Inspection on 06/09/05 for Params The (18)

This inspection was carried out on 6th September 2005.

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 but made no statutory requirements on the home.

Other inspections for this house

Params The (18) 23/07/07

Params The (18) 05/06/06

Params The (18) 27/01/06

Params The (18) 04/02/05

Params The (18) 28/09/04

Similar services:

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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 The Params (18) 18 Foxley Lane Purley Surrey CR8 3ED Lead Inspector Lee Willis Unannounced 6 September 2005 10:30 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 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 Stationary 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. The Params (18) G53-G53 S25853 ParamsUI V203917 230805 Stage0.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Params (18) Address 18 Foxley Lane, Purley, Surrey, CR8 3ED Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8660 7747 020 8763 8615 Mr Siva Kandaswami Parameswaran Mrs Isabel Parameswaran Care Home 13 Category(ies) of LD Learning Disability (13) registration, with number of places The Params (18) G53-G53 S25853 ParamsUI V203917 230805 Stage0.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: A variation has been granted to allow one specified service user over the age of 65 to be accommodated subject to (a) annual review (b) staff have the training and skills to work with the service user and (c) that there are no significent changes to the service users health/care needs. Date of last inspection 4 February 2005 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 supoort for up to thirteen adults with learning disabilities. All the service users currently residing at the Params are aged forty and over. Since the last inspection there have been no new admissions or significant changes made to the homes physical environment. Mrs Isabel Parameswaran co-owns the home with her husband Siva, and as the registered manager, Isabel remains in operational day-to-day control of the service, although she often shares this responsibility with the homes Deputy manager. The building itself is a fine detached Victorian property positioned on a hill close to the centre of Purley, which has a wide range of local shops, cafes, pubs, as well as good bus and rail links to Croydon and the surrounding areas. The home is approached up a steep set of steps. Built over three floors it comprises of a main and second much smaller sun lounge, a seperate dinning room, first floor smoking area, top floor games room, kitchen, laundry, and office space. All the service users bedrooms are single occcupancy. There are sufficient numbers of bathroom and toilet facilities located throughout the home located 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 lot of well established plants, shrubs and trees. The Params (18) G53-G53 S25853 ParamsUI V203917 230805 Stage0.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and began at 10.00am on the morning of Tuesday 6th September 2005. It took two and a half hours to complete. Five service users were met during this inspection and two were spoken with at length about the quality of care they received at the home. Since April 2005 the Commission has received twenty-four comment cards in respect of this service, of which twelve have been completed by the service users, nine by their relatives, two by Care Managers representing different placing/funding authorities, one by an advocate, who is a regular visitor to the home, and finally one by a General Practitioner. The majority of this inspection was spent talking to the homes deputy manager, two service users and a member of staff on duty at the time. A considerable amount of time was also spent examining the homes records, touring the premises, and playing Snooker with one service user. 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: All the comment cards received from service users, their relatives, and other representatives, including Care Managers, an advocate and GP, were extremely positive about the standard of care being provided by the home. An advocate wrote, ”I always find the staff helpful and very keen to respond to any concerns or issues that I bring to their attention”. A service users relative added “It gives me great comfort to know that (my kith and kin) is happy and well looked after at the Params. I think this is an excellent home”. Both service users spoken to at length also said they liked living at the home and were very clear which members of staff they would prefer to talk to if they had a problem. It was clear from the interaction observed between the service users and staff that they have a good working relationship that appears to be based on mutual trust and respect. The five service users who were at home at the time of this unannounced inspection were all engaged in a number of leisure activities and domestic chores around the house, including collage making, playing snooker, washing up and preparing hot drinks. It remains a cornerstone of the homes philosophy of care that service users should be actively encouraged to be responsible for certain household chores as part of a structured programme to maximise their independent living skills. Service users also get involved in the day-to-day running of the home and are encouraged to attend regular menuplanning and residents meetings. The home has also experienced low rates of staff turnover in the past twelve months, which means the service users receive continuity of care from experienced individuals who are familiar with their individual wishes, needs and routines. The Params (18) G53-G53 S25853 ParamsUI V203917 230805 Stage0.doc Version 1.40 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 Params (18) G53-G53 S25853 ParamsUI V203917 230805 Stage0.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Params (18) G53-G53 S25853 ParamsUI V203917 230805 Stage0.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 & 5 The homes Statement of purpose and guide contains all the relevant information about the service, although this document should be divided and a separate guide and Statement of purpose supplied to each of the service users and or their representatives to ensure they have all the information they need to make an informed decision about the suitability of the home. EVIDENCE: As required in the homes previous inspection report the proprietor has revised the homes Statement of purpose/service users guide to include information about its admissions procedures. However, the home continues to keep this information in a single source document, the only copy of which is held in the office. The Deputy manager said it was custom and practice for prospective new service users and their representatives to make a request to lend the document to aid them with the admissions process. The proprietor is reminded that service users and their representatives must be supplied with their own copies of the service users guide to enable them to make an informed decision about where or not to move in. As recommended in the homes previous report this task will be made a lot easier if the proprietor was to separate the service users guide from the Statement of purpose, thus producing a far more service user ‘friendly’ document that would not only be far easier to read, but also to distribute. The Params (18) G53-G53 S25853 ParamsUI V203917 230805 Stage0.doc Version 1.40 Page 9 Having discussed service users terms and conditions of occupancy with the Deputy manager it was disappointing to note that despite recommendations made in previous reports the proprietors had not considered introducing bipartite contracts, agreed between the home and each service user/representatives, in addition to the Local Authorities ‘blanket’ tri-partite agreements, which did not contain any information about the homes general rules. Nevertheless, the Contracts sampled at random, which had been agreed by the service users, the home and the relevant placing authority included all the information required by the Care Homes Regulations (2001) and the associated Standards, although the amount of fees the service users/representatives are expected to pay will need to be amended to accurately reflect the homes current range of charges for services/facilities provided. The Params (18) G53-G53 S25853 ParamsUI V203917 230805 Stage0.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of the outcomes for Standards 6 to 10 were assessed on this occasion. EVIDENCE: The Params (18) G53-G53 S25853 ParamsUI V203917 230805 Stage0.doc Version 1.40 Page 11 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 standard(s) 12 & 17 The number and range of social, educational and vocational opportunities the service users have to engage in, both at home and in the wider community, appears to be extremely varied and stimulating. Dietary needs are well catered for, nutritionally balanced, and clearly based on personal preferences and choice. EVIDENCE: It was evident from comments made by service users and staff met, as well as records examined, that the service users continue to be supported to engage in a wide variety of social/leisure activities of their choice. Nearly two thirds of the service users were out at the time of this unannounced inspection either attending a variety of day centres, a self-advocacy meeting, the gym, visiting family or out at work. Two service users spoken with at length said there were always plenty of things to do in the home. During a brief tour of the premises a couple of service users who had decided to stay in their bedrooms were both busy, one on their home computer and the other cutting up pictures for a collage. Having been invited to play a couple of frames of snooker with a service user whose table it was he said he liked playing against his keyworker when he was on duty. The Params (18) G53-G53 S25853 ParamsUI V203917 230805 Stage0.doc Version 1.40 Page 12 All five of the service users met said the quality of the meals at the home was excellent. One service user said they had bacon and eggs for breakfast that morning, which was their favourite. Several others said they were looking forward to having stir-fry for lunch. The deputy said one service user is encouraged to prepare their own meals to enable them to develop their independent living skills and maintain a degree of choice about what they eat. Service users met all said staff help them plan the menus and always take their food likes and dislikes into account. It was positively noted that hot drink making facilities were available in the main dining area and one service user was observed making themselves a cup of tea. During a tour of the kitchen it was positively noted that the member of staff who was cooking the stir-fry was wearing a protective apron in accordance with basic food hygiene standards, along with a service user who was doing the washing up. Ample stocks of fresh foodstuffs were being correctly stored in fridges and the larder. The Params (18) G53-G53 S25853 ParamsUI V203917 230805 Stage0.doc Version 1.40 Page 13 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 standard(s) 19 & 20 Suitable arrangements are in place to ensure that service users physical and emotional health care needs are met, and that they are protected by the homes procedures for dealing with medicines. EVIDENCE: No significant accidents involving service users have occurred in the home since the beginning of the year and therefore there have been no unplanned emergency admissions to hospital. Records indicate that the two accidents that did occur both pertained to falls and none of the service users involved sustained any major injuries. The two incidents of verbal aggression directed at service users by another resident were appropriately dealt with staff at the time and all the relevant professional bodies, including Care managers representing the host and funding authorities, as well as the Commission, were all notified without delay, in accordance with the relevant protocols. As required in the homes previous report it was positively noted that all those service users who are currently prescribed ‘as required’ (PRN) medication have detailed protocols in place that set out clearly when and how staff should give out this type of medication, and who is ultimately responsible for authorising its use. The Params (18) G53-G53 S25853 ParamsUI V203917 230805 Stage0.doc Version 1.40 Page 14 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 standard(s) 22 & 23 Complaints are handled objectively and the service users are confident that any concerns they may have are listened to and acted upon. The home has suitably robust procedures in place in respect of vulnerable adult protection and abuse, although more specific behavioural guidelines need to be established to enable staff to appropriately deal with incidents of aggression to minimise the risk of service users being harmed or abused. EVIDENCE: The home has a detailed complaints procedure, which is available in a service user ‘friendly’ format and included in the homes Statement of purpose/guide. Two service users spoken with at length both said staff were on the whole very approachable and that they always felt they were listened too. This is backed up by the homes complaints log that shows that all five of the complaints made about the homes operation in the past twelve months were all investigated and promptly dealt with, in accordance with the service providers own procedures. All five complaints were either fully or partially substantiated, according to the complaints log, and resolved to the complainant’s satisfaction within 28 days. The home has a comprehensive collection of procedures for responding to allegations or suspicion of abuse, which were implemented when it was alleged that one service user physically struck another. Although the allegation was not proven the Deputy manager compiled some specific guidance for staff to follow when dealing with this particular individuals sometimes aggressive. Having discussed these behavioural guidelines with the deputy it was agreed that they needed to be expanded upon to set out in greater detail how staff were expected to manage such incidents in the future. The deputy said he has The Params (18) G53-G53 S25853 ParamsUI V203917 230805 Stage0.doc Version 1.40 Page 15 made a referral to the individual’s psychologist to agree some new risk management guidelines. The Params (18) G53-G53 S25853 ParamsUI V203917 230805 Stage0.doc Version 1.40 Page 16 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 standard(s) 26, 27, 28 & 29 The size, layout, and interior décor of the home ensure the service users live in an extremely homely, comfortable and atheistically pleasing environment. Mobility equipment and other facilities are in place to ensure service user have every opportunity to maximise their independence, although more specific guidelines will need to be established in respect of the homes new moving and handling equipment to minimise the risk of both service users and staff being harmed. The Params (18) G53-G53 S25853 ParamsUI V203917 230805 Stage0.doc Version 1.40 Page 17 EVIDENCE: Since the homes last inspection new carpet has been laid in the main entrance hall, stairwell, first floor smoking room and office. Having been invited to view two service users bedrooms with the occupant’s permission it was clear that the service users are able to bring their own furniture and other belongings with them when they move in. Both bedrooms viewed were extremely personalised with all manner of posters, photographs, ornaments and electrical home entertainment equipment, including televisions, and in one case, a home computer. Having tested the temperature of hot water running from a tap attached to the first floor bath nearest the smoking room it was found to be a safe 40 degrees Celsius at 11.00am. The mobility needs of one the homes oldest service users have been rapidly changing in the past twelve months and it was positively noted that the home had purchased a new bath seat and outside chair lift to try and meet them. The Deputy manager said the new moving and handling equipment had been approved by a qualified physiotherapist, but was unable to locate the relevant risk assessments. Furthermore, despite the co-proprietor and Deputy manager’s assurances that sufficient numbers of the current staff had been ‘suitably’ trained to use the new ‘Stairmatic’ chair no documentary evidence of this training was available on request. Having been in telephone contact with the relevant placing authority, the service users Care Manager has agreed to make a referral to the Social Services Occupational Therapy Department for a risk assessment of the chair to be carried out. In the interim, the homes Deputy has also agreed to undertaken a thorough moving and handling assessment and establish clear guidelines for staff to follow when using the chair. Documentary evidence of the training undertaken by staff who have been ‘authorised’ to use the chair must also be available for inspection on request. The Params (18) G53-G53 S25853 ParamsUI V203917 230805 Stage0.doc Version 1.40 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35 & 36 In the main the home ensures that sufficient numbers of ‘suitably’ experienced staff are on duty at all times to meet the health and welfare needs of the service users. However, sufficient numbers of staff still need to be suitably trained in the use of moving and handling techniques to ensure the health and safety of both service users and staff are protected. EVIDENCE: One member of staff spoken with at length said the homes policies and procedures are often discussed at team meetings, and that a new record has been introduced, which staff must sign and date, as evidence that they have read and understood the contents of these policy documents. The Deputy manager stated that five out of twelve members of the homes current care staff team had now achieved a National Vocational Qualification in care - level 2 or above, and that two others were on course to have completed their training by the end of the year. Furthermore, arrangements had already been made for another member of staff to commence their NVQ training by the end of September’05. The home is clearly committed to staff training and well on course to have at least 50 of its care staff team trained to an NVQ level by the end of 2005. The Params (18) G53-G53 S25853 ParamsUI V203917 230805 Stage0.doc Version 1.40 Page 19 There have been no changes to staffing levels since the last inspection, which remains adequate to meet the assessed needs of the service users. One member of staff said the home continues to employ at least three care workers during the day and one staff at night (waking). Four members of staff, including the Deputy manager, two carers and the cleaner, were all on duty at the time of this unannounced morning inspection. Both the homes co-proprietors and registered manager, who live in a separate property at the rear of the home, were also available at various times throughout the course of this visit. Since the last inspection the home has remained fully staffed and consequently the manager has not needed to recruit any new members. As required in the homes previous report up to date criminal records and protection of vulnerable adults (POVA) checks had been carried out in respect of the homes cleaner and most recent recruits. The Deputy has also produced a POVA first procedure. The Deputy manager has also recently undertaken a training needs assessment of his staff team, which shows that sufficient numbers have now received training in a variety of core practice skills relevant to the work they are expected to perform, including fire safety, first aid, basic food hygiene, person centred care planning, health and safety, and handling medication. Furthermore, arrangements have been made for the remaining 50 of the current staff who have yet to receive training in recognising, preventing and reporting abuse/POVA, to do so by the end of the year. As mentioned in a previous section the home has recently purchased some new moving and handling equipment to meet one service users changing needs. To ensure sufficient numbers of staff are suitably trained to meet this individuals changing needs all staff must attend an accredited moving and handling course and receive specific training in the safe use of the new ‘Stairmatic’ chair. Progress on these matters will be assessed at the homes next inspection. Supervision records sampled at random revealed that staff are receiving at least one formal supervision with the homes Deputy manager on a bi-monthly basis. The Deputy concedes that now the home is fully staffed he is finding it increasingly difficult to maintain this level of staff supervision. It is therefore recommended that sufficient numbers of the homes senior staff team attend a suitable course to be able to supervise their colleagues in future. The Params (18) G53-G53 S25853 ParamsUI V203917 230805 Stage0.doc Version 1.40 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 & 42 In the main the homes health and safety arrangements are sufficiently robust to ensure service users, their guests and staffs’ health and welfare are, so far as reasonably practicably, protected. Nevertheless, the homes water heating still needs to be tested on a more frequent basis to ensure compliance with Legionella. EVIDENCE: Mrs Isabel Parameswaran, as the registered manager and co-onwer of the Params, continues to be the named individual responsible for the service, although it is clear from the homes last three inspections that the Deputy manager, Cosmo Kapondeni, is becoming increasingly responsible for the homes day-to-day operation. 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 managering the home must have achieved this award by the end of 2005 to meet National Minimum Standards. Cosmos said discussions were still on-going with the proprietors about the possibility of The Params (18) G53-G53 S25853 ParamsUI V203917 230805 Stage0.doc Version 1.40 Page 21 him being appointed the homes manager with overall responsibility for the day-to-day running of the home. The proprietors position on this matter should be clarified and the Commission notified about the outcome. Cosmos has the necassary experience to undertake this role and the Commission would consider any registered managers application he may submit. Up to date Certificates of worthiness were in place as evidence that a ‘suitably’ qualified professional had checked the homes fire extinguishers in the past twelve months, although the homes water heating had not been tested for over a year to ensure compliance with Legionella. The homes fire safety risk assessments are up to date and the last fire drill was carried out in Apirl’05. The home has also purchased a new fire safety and prevention video, which all staff must view as part of their training. The Params (18) G53-G53 S25853 ParamsUI V203917 230805 Stage0.doc Version 1.40 Page 22 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 x x x 2 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x 3 3 3 2 x Standard No 11 12 13 14 15 16 17 x 3 x x x x 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Params (18) Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x x x x 2 x G53-G53 S25853 ParamsUI V203917 230805 Stage0.doc Version 1.40 Page 23 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 1 Regulation 5(1)(a) to (f) & (2) Requirement A service users guide to the home, which is seperate from the homes Statement of purpose, must be compiled, contain all the information required by the Standards, be available in a more service user friendly format, and copies supplied (or at least offered) to all the service users and the Commission. Previous timescale for action of 1st April 2005 not met in respect of the guide not being supplied to all the service users, both existing and prospective. Costed contracts must be up dated to accurately reflect the current range of fees the home charges for services and facilities provided. More specific risk/behavioural management guidance for staff to follow, agreed between a service user and all the relevant professionals involved with their care, need to be established and included in the individuals care plan. A qualified Occupational Therapist must undertake a Timescale for action 1st November 2005 2. 5 5(1)(b), (c) 1st November 2005 1st December 2005 3. 23 13(4) & 17(1)(a), Sch 3.3(q) 4. 29 13(4) (5) & 18(1) 1st October 2005 Page 24 The Params (18) G53-G53 S25853 ParamsUI V203917 230805 Stage0.doc Version 1.40 5. 35 13(5) & 18(1), Sch 2.4 13(4) 6. 42 moving and handling assessment of the homes new mobility equipment and clear guidelines established for its safe and appropriate use by staff. Sufficient numbers of staff must receive moving and handling training. Documentary evidence of this training must be avialable for inspection on request. The homes water heating must be checked by a suitably qualified engineer to ensure compliance with Legionella. 1st December 2005 1st October 2005 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. 3. Refer to Standard 32 36 37 Good Practice Recommendations 50 of the homes staff team (carers) should have achieved, or at least started, their NVQ level 2 or above in care by the end of 2005. Sufficient numbers of the senior staff team should receive training which will enable them to supervise their colleagues. The Deputy managers 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 by the end of 2005. 4. 37 The Params (18) G53-G53 S25853 ParamsUI V203917 230805 Stage0.doc Version 1.40 Page 25 Commission for Social Care Inspection Croydon, Kingston & Sutton 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 The Params (18) G53-G53 S25853 ParamsUI V203917 230805 Stage0.doc Version 1.40 Page 26 - 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. 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