Inspection on 27/04/06 for Perrymans

This inspection was carried out on 27th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Perrymans 25/09/07

Perrymans 29/11/05

Perrymans 08/07/05

Perrymans 15/01/05

Perrymans 02/08/04

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 Perrymans 56a Abbey Road Barkingside Ilford Essex IG2 7NA Lead Inspector Jackie Date Unannounced Inspection 27 April to 26th May 2006 10:00 th DS0000025917.V292355.R01.S.doc Version 5.1 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 DS0000025917.V292355.R01.S.doc Version 5.1 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. DS0000025917.V292355.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Perrymans Address 56a Abbey Road Barkingside Ilford Essex IG2 7NA 020 8518 1058 020 8518 1058 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) perrymans@mcch.org.uk Maidstone Community Care Housing Society Limited (MCCH) Mr Robert Richard Mapother Care Home 6 Category(ies) of Learning disability (6) registration, with number of places DS0000025917.V292355.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Clients with learning disabilities and associated physical disabilities. To include one named person over 65 with PD Date of last inspection 29th November 2005 Brief Description of the Service: Perrymans is a home for six adults with severe learning disabilities and some physical disability. Residents have little or no verbal communication skills, and very limited ability to make decisions about their lives. They all need a lot of support from staff for every aspect of their daily life. The home was purposebuilt on one level and is accessible to wheelchair users throughout. The house is in Newbury Park close to bus routes, the station and local shops. Bathrooms and toilets are adapted to be suitable for residents with limited mobility. Each resident has their own bedroom that is decorated and personalised according to their likes. There is a lounge/dining area and a garden with patio areas. Most residents go to some day activities outside the home on one or two days of each week. At the time of the visit four ladies and two men were living at the home. MCCH was not able to provide details of the fees for individual occupancy. DS0000025917.V292355.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection visit lasted for about seven hours and took place from 10 am. The manager, staff and two of the residents were spoken to. All of the communal rooms in the house were seen and staff, care and other records were checked. Care staff were asked about the care that residents receive, and were also observed carrying out their duties. Due to the level of their disability the residents were not able to give any direct feedback about the care that they receive and some of the relatives and other professionals were contacted and asked for their opinions of the service. Feedback was received from two relatives. The inspector also attended a staff meeting. This was a key inspection and all of the key inspection standards were tested. What the service does well: What has improved since the last inspection? What they could do better: Residents need to have more activities both in the home and in the community so that they have an interesting and fulfilling lifestyle. There needs to be sufficient staff to support them in this. DS0000025917.V292355.R01.S.doc Version 5.1 Page 6 Medication needs to be more carefully administered to ensure that residents get the right medication safely. A lot of work is needed in the house to ensure that residents live in a comfortable and pleasant home that is suitable for their needs. This includes some redecoration, new carpets, a more suitable specialist bath and additional storage space. 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. DS0000025917.V292355.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000025917.V292355.R01.S.doc Version 5.1 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 the following standard(s): 2 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. Information is available to enable the staff team to meet residents’ needs. If a vacancy arose the required information would be gathered on a prospective resident and they and their relatives could spend time in the home to find out what it would be like to live there and to enable the resident to make a choice about living in the home, within their capacity to do so. EVIDENCE: There have not been any new admissions for a couple of years. The organisation has an admissions procedure that includes gathering of information and assessments. It also contains details of how a prospective resident would be introduced to the home. The staff are aware of this and would be able to assess and introduce a new resident to the home if needed. Each resident has a care plan that contains information about what they can do, their likes and dislikes and what help and support they need. The staff team know residents well and know what they can do, their likes and dislikes and what help and support they need to meet these needs. The residents are unable to comment on what it is like to live in the home, but those seen appeared to be happy and relaxed. DS0000025917.V292355.R01.S.doc Version 5.1 Page 9 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 and 9 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. Residents’ plans contain detailed information so that staff can meet their needs. The residents’ plans and risk assessments have been reviewed and therefore contain up to date information about their needs. EVIDENCE: DS0000025917.V292355.R01.S.doc Version 5.1 Page 10 All of the residents have plans, which cover the necessary areas and include religion, culture, mobility, personal care, eating and drinking. The plans give details of how each person needs/likes to be supported. There are also primary care guidelines. These give more detailed information about eating, drinking, personal hygiene and morning and evening routines. For example, one resident likes to stay up late at night. The degree to which residents can be involved in the development of the plan is very limited due to their profound learning and communication difficulties. Each resident has a diary and the staff record details of what the person has done and progress towards individual goals. The residents’ plans have been reviewed and minutes were available in the files seen. At the time of the last inspection a relative confirmed that they had been part of the review. A representative of the day service also attended. The previous inspection strongly recommended that key workers attend residents’ reviews and are involved in the whole process as they are the main link between the home, relatives and other services. In addition they also work more closely with their key resident and prepare the reports. Key workers will now attend future reviews as far as possible. Residents’ monthly evaluations are completed by key workers and used to monitor the service provided to residents and also to provide information for the reviews. Copies of the reports were in the residents’ files and they cover all areas of their care. There are risk assessments in place. These identify risks for the residents and indicate ways in which the risks can be reduced to enable the residents needs to be met as safely as possible. For example, the support a resident needs to get on the bus or when in the kitchen. The risk assessments have been reviewed and were up to date. In the files seen old risk assessments had been separated from older information to ensure that staff have easy access to correct and up to date information. DS0000025917.V292355.R01.S.doc Version 5.1 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 the following standard(s): 11, 12, 13, 14, 15, 16 and 17 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to the service. The residents are encouraged to take part in activities and to be part of the local community but these activities are limited, particularly at the weekends. Residents are supported to keep in contact with their relatives and relatives are welcomed at the home. Residents are given meals that meet their needs and individual preferences. EVIDENCE: All of the residents need support from the staff team when they go out. Most of the residents go to day services for part of the week and go out for lunch and go to the local shops and markets. Some of the residents go to church on Sunday. An aromatherapist visits twice per month and most of the residents have this. One resident in particular really likes aromatherapy. However feedback from some staff and relatives was that activities are limited, DS0000025917.V292355.R01.S.doc Version 5.1 Page 12 particularly at weekends. Also that activities within the home are limited. The inspector visited the home on three occasions during the course of the inspection period and did not observe any of the residents that were in the home, being engaged in any activities. Suitable activities must be provided in the home and residents must be supported to participate in a range of activities in the community. This will mean that residents will enjoy a more fulfilling lifestyle. All of the residents had holidays last year and planning for this years holidays has begun. At the time of the first visit two of the residents had gone to Centre Parcs accompanied by staff and one of their mothers. This relative was very pleased to have been able to go on holiday with her son, something that would not have been possible without the support of the staff team. Two of the residents have a lot of contact with their families. The mother of one resident comes to lunch every Sunday and staff also take this resident to visit his mother each week. Another visits her family each Saturday. The residents are encouraged to make choices in as far as they are able. One resident can ask for a drink and make her wishes known. For example she had indicated that she wanted her hair done and this request was passed on to staff at the staff meeting. A service user from a local Day Centre comes to the home for one day each week and helps in the garden. During the course of the visit he was observed making drinks for himself and talking to staff. It was evident that he is comfortable working at the home, enjoys his time there and that his contribution is valued. Menus are nutritious and varied and are based on staff knowledge of residents’ likes and dislikes. Meals are homemade as far as possible. One of the residents receives her food via a “PEG” feeding tube and staff have been trained to do this. Two other residents now have to have their food liquidised. Instructions on how this needed to be done are in the kitchen along with a picture of a liquidised meal showing that each item should be liquidised separately so that residents can still enjoy the taste of different foods. DS0000025917.V292355.R01.S.doc Version 5.1 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 the following standard(s): 18, 19 and 20 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to the service. Residents receive personal care that meets their individual needs and preferences and the staff team support them to get the healthcare that they need. The manager and staff team need to monitor the administration of medication more tightly to ensure that the residents are given prescribed medication safely. EVIDENCE: The residents all require a lot of support with their personal care and details of the help that they need and how they prefer to be supported are in their “primary care” guidelines. One care plan states, “give her a choice of clothes”. Daily records show that residents are changed during the night when needed. On the day of the visit residents seen looked clean and well dressed. At the time of the previous inspection some concerns were raised with regard to the personal hygiene of one of the residents and feedback received was that “this has improved but does depend on which staff are on duty”. There was also a message in the homes communication book that the sister of one of the residents had phoned to say that she was pleased with the way the resident had looked when she went home for a visit. The requirement with regard to DS0000025917.V292355.R01.S.doc Version 5.1 Page 14 personal care has therefore been met but will be monitored during future inspections and feedback will be sought on this subject. Residents’ personal care needs are met. All of the residents go to the local doctor and specialist help is received when needed. Staff take residents to all of their medical appointments. Residents’ files have details of health care issues and show that residents have regular access to health care professionals. Records are kept of medical appointments and these show that residents have checks from the optician, dentist and when needed the chiropodist. During the staff meeting that the Inspector attended residents’ health needs were discussed and staff were given full information about an injury to one resident’s hand and also the seizures that led to this. Staff were following this up and the appropriate doctor was being contacted for an appointment. Therefore residents’ health care needs are being met. None of the residents are able to self medicate and medication is administered by staff that have been trained and deemed capable to do this. The organisations medication procedure requires that a second member of staff witnesses medication administration. Earlier this year a medication error was made and the appropriate action was taken. An investigation was carried out and one member of staff is not administering medication until they have received further training and been reassessed as competent. One of the residents receives medication via a PEG feeding tube and this process was observed during the inspection. A member of staff confirmed that they had received training about using the PEG feeding tube and was able to explain what they needed to do and why. They also encouraged the resident to be involved in the process by holding that tube and telling her what was happening. Medication is checked during the handover process to ensure that it has all been administered. However examination of the MAR (medication administration record) found that this was not always appropriately completed and the information in it was not always clear. There were some gaps when medication had not been signed for. One resident’s medication stated that they should be given between 10 and 20 mls of paracetamol but there was no record of how much the person is actually given. The manager said that they always give 20 mls. For another resident the record indicates that they should be given five spoons but the actual dosage is not specified. These issues were discussed with the manager at the time of the visit and the need for the organisations medication procedure to be followed and for the administration of medication to be closely monitored was stressed. Medication must be safely administered to ensure that residents receive the correct medication and to minimise the risk of an error. All staff have a responsibility for this and need to raise anything that is not clear and any gaps in recording. DS0000025917.V292355.R01.S.doc Version 5.1 Page 15 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 and 23 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. There is a complaints procedure that would be followed in the event of any complaints being made. Staff are aware of issues of abuse and work to protect residents from abuse. EVIDENCE: There is a complaints procedure. However due to the degree of their disability is unlikely that any of the residents would be able to make a complaint without support. The residents have been enrolled with the local advocacy service but at the present time there are not any advocates available to work with the residents. The organisation has produced a detailed adult protection policy that tells staff the actions to take in the event of abuse/suspected abuse being discovered. Staff have attended a course on protecting residents from abuse and are aware of their responsibility to residents. In the past the appropriate action has been taken when there has been a suspicion or allegation of possible abuse. All of the residents need help with their finances and do not have the capacity to understand about the concept of spending or saving money. Records are kept of financial transactions. Regular checks are made at the staff handover to ensure that these are correct. Residents’ finances checked at the time of the inspection were correct and appropriate receipts were on file. There are safeguards in place where large expenditures of personal money is being spent DS0000025917.V292355.R01.S.doc Version 5.1 Page 16 on behalf of a resident, and where the resident is not able to fully understand or contribute to the decision-making process. DS0000025917.V292355.R01.S.doc Version 5.1 Page 17 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, 25, 26, 27, 28, 29 and 30 Quality in this outcome area is poor. This judgment has been made using available evidence including a visit to the service. The residents live in a home that is suitable for their needs. However several areas require new carpets and redecoration in order to meet acceptable standards. The proposed improved specialist bath for residents’ use has not been fitted and therefore the bathing facilities do not adequately meet residents’ current needs. EVIDENCE: DS0000025917.V292355.R01.S.doc Version 5.1 Page 18 The house is near to the local shops and bus routes. The communal space consists of a large lounge/diner, kitchen, laundry room and a garden. The building is accessible for wheelchair users throughout. Each resident has a single bedroom that is suitable for his or her needs. New furniture has been purchased for three of the bedrooms and this was being stored until decoration had been carried out and new carpets fitted. The office is also used as a sleeping in room with a separate shower for staff. There have been a lot of problems with the heating system and this has resulted in several repairs being made and new radiators being fitted. This work was almost completed. The leaking radiators have caused damp in some of the bedrooms and the wallpaper to peel off in places. The previous inspection required that any bedrooms with damaged wallpaper must be redecorated. The timescale for this requirement has not yet been reached. The manager said that the decoration had been delayed because they needed to make sure that the repairs and replacements to the heating system were sufficient. The bedrooms with damaged wallpaper must be redecorated so that residents live in a comfortable and homely environment. Carpet, particularly in the corridors, has been damaged when repairs have been carried out. In places the carpet had been taped down for safety. The organisation is in discussion with the housing association about a claim for replacement being made to the insurance company. At the time of the visit the manager was informed that this was a health and safety risk and must be addressed within four weeks. In addition to this the carpet in one of the bedrooms has several stains on it due to spillage when the “PEG” feeding machine is being used. This carpet needs to be replaced and the manager confirmed that this would be done. This was also a requirement of the previous inspection and again the timescale for completion has not yet been reached. Again this work must be carried out to ensure that the residents live in a safe, comfortable and homely environment. There are enough baths, showers and toilets and these are adapted to meet the residents’ needs. At the time of the last visit the Inspector was told that the bathroom would be completely renovated in the line with recommendations made by the GP and an occupational therapist. This included a new specialist bath. However the bathroom has been retiled and new flooring laid but a new bath has not been fitted. The manager said that there had been some written information about the need for a different bath but that this had been sent with the request for the new bath. At the time of the inspection there were not any plans to replace the bath. Suitable adaptations, equipment and facilities must be provided to meet the needs of the residents. Therefore if the assessment has been made that the bathing facilities are no longer appropriate to meet the needs of the current residents then the bathing facilities must be replaced. This will ensure that residents are safely bathed using the most appropriate equipment. In addition it will minimise any risks to staff during the process. DS0000025917.V292355.R01.S.doc Version 5.1 Page 19 The home also has a shower room that has a lot of loose tiles. These must be properly fixed or replaced so they do not present a danger to residents. At the staff meeting staff reported the problem with the tiles and also raised other repairs and items that needed replacing. For example crockery and the kettle. Sufficient and suitable kitchen equipment and crockery must be available to safely and hygienically meet residents’ needs. It was apparent that staff are concerned for the welfare and safety of the residents and about standards within the home. However these issues do not seem to be raised as and when they occur. There must be a system in place to ensure that any repairs, including minor repairs, and any items needed are identified at an early stage. This will ensure the residents are in a safe environment that has the necessary items to meet their needs. Due to the needs of the residents the home has a lot of items that need to be stored but there is very little storage space. This has been discussed previously and it was suggested that a shed be purchased for storage. However this has not happened. Sufficient storage space must be available so that items are appropriately and safely stored and that residents’ bedrooms and communal areas do not become cluttered. This was a requirement of the previous inspection but the timescale for completion has not yet been reached. Since the visit it has been agreed that a shed can be purchased and this will be monitored in future inspections. During the course of the team meeting staff raised the issue of cleaning and discussed and agreed some changes to the way the cleaning is done. From the discussions it was evident that staff present were committed to ensuring that there are acceptable standards of cleanliness and hygiene at the home. At the time of the inspection the home was adequately clean, with the exception of the stained carpets, and free from offensive odours. DS0000025917.V292355.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to the service. Staff are competent and receive the necessary training to meet residents’ current needs and provide an appropriate service for them. However staffing levels need to be reviewed to ensure that they are sufficient to allow for this. Staff are properly recruited and the necessary checks carried out. This helps to protect residents and keep them safe. In addition to informal support staff now receive regular formal supervision and regular staff meetings are held. This gives a chance for work practice and the development of the service to the discussed. EVIDENCE: The staff team all have experience of working with people with learning disabilities. As at the previous inspection there are still staff vacancies but regular relief staff and a casual worker cover these. Therefore the residents are receiving a service from a consistent group of staff. Staff on duty said that they had received training since they started work in the home. This has included induction, adult protection, manual handling, and medication and in some cases NVQ. They also said that the training programme for the coming DS0000025917.V292355.R01.S.doc Version 5.1 Page 21 year was available and that they have been looking at this and will be discussing training needs in supervision. Staff were clear about their duties and responsibilities towards the residents. Four staff have attained NVQ level 3 and two are studying for a learning disabilities degree at Havering College. In addition to this one staff is doing NVQ level 2 and two others are about to start this. Therefore a competent and appropriately qualified staff team supports the residents. The usual staffing is three staff on the early shift, two staff on a full late shift and one staff working from 3 p.m. to 7:30 p.m. At night there is one waking night staff and one sleep in staff. The person on the shorter late shift is responsible for the cooking and assists with getting some people ready for bed. One resident likes to go to bed straight after the evening meal. Feedback from staff was that the staffing levels are sufficient but that it is very difficult to do all of required tasks for the 3 p.m. to 7:30 p.m. shift. Other feedback was that there did not appear to be sufficient staff to cover both residents going out regularly and supervising those that remained at home and that this contributed to the limited activities as stated in the section on lifestyle earlier in the report. Therefore staffing levels must be reviewed and the registered person must demonstrate how staffing levels meet all of the residents’ assessed needs. The organisation operates an appropriate recruitment procedure. Jobs are advertised, application forms completed and interviews held. The necessary checks are undertaken prior to staff commencing employment. Staff records are held centrally at the organisations head office in line with an agreement made with the Commission. Staff spoken to also said that since the last inspection they had been receiving regular supervision and that staff meetings have been happening regularly. They said they found this very helpful and that both the manager and deputy are very approachable and “that you can talk to them”. Regular supervision and staff meetings were requirements of the last inspection and these have both been met. Therefore the staff team receive the support and guidance that they need to carry out their duties. DS0000025917.V292355.R01.S.doc Version 5.1 Page 22 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, 39 and 42 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to the service. The home is well managed and with the exception of the damaged carpet a safe environment provides a safe environment for the residents. The manager and organisation monitors the quality of the service provided to residents to check if their needs are being met. EVIDENCE: The manager has a lot of experience of working with people with learning disabilities and of managing residential services. He has successfully completed NVQ levels 2 & 3 and is now doing NVQ level 4 in care and management. Feedback from staff and relatives was that the manager is approachable and supportive. Also that he will deal with any issues or problems that arise. The home is appropriately managed. DS0000025917.V292355.R01.S.doc Version 5.1 Page 23 The quality of the service provided to the residents is monitored by the home manager and by the organisation. The last time that the standard on quality was checked the service manager was carrying out monthly monitoring visits to assess how effectively the home was operating to meet its stated aims and objectives, and reports were written. These indicated the action to be taken when deficiencies are identified. Copies of these reports were available in the home and copies were sent to the Commission. However since the last inspection these visits have not been carried out regularly and were not done in February or March 2006. The manager said that quality assurance was a priority to the organisation and that the issue of these visits had been discussed. As result of this another person had been appointed to carry out the visits from April 2006. The visit for April had been done. The visit for May was being carried out when the Inspector went to the home to give some feedback to the manager. Therefore a requirement has not been made with regard to this and further checks will be made at the next inspection to ensure that the registered provider monitors the service appropriately and that the residents are provided with a good quality service that meets their needs. All of the necessary health and safety checks are carried out and with the exception of the damaged carpet in the corridors a safe environment is provided for the residents. The section of the report on the environment gives further information about the carpet and a requirement been made there. DS0000025917.V292355.R01.S.doc Version 5.1 Page 24 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 X 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 2 25 3 26 2 27 2 28 2 29 2 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 3 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 2 13 3 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 2 X DS0000025917.V292355.R01.S.doc Version 5.1 Page 25 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 YA14 Regulation 12 Requirement Suitable activities must be provided in the home and residents must be supported to participate in a range of activities in the community. Medication must be safely administered and medication administration records appropriately kept. Sufficient storage space must be available so that items are appropriately and safely stored. Loose tiles in the shower room must be properly fixed or replaced. Sufficient and suitable kitchen equipment and crockery must be available. There must be a system in place to ensure that any repairs, including minor repairs, and any items needed are identified at an early stage. The stained bedroom carpet must be replaced. The carpet in the corridors must be replaced. The bedrooms with damaged DS0000025917.V292355.R01.S.doc Timescale for action 30/09/06 2. YA20 13 30/06/06 3. YA24 18 30/06/06 4. 5. 6. YA24 YA24 YA24 23 18 23 30/06/06 31/07/06 31/07/06 7. 8. 9. YA26 YA28 YA26 23 23 23 30/06/06 31/05/06 30/06/06 Page 26 Version 5.1 wallpaper must be redecorated. 10. 11. YA27 YA33 23 18 The bath must be replaced with one that meets the assessed needs of the current residents. Staffing levels must be reviewed and the registered person must demonstrate how staffing levels meet all of the residents assessed needs. 30/09/06 31/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000025917.V292355.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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 DS0000025917.V292355.R01.S.doc Version 5.1 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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