moving and handling, infection control and undertaking staff supervision training. The homes arrangements in respect of its day-to-day management also need to be clarified and the person designated as in charge must obtain a professionally recognised managers qualification. As previously mentioned, the service is a safe one in the main, although certain health and safety arrangements need to be improved. For example, all the homes portable electrical appliances need to be checked by a suitably qualified engineer on a more frequent basis and its water heating systems tested for legionella at least once a year. Furthermore, the deputy manager was reminded that any items of food taken out of there original packaging must not be kept in the fridge in unmarked containers. Finally, the fire resistant door with the faulty sound activated realise mechanism needs to be repaired as a matter of urgency and the staff reminded that under no circumstances must fire doors be wedged open. Params The (18) DS0000025853.V271469.R01.S.doc Version 5.0 Page 7 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. Params The (18) DS0000025853.V271469.R01.S.doc Version 5.0 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.V271469.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 5 No progress has been made by the home to provide each of its service users with an up to date version of the homes guide. Consequently, service users, their representative and the Commission do not have access to all the information they need to make an informed judgement about the standard of care provided by the home. Furthermore, the home has failed to up date each service users terms and conditions of occupancy. Consequently, the range of fees the service users are currently charged for services and facilities provided are not reflected in their contracts. EVIDENCE: Despite being identified as a major shortfall in the homes two previous inspection reports and an action plan completed by the deputy manager indicating that the homes ‘service users guide will be extracted out of the Statement of purpose and made available to those service users who want it by 1st November 2005’, no progress has been made to address this matter. The proprietors and deputy manager are reminded that in accordance with the Care Homes Regulations (2001) they have a duty of care to supply both prospective and existing service users, as well as their representatives and the Commission, with up to date versions of there service users guide. As suggested in previous reports this task would be made a lot easier if the proprietors were to separate the service users guide from the homes Params The (18) DS0000025853.V271469.R01.S.doc Version 5.0 Page 10 Statement of purpose, thus producing a far more service user ‘friendly’ document that would not only be far easier to read, but also distribute. It is unacceptable to merely lend out the homes statement of purpose to anyone who requests it. The timescale for this requirement to be met will be extended for a third and final time and must be addressed by 1st April 2006. The home remains fully occupied and has not admitted any new service users in the past six months. Having examined a couple of service users terms and condition of occupancy, it was disappointing to note that despite the requirement being made in the homes previous inspection report no progress had been made to up date these contracts. Consequently, the range of fees currently charged for services and facilities provided is not reflected in any service users terms and conditions of occupancy. Params The (18) DS0000025853.V271469.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Care plans accurately reflect service users assessed and changing needs, which enables the staff to plan for and meet them, although the minutes of all care plan review meetings must be appropriately maintained as evidence they that are being undertaken at regular intervals. EVIDENCE: Four care plans sampled at random were all clearly based on individual needs assessments and generally covered most aspects of service users personal, social and health care needs. It was also positively noted that despite this the deputy manager had nevertheless decided to produce a far more person centred format, which he planned to introduce by April 2006. One service users care plan had already been updated and contained a lot of detailed information about the individual’s food preferences and social interests. It also contained a section entitled ’what is being done’, which set out in detail all the Support this particular individual was being provided to ensure there identified needs were met and personal goals achieved. Params The (18) DS0000025853.V271469.R01.S.doc Version 5.0 Page 12 Two out of four of the care plans inspected at random had both been reviewed in the past six months, although no written records were available on request to proof that the other two had been reviewed in the past twelve months. Nevertheless, it was positively noted that at one service users most recent care plan review the service user, their family, keyworker and independent advocate, had all been invited to attend. Since September 2005 three service users meetings have been held at the home. Minutes indicated that popular topics of conversation included menu and activity planning, as well as choosing destinations for holidays. One service user spoken with at length said these meetings were generally well attended. Risk assessments are included in service users care plans, which set out in detail what action is be taken by staff to ensure identified risks and/or hazards are, so far as ‘reasonably’ practicable, minimised. The home has recently purchased a ‘Baronmead’ stair climber to ensure one service user, whose physical needs have significantly altered in the past twelve-month, is able to continue accessing the wider community via the steep steps at the front of the house. A moving and handling risk assessment has been undertaken by the home, which clearly identifies all the potential risks associated with its use and how to operate it safely. The assessment makes it clear that two ‘suitably’ trained and experienced members of staff must only operate the chair in ‘fair’ weather conditions. Params The (18) DS0000025853.V271469.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 13, 15 & 16 Social, leisure and employment opportunities for service users to engage in both inside the home and in the wider community are well managed and provide the service users with daily variety and stimulation. EVIDENCE: The deputy manager said that half a dozen or so of the service users regularly attend Sunday services at a number of churches in the area, including a local Baptist and Methodist one. The service users travel independently to these services and information about peoples spiritual needs is contained in their care plans. On arrival around half the service users were at home relaxing in their bedrooms, watching television in the main lounge, or drawing. The rest of the service users were out in the wider community pursuing all manner of social, education and vocational activities. Some service users were attending classes at a local college, others day centres and one service user was doing paid work as a cleaner at a well-known retail outlet. Another service user was out shopping. Params The (18) DS0000025853.V271469.R01.S.doc Version 5.0 Page 14 The home has its own transport by way of a six-seater people carrier. Three of the homes staff are suitably qualified to drive the vehicle, which the deputy manager says is sufficient to ensure good use is made of it. One service user met said they regularly go out in the homes vehicle to a variety of places, including the shops and the GP’s surgery. Both the service users spoken with at length said staff always treated them with respect and knocked on their bedroom doors before entering. Another service user said staff always ensured personal care was always provided behind closed doors. The one service user who continues to smoke is permitted to do within the confines of the first floor lounge room. Staff are not permitted to smoke in the home and must do so outside. Params The (18) DS0000025853.V271469.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 & 19 Suitable arrangements are in place to ensure that service users physical and emotional health care needs are identified, planned for and met. EVIDENCE: The care plan for the one service user whose physical needs have significantly altered in the past year has been up dated to reflect these changes. It was clear from conservations with the service user that they have received a lot of input from a number of qualified healthcare professionals, including a qualified occupational therapist and physio, who continue to visit him at home on a regular basis. As previously mentioned, a ‘Baronmead’ stair climber, along with a walking frame, portable bath chair, and indoor stair ramp has all been purchased by the home, as recommended by the OT. The physio has also introduced a daily exercise programme. A copy of the routine is included in the individuals care plan. The homes accident book revealed that there had been no unplanned admissions to hospital since September ’05, although four incidents had occurred in this time. It was positively noted that in response the deputy manager carried out a risk assessment and has established a risk management strategy in order to minimise the likelihood of similar incidents reoccurring in the future. Params The (18) DS0000025853.V271469.R01.S.doc Version 5.0 Page 16 Params The (18) DS0000025853.V271469.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 The homes arrangements for dealing with complaints and allegations/suspicion of abuse are sufficiently robust to ensure the service users and their representatives are listened and action taken to protect the people who live there from avoidable harm. Nevertheless, the home needs to be more and open and transparent and are reminded that the Commission must be notified without delay about the occurrence of any significant events involving service users. EVIDENCE: The homes complaints log revealed that two formal complaints had been received by the home in the past six months. The first was made in respect of the noise being made by the homes washing machine at night. This matter was promptly investigated by the home and an action plan agreed that staff should not wash clothes after 8pm in the evening. The second was made on behalf of a service user by their relative who complained that their loved ones money had gone missing. The incident was reported to the individuals care manager and the matter investigated internally by the homes co-owner/manager. In the subsequent report she concluded that the service user was probably pick pocketed whilst shopping at a local supermarket. As a result of a number of other significant incidents involving this particular service user it has been agreed with their placing authority to provide them with one-to-one staff support when she is out in the wider community. However, while the home is commended for ensuring such swift action was taken in response to these concerns the Commission should have been notified without delay about the suspected theft and the other significant incidents involving this individual. Params The (18) DS0000025853.V271469.R01.S.doc Version 5.0 Page 18 In the past twelve months there have been no allegations of abuse made within the home, although there have been a few incidents of aggression involving service users. As required in the homes previous report it was positively noted that this particular individuals care plan now contained specific guidance to help staff deal with behaviours that challenge the service from time to time. Furthermore, sufficient numbers of the homes current staff team have now attended an accredited recognising, preventing and reporting vulnerable adult abuse training, although no documentary evidence by way of certificates of attendance were available on request. One service user met said that to the best of their knowledge their guests are never charged for any hot drinks and food they consume during visits. Params The (18) DS0000025853.V271469.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27, 28, 29 & 30 Overall, the size and layout of the home, which is furnished and decorated to a reasonable standard, ensuring the service users have a homely, safe and clean environment in which to live. EVIDENCE: No changes have been made to the environment of the home since September 2005 and the deputy manager was confident that the proprietors have no plans to significantly alter the building for the foreseeable future. The carpet in the main lounge is looking rather worn and threadbare in places and needs replacing sooner rather than later. Having tested the temperature of the hot water emanating from the first floor bath nearest the smoking lounge it was found to be a safe 42 degrees Celsius at 14.00. The deputy manager said that all the homes water outlets had been fitted with preset, tamper-proof and fail-safe thermostatic mixer valves as standard to ensure water temperatures never exceeded 43 degrees Celsius. Params The (18) DS0000025853.V271469.R01.S.doc Version 5.0 Page 20 As previously mentioned one service user whose needs have significantly altered in the last year has received a considerable amount of input form various healthcare professionals, including a occupational therapist and physio, who suggested the home purchase a portable interior ramp, bath chair and walking frame to ensure this particular individuals independence was maintained. The deputy manager said the individuals healthcare needs will continue to be closely monitored by staff. The homes washing machine is capable of washing foul laundry at appropriate temperatures, in accordance with infection control regulations. The machine also has a sluicing facility. The floor and walls in the laundry are readily cleanable and a wash hand basin is prominently sited in this room. Params The (18) DS0000025853.V271469.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36 Overall, the home ensures that sufficient numbers of suitably competent staff are on duty at all times to meet the health and welfare needs of the service users. However, more need to receive suitable training in moving and handling techniques, infection control and carrying out staff supervision to ensure all the service users needs are being met. EVIDENCE: The deputy manager stated that two staff have already achieved their National Vocational Qualification in care (Level 2 or above) and another three have enrolled on suitable courses. The home is just about on course to meet Government training targets for care workers and ensure that 50 are NVQ qualified. Progress on this matter will be assessed at the homes next inspection. The proprietors are reminded that the deadline for this training to be met expired on 1st January 2006. Params The (18) DS0000025853.V271469.R01.S.doc Version 5.0 Page 22 There have been no changes made to staffing levels in the past twelve months, which remain adequate to meet the assessed needs of the service users. With two care workers, the deputy manager and a domestic all on duty at the time of the morning inspection this corresponded with that mornings duty roster. One of the homes co-owners was also ‘on call’ in the proprietor’s own home, which is located at the rear of the garden. The deputy manager said the proprietors are always on hand to offer him advice and support as and when he requests it. The ethnic and cultural mix of the current staff team does not accurately reflect that of the service users, who are mainly white Caucasians. The vast majority of staff are of central European, African and Southeast Asian origin. The deputy manager should be mindful of this cultural imbalance when he next recruits new staff. Since the homes last inspection the deputy manager has re-employed a former member of staff, as well as a new volunteer. The files for the two new members of staff were examined in some depth and found to contain proof of there identifies, two written references and protection of vulnerable adults register (POVA first) checks. This information had been obtained before these care workers commenced their employment at the home. As required in the homes previous report the deputy was able to produce a letter to show that two members of the current staff will attend a moving and handling course on 16th February 2006. The deputy said he hoped the rest of his staff team would have received similar training by April 2006. Furthermore, with only two members of the current staff team qualified to use the new ‘Baronmead’ stair climber, more staff will need to be trained in its safe operation to ensure sufficient numbers of staff are always on hand. The one member of staff spoken to at length was very clear about the homes infection control and disposing of clinical waste arrangements. These positive comments notwithstanding sufficient numbers of the current staff team need to attend infection control courses. The home has a contract for dealing with its clinical waste, which is kept outside in a plastic bin. The waste is collected on a weekly basis. Sufficient stocks of aprons and gloves were also available in the home. It was positively noted that as recommended in the homes previous report two members of the senior staff team have been delegated the task of supervising their colleagues, thus ensuring that each member of staff now receives at least one formal supervision session every two months. However, these senior members of staff have not been ‘suitably’ trained to carry out this task. This training shortfall must be rectified as a matter of urgency. Params The (18) DS0000025853.V271469.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 & 42 In the main the homes health and safety arrangements are sufficiently robust to ensure the welfare of the service users is, so far as reasonably practicably, protected. Nevertheless, in order for the home to fully comply with health and safety regulations all the homes portable electoral appliances must be tested at more regular intervals, food taken out of its original packing not be left in unmarked containers in the fridge, and fire resistant doors not left wedged open. EVIDENCE: Mrs Isabel Parameswaran, as the registered manager and co-owner of the Params, continues to be the named individual responsible for the service, although it is clear from the homes last four inspections that the Deputy manager, Cosmo Kapondeni, is becoming increasingly responsible for its dayto-day running. Neither Mrs Parameswaran nor Mr Kapondeni have completed their NVQ Level 4 Management and Care training, which they have both been studying for sometime. The proprietors are reminded that the named individual responsible for managing the home should have achieved this award by the Params The (18) DS0000025853.V271469.R01.S.doc Version 5.0 Page 24 end of 2005, in order to meet National Minimum Standards. Cosmos said discussions were still on-going with the proprietors about the possibility of him being appointed the homes manager with overall responsibility for its day-today running. The proprietors position on this matter still needs to be clarified and the Commission notified about the outcome. Up to date Certificates of worthiness were in place as evidence that a ‘suitably’ qualified professional had checked the homes gas installations, electrical wiring, fire alarm system, extinguishers, new ‘Baronmead’ stair climber and water heating for legionella in the past twelve months. The homes emergency lighting has also been tested in the past six months. However, the homes portable electrical appliance annual test is over due by at least a month and various items of food, including baked beans, a sandwich and some boiled potatoes, were all found in unmarked containers in the fridge, contrary to basic food hygiene standards. All food taken out of its original packaging must be labelled and dated. The homes fire alarm records revealed that its fire alarm system continues to be tested on a weekly basis, although is was concerning to note that a fire resistant door on the ground floor was being wedged open, contrary to fire safety guidance. The deputy believed the batteries in this sound activated release mechanism had gone flat. This situation needs to be rectified as a matter of urgency and the proprietors are reminded that under no circumstances must fire resistant doors ever be wedged open. Params The (18) DS0000025853.V271469.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 1 3 X X 1 Standard No 22 23 Score 2 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 X 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 2 2 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Params The (18) Score 3 3 X X Standard No 37 38 39 40 41 42 43 Score 3 X X X X 2 X DS0000025853.V271469.R01.S.doc Version 5.0 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 YA1 Regulation 5(1) & (2) Requirement A written guide to the care home must be produced that is separate from the homes Statement of purpose, which shall include all the information specified in the Care Homes Regulations (2001), be available in a more service user friendly format, and copies supplied (or at least offered) to each of the service users, their representatives and the Commission. Previous timescales for action of 1st April & 1st November 2005 not met. Each service users terms and conditions of occupancy must be up dated to accurately reflect the current range of fees the home charges for services and facilities provided. Previous timescale for action of 1st November 2005 not met. DS0000025853.V271469.R01.S.doc Timescale for action 01/04/06 2. YA5 5(1)(b) (c) 01/04/06 Params The (18) Version 5.0 Page 27 3. YA6 4. YA22 5. YA23 6. YA35 7. YA35 8. YA35 Each service users care plan must be reviewed at least once every six months and up dated accordingly to reflect any changes. Documentary evidence to show these reviews have taken place must be available for inspection on request. 37(1)(e) (f) The Commission must be noted without delay about the occurrence of any significant event, which occurs in the home, which includes any event that adversely affects the well being of service users and theft. 13.6&19,Sch 2.4 Documentary evidence of all the recognising, preventing and reporting abuse training the staff team have received must be available for inspection on request. 13.5&18.1Sch Sufficient numbers of staff 2.4 must receive training in moving and handling techniques. Documentary evidence of this training must be available for inspection on request. Previous timescale for action of 1st December 2005 only partially met. 13.3&18.1 Sch Sufficient numbers of staff 2.4 must receive training in infection control. Documentary evidence of this training must be available for inspection on request. 18.1 2&19Sch Sufficient numbers of senior 2.4 staff who supervise their work colleagues must be suitably trained to do so. Documentary evidence of this training must be 15(2)(b), (c) (d) DS0000025853.V271469.R01.S.doc 01/03/06 01/03/06 01/04/06 01/07/06 01/07/06 01/04/06 Params The (18) Version 5.0 Page 28 9. 10. YA42 YA42 13(4) 16(2)(j) 11. YA42 23(4)(c) available for inspection on request. All the homes portable 15/02/06 electoral appliances must be tested on an annual basis. All food stored in the home 01/02/06 which has been taken out of its original packaging must be correctly labelled and dated. Under no circumstances 01/02/06 must fire resistant doors be wedged open and the faulty sound activated release mechanism attached to this door must be repaired as a matter of urgency. 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. 4. 5. Refer to Standard YA28 YA32 YA33 YA37 Good Practice Recommendations The proprietors should consider replacing the rather worn and threadbare carpet in the main lounge with more suitable floor covering. 50 of the homes staff team (carers) should have achieved an NVQ level 2 or above in care. The deputy manager should be mindful of the cultural and ethnic imbalance that exists between the homes current staff team and the service when he next recruits. The deputy manager’s role should be clarified with regard his responsibilities as the individual in charge of the dayto-day running of the home and the Commission notified about the proprietors decision. The individual responsible for the management of the home should have achieved an NVQ Level 4 in Management and Care. 6. YA37 Params The (18) DS0000025853.V271469.R01.S.doc Version 5.0 Page 29 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Params The (18) DS0000025853.V271469.R01.S.doc Version 5.0 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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