Inspection on 17/07/07 for Ronak Home

This inspection was carried out on 17th July 2007.

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 no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ronak Home 14/01/09

Ronak Home 01/07/08

Ronak Home 10/04/06

Ronak Home 11/08/05

Ronak Home 14/04/05

Ronak Home 15/10/04

Ronak Home 10/05/04

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 Ronak Home 120 Alderman`s Hill London N13 4PT Lead Inspector Jane Ray Key Unannounced Inspection 17th July 2007 08:45 Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ronak Home Address 120 Alderman`s Hill London N13 4PT 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) 020 8882 3586 020 8447 9105 MHJ Crausaz Ltd Elizabeth Coleman Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th April 2006 Brief Description of the Service: Ronak Home is operated by MHJ Crausaz Ltd. This company has other homes locally. This home is registered for ten adults, aged between 18 and 65 years, who have a learning disability. The majority of current service users are non-verbal and a number have a diagnosis of autism. The home is a semi-detached three-storey house with a garden. There are ten single bedrooms, of which eight are en-suite. The home is situated close to the facilities of Palmers Green and is opposite a large park. There are good public transport services locally. High staffing levels and some day services are provided by the company in line with the service users individual needs. The homes stated aims are to provide care and support to ten younger adults who have learning disabilities. At the time of the inspection the range of fees at Ronak were £1612 - £3334 a week. The provider must make information available about the service, including inspection reports, to service users and other stakeholders. Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 17 July 2007 and was unannounced. The inspection lasted for six hours and was the key annual inspection. The inspection looked at how the home was performing in terms of the key National Minimum Standards for Younger Adults and the associated regulations. The inspector was able to speak to and observe the support given to all of the nine current service users. The inspector was also able to spend time talking to the deputy manager as well as the two members of care staff who were working in the home. The inspector did a tour of the premises and also looked at a range of records including service users records, staff files and health and safety documentation. The home had provided the inspector with a completed preinspection questionnaire prior to the inspection. What the service does well: The home provides a high standard of care and support to a group of people with a range of complex and challenging needs. The home by working consistently and professionally with the people living in the home in partnership with other care professionals is able to support them to make significant progress with their personal development. The deputy manager and staff demonstrated a good knowledge of the people living in the home and were able to recognise their individual needs and how to respond appropriately to them. The residents were observed to be very relaxed within their home environment and there is an appropriate balance between enabling people to have a flexible routine based on their individual needs whilst also supporting them to ensure that their daily activities promote a healthy lifestyle. The residents are supported to have their individual needs met by a key working and care planning system that it working towards being person centred. The people living in the home have a good relationship with the staff and feel comfortable and confident to express their wishes using a range of communication to which the staff respond appropriately. Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 6 The residents are supported to access a range of educational and leisure activities based on their individual interests and this enables them to have participation in the local community. Some of the people living in the home have close contact with families and friends and this is promoted by the home. The residents dietary needs are met with a balanced and varied selection of fresh food that meets their health needs, tastes and cultural needs. The home has a well established and team of staff who are being supported by a deputy manager with a new manager appointed. The home is very comfortable and spacious and the residents each have a single bedroom that is personalised to their taste. The home also has access to a vehicle that is helpful in facilitating some of the community activities. The people living in the home are protected and supported by the effective use of policies and procedures including medication systems, adult protection procedures, comprehensive risk assessments and health and safety procedures. What has improved since the last inspection? The last inspection took place on the 5 August 2006 and this made 10 requirements and 3 recommendations of action that needed to take place in order to meet the National Minimum Standards for Younger Adults and the associated regulations. Of these all the requirements and two of the recommendations were fully met, although one of the requirements no longer applies to the service. Details of these improvements are as follows: • • • • • People in the service now have comprehensive assessments prepared by the home Actions agreed at the residents review meetings are now reflected in their care plans Care plans are being reviewed each month The risk assessments for the people living in the home are now comprehensive and address anger management Staff have now either received training on the protection of vulnerable adults or training is arranged Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 7 • • • • • • A deputy manager is now in post Most of the staff have received epilepsy training although some need this training refreshed Staff records are now well organised Most staff have now received the necessary health and safety training although a few need refresher training The fire doors are now closing appropriately Staff are receiving regular supervision What they could do better: Seven requirements and five recommendations have been made at this inspection. Two requirements and one recommendation were made under the heading choice of home. This is to ensure that a professional assessment is received prior to the person being admitted to the home and that staff receive training on makaton and refresher epilepsy training where needed. One requirement and one recommendation were made under the heading of individual needs and choices. These were to ensure that where a resident has a buzzer on their door that the reasons for this are addressed in the risk assessment and to further develop the person centred care plans. One recommendation was made under the heading of personal and healthcare to ensure staff remember to preserve the residents privacy at all time. A requirement was made in the section concerns, complaints and protection to ensure staff have completed training on positively supporting people who have complex challenging behaviours. The section on the environment one requirement was made to ensure the drainage, plumbing and lighting throughout the house is working properly. Two requirements and one recommendation were made in the section called conduct and management of the home to review the fire safety risk assessment, complete a quality assurance exercise and to ensure the few staff who have not had outstanding health and safety training have this made available in the rolling training programme. Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 8 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 9 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 Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1,2,3,4 and 5 were inspected. People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home can be assured that they will be assessed and that the service can meet their needs. New people moving to the home must have an assessment by a care professional and this information must be made available prior to the admission. EVIDENCE: I looked at the statement of purpose and service user guide. The statement of purpose contains all the appropriate information. The service user guide is in a user-friendly format and clearly explains what the home will provide. Four service user case notes were inspected and these all included a contract between the home and the resident and these had been signed as needed by the resident or an appropriate representative. The four case notes I inspected all had comprehensive assessments prepared by the staff in the home. These provided a good summary of the needs of each person and linked with the care plans. Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 11 Since the last inspection two permanent new residents have moved into the home. One had no record of an assessment prepared by a care manager prior to their admission. The staff explained that both the new residents had visited the home prior to their admission with relatives. One person had received respite care in the home. The admissions process is reflected in the statement of purpose. The staff spoken to said they had received training on meeting the needs of the people living in the home. This was reflected in the training records. It was however noted that some staff needed to have their epilepsy training updated and it is recommended that this is arranged with the learning disability team. It was also noted that the staff need some makaton training as this is used as a method of communication with several of the residents. Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 12 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7,8 and 9 were inspected. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home are supported to have a person centred care plan that reflects their individual wishes and within the home they are able to express their views on how they wish to lead their lives. EVIDENCE: I inspected four case notes for the people living in the home. Each person has detailed individual care plans that are focused on the individual needs of that person. These incorporate goals that are realistic and clear. Everyone living in the home has their care plan goals reviewed monthly to monitor their progress. All of the people living in the home had participated in a review meeting with their care manager in the last year. The record of this meeting had been prepared and was available in each persons case notes. It was positive to see that where action had been agreed at the meeting that this had been implemented and the details had been recorded in the persons care plan. Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 13 For example at the review for one of the men it was agreed that any challenging behaviour would be recorded in an ABC chart and this was recorded in his care plan and the charts were in place. One person has got a person centred plan and this included photos and drawings completed by the resident. He was very pleased with this care plan and was able to look at the pictures. It is recommended that this is extended to other people living in the home and that photos and pictures are used as most people are unable to read. The four people living in the home all had a named key worker. Two members of staff when asked about their key worker roles were able to describe fully how this is implemented. One person living in the home was able to tell me the names of his two key-workers and his care plan goals that he is aiming to achieve. All of the four residents whose case notes were inspected have complex behaviours. These people have a care plan or behavioural guidelines describing how the staff should most appropriately support them when they are angry or distressed. These guidelines were clear and helpful. One person had received specific help for anger management and this input had been incorporated into his care plan. The four residents whose case notes were inspected all included individual risk assessments covering all areas of potential risk and these identified what action the home would take in response to the identified risks whilst at the same time promoting each persons independence. These had been reviewed and were up to date. It was however noted that one person living in the home has a buzzer on her bedroom door to alert staff to when she is leaving her room. This needs to be incorporated into her risk assessment. Each person living in the service has a record of the individual arrangements in place to support them to manage their personal finances. Throughout the inspection the people living in the home were observed interacting with the staff and making decisions concerning their daily lives through the use if speech, gestures and sign language. This included choosing what they wanted to eat or drink and when they felt ready to go out. The staff showed a good understanding of what the person was communicating and were able to respond as needed. The record of the resident meetings was inspected. These took place on a regular monthly basis and discussed activities, food, outings, holidays and changes in the home. Pictures are used in this process to support communication. The deputy manager explained that one person attends a monthly selfadvocacy group and another person living in the home has been referred for an individual advocate. Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 14 Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 15 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 11,12,13,14,15,16 and 17 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people living in the home are supported to have full and active lifestyles that reflect their interests and offer opportunities for the development of new skills. They also enjoy contact with their relatives. EVIDENCE: The deputy manager explained that the people living in the home access a range of activities based on their individual needs and interests. One person attends a day centre on a full time basis. Two people go to college once or twice a week and another resident is enrolling at college. Most of the people living in the service have a programme of activities provided by the home as they are unable to attend centres or colleges due to their complex behaviours. These programmes include home based activities linked to independent living Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 16 skills, lots of outside exercise and use of community based facilities such as bowling, swimming and snooker. One of the residents was able to tell me how he enjoys a range of leisure activities that include seeing friends, going shopping eating out and going to the cinema. He also explained how he uses his bus pass. I looked at the records of each persons activities and could see they were supported to enjoy full and active lifestyles. The deputy manager explained that three of the people living in the home practice their religion and enjoy going to church. One of the residents explained how a volunteer comes to the home each Sunday to take him to church. The manager explained that they will all be going on holiday in two groups later in the year to Butlins and Centre Parks. The manager explained that most of the people living in the home have contact with their families. They are made welcome in the home or the residents are supported to go to their family homes. One of the residents was able to explain to me that he was being supported that weekend to go to Wales to visit a close friend. It was observed that there was a comfortable atmosphere in the home with the staff communicating appropriately with the residents. The people living in the home were observed to be relaxed with the staff. I was able to observe that the routine is flexible for the residents and that some choose to get up early and others got up later. The home has a four-week rolling menu and also keeps a record of the food eaten by the residents. I looked the record of the food eaten over the last two weeks and this offered a healthy and varied diet that also reflected the resident’s cultural needs. There was plenty of fresh fruit and vegetables available in the kitchen. Lunch was prepared during the inspection and was nutritious. The fridge and freezer temperatures are checked daily to maintain food safety. Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 17 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19 and 20 were inspected. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home can be assured that they will be assisted to access healthcare appointments to get the support they need. Medication systems within the homes are well organised. EVIDENCE: I observed during the inspection that the people living in the home were given support with their personal care based on their individual needs. The residents were all adequately dressed and groomed. Most of the people living in the home have en-suite bathrooms and this helps to maintain their privacy. I did however observe that one member of staff had to be reminded by the deputy manager to close the toilet door on behalf of a resident. The people living in the home were observed participating in domestic activities in the home including bringing down their laundry and cleaning their bedrooms. Their individual care plans also included how they were being Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 18 supported to develop their independent living skills. The staff were also able to describe how they support the residents to carry out their domestic activities. The healthcare records were inspected for the four people living in the home. They had all been supported to access the GP, dentist and optician for their primary healthcare checks in the last 12 months. In addition the residents receive input for their specialist healthcare needs and it is also positive to note that a number of other services including psychology and dietician input had been accessed as required for specialist advice. All the people living in the home are supported to check their weight on a monthly basis. The home uses a Lloyds dossette box medication system supplied by a local pharmacist. The medication administration records were inspected and are completed correctly. The medication entering the home is recorded appropriately on the medication administration record. There is a separate record for medication returned to the pharmacist. The medication available was correct. Some of the residents have PRN medication and guidelines are in place for when these should be administered. Training records were inspected and sixteen of the twenty-one permanent staff had received medication training. The staff who administer the medication have completed the training. The medication storage cupboard is in the lounge and the deputy manager explained that it is being replaced by the pharmacist to provide more storage space. The pharmacist is also providing a separate medication fridge. Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 were inspected. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home can be assured that the correct training and procedures are in place to protect them from the risk of being abused. EVIDENCE: I looked at the complaints record and saw that there had been no complaints since the previous inspection. An appropriate format is available to record complaints and this monitors the time taken to resolve the complaint. The complaints procedure was also inspected and this was in a format accessible for the residents. One person spoken to during the inspection said that he would feel comfortable raising any problems with the staff. The inspector saw that the home had a protection of vulnerable adults procedure prepared by the company. The staff training records were inspected and showed that all the permanent staff had either received training on the protection of vulnerable adults or had training dates booked in August. The staff training records also showed that thirteen of the twenty-one permanent staff had received training on how to work positively with service users who have complex challenging behaviours and training needs to be arranged for the rest of the team. Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 20 I spoke to two staff during the inspection and they both showed a good knowledge of the complaints and adult protection procedures. The inspector looked at the personal finances for two service users. These showed that their benefits were being paid directly into their building society accounts. There are records of expenditure with receipts available. Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24,25,27,28 and 30 were inspected. People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home are benefiting from an environment that is clean, tidy and homely. Work is needed to ensure all the plumbing and lighting is working properly in the home. EVIDENCE: I did a tour of the building and the home was clean and tidy. Residents had been supported to personalize their bedrooms. The furniture in the communal areas is designed to meet the needs of the service users by being strong and yet a style that is in keeping with the home. Each service user has a single room. Two service users have a futon bed, one because he had previously wanted to sleep on the floor and has been supported to move onto a low bed and the other because his epilepsy puts him at risk of falling. One service user who has mobility issues has a ground floor bedroom and a bathroom with a Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 22 shower and shower chair that meets his specific mobility needs. Hygiene is promoted in the home by antibacterial hand wash and disposable hand towels being available in shared bathrooms and toilets. The people living in the home frequently damage the fabric of the building. I was pleased to see a handyman working in the home to address the wear and tear. From observation and discussions with the deputy manager I was aware that there are problems with the drainage in the ground floor en-suite shower room and with flushing toilets on the ground floor of the home. It was also explained that there was only one bulb in the dining room light fitting and this is because more bulbs cause the electricity to go out. These issues need to be addressed. The flooring in the laundry needs to be replaced and the deputy manager explained that plans are in place to decorate this area. It was also observed that the fire doors throughout the home were appropriately closed. The deputy manager explained that the home does not yet have internet access. Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32,33,34,35 and 36 were inspected. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people living in the home are supported by a stable team of staff who have completed the correct recruitment checks and have received the appropriate training and supervision to perform their work to a good standard. EVIDENCE: I looked at the staff rota. The staff team consists of a manager, deputy manager and a team of carers and one bank carer. During the last six months six new staff have joined the team of which one transferred from another home in the company. The deputy manager explained that at the time of the inspection the service is fully staffed and does not use agency staff. The people living in the home need very high levels of support and have 1:1 or 1:2 staffing levels. This means that during the day there are about six care staff working. At night there are two waking night staff, one male and one female. In addition the home has a full time cleaner. Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 24 The deputy manager explained that ten of the staff have completed an NVQ in care and nine have started the qualification. This means that most of the staff team are appropriately qualified or are undertaking the appropriate qualification. The recruitment checks were inspected for four staff and these were in place including two references an application form, ID and visa where needed and a CRB disclosure. The contracts for four members of staff were inspected and these were all appropriately completed and signed, with the exception of one member of staff who is still in her probationary period. The record of staff team meetings was inspected and these meetings take place on a monthly basis and discuss a wide range of operational issues. The staff members spoken to during the inspection confirmed they attend these meetings. The induction records were inspected for four staff. These consisted of a comprehensive induction checklist to work through. Three of the staff had a record of completing this training. One member of staff has this training underway. The induction has been extended to include a workbook for new staff to complete in line with the TOPPS induction standards. The training programme arranged by the company was also inspected up to September and this provides a rolling programme for staff to access as required. The staff supervision records were inspected for four staff. The staff had all received regular individual supervision, which covered work practice, key working, team issues, training and goals. Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 25 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37,38,39 and 42 were inspected. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users can be confident that the home is overseen by an experienced acting manager and a permanent manager has been recruited. Their health and safety is protected by the appropriate measures being in place although work the fire safety risk assessment needs to be reviewed to include all the fire safety measures. EVIDENCE: A manager has been recruited to manage the service and will come into post once the recruitment checks are in place. In the meantime the deputy Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 26 manager is managing the service and she was observed to be undertaking this role in a calm and capable manner. The registered person monthly monitoring visits to the home have been delegated to other managers and are taking place as required with the reports being sent to the CSCI. The latest quality assurance information was inspected. This was completed in July 2006. Questionnaires had been completed by staff acting on behalf of the service users and by staff themselves. The outcomes from this have been summarized in to action plans. A new quality assurance system has been made available in the home that has a user-friendly format and this needs to be implemented later in the year. The health and safety training records were inspected for all staff. They had mostly completed training on fire safety, moving and handling, infection control, food hygiene and health and safety. The training matrix identifies the few staff who still need training and this needs to be picked up in the rolling training programme later in the year. The fire safety measures were inspected. The fire appliances and fire alarm had been serviced. Weekly fire alarm and emergency light checks and monthly drills are recorded as taking place. A fire safety risk assessment is available but needs to be amended to include all the measures taken to ensure fire safety in the home such as training, drills, alarm checks, electrical and gas checks etc. A fire safety emergency plan is available and displayed to be used if required. The current certificates were available to confirm the maintenance for the gas system, electrical installations and portable electrical appliances. The insurance certificate for the home was inspected and was satisfactory. The record of accidents and incidents was inspected and these are all recorded appropriately. Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 2 3 2 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 x 27 3 28 3 29 x 30 3 STAFFING Standard No Score 31 x 32 4 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 2 x LIFESTYLES Standard No Score 11 3 12 3 13 4 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 2 x x 2 x Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? NO 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 YA2 Regulation 14(1)(a) Requirement The registered person must ensure they receive an assessment from an appropriate care professional prior to a person being admitted to the home. The registered person must provide the staff with makaton training. The registered person must ensure that where a person has a buzzer on their bedroom door that this is incorporated in their risk assessment. The registered person must ensure all the staff have received training on how to support the people with their complex challenging behaviours. The registered person must ensure that building work is carried out to ensure the drainage, plumbing and lighting is working properly throughout the home. The registered provider must undertake the annual quality assurance exercise. The registered person must review the fire safety risk DS0000010634.V341855.R01.S.doc Timescale for action 31/08/07 2. 3. YA3 YA9 18(1)(c) 13(4) 31/10/07 31/08/07 4. YA23 18(1)(c) 31/10/07 5. YA24 23(2)(b) 30/11/07 6. 7. YA39 YA42 24(1)-(3) 23(4) 30/11/07 30/09/07 Ronak Home Version 5.2 Page 29 assessment to ensure it includes all the necessary fire safety measures. 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. 4. 5. Refer to Standard YA3 YA6 YA18 YA37 YA42 Good Practice Recommendations The registered person should ensure that where staff need their epilepsy training refreshed that this is arranged. The registered person should extend the implementation of person centred planning. The registered person should ensure that staff are aware of the importance of respecting each residents privacy at all times. The registered person should consider providing internet access in the home to ease communication both within the organisation and with other external organisations. The registered person should ensure the rolling training programme picks up all the outstanding health and safety training needed by the staff team. Ronak Home DS0000010634.V341855.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Harrow Area Office 4th Floor, Aspect Gate 166 College Road Harrow London HA1 1BH National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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