Inspection on 12/12/08 for Ruby Home

This inspection was carried out on 12th December 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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Cherry Tree House

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Ruby Home 45 Kilburn High Road London NW6 5SB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Andreas Schwarz     Date: 1 2 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Ruby Home 45 Kilburn High Road London NW6 5SB 02073722346 02073722346 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Victoria Kujore Type of registration: Number of places registered: Maceile Care Management Ltd care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The Registered Person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding Learning Disability or Dementia - Code MD The maximum number of service users who can be accommodated is: 6 Date of last inspection Brief description of the care home Ruby Home is a registered care home, which is run and managed by Maceile Care Management Ltd. Maceile Care Management Ltd have another home in Willesden. Ruby Homes has been registered with the Commission for Social Care Inspection in July 2008 and the registered manager is Mrs Victoria Kujore. The home has six bedrooms, which are located on three floors. The home is located on Kilburn High Road and has no outside space such as garden or patio. Communal areas are located in the basement of the property. Fees and charges range from £670,00 to £1800,00 per week depending on service users needs. Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 6 Care Homes for Adults (18-65 years) Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection took place in December 2008 and lasted 7 hours. The registered manager was not available during this inspection. We were supported by the Team Leader Mr Jama during the key inspection. We spoke to one of the directors over the phone. We spoke to two members of staff and two people using the service. The Annual Quality Assurance Assessment (AQAA), has not been returned to us within the given timescale. We would like to thank everybody involved in the key inspection process. Care Homes for Adults (18-65 years) Page 6 of 31 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 31 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We looked at national Minimum Standards 1 and 2 during this inspection. People using the service are involved in the assessment process, which is done in detail and holistically. Evidence: We viewed the homes statement of purpose and service users guide, both documents have been updated and the change in ownership to Maceile Care Management Ltd has been included. Both documents are detailed and provide the required information about the service, which is provided by the home. The current inspection report is available on the noticeboard and staff told us that additional copies can be obtained. Staff told us that the home has introduced Ashton Care programme on the 9 December 2008. This computer programme allows staff to record anything relating to people using the service. Staff told us that the directors will train staff in how to use the programme safely and appropriately. Care Homes for Adults (18-65 years) Page 9 of 31 Evidence: The home has admitted one new service user since changing the registration in July 2008. We looked at two assessments during this inspection. Both assessments were very detailed and contained information about the persons needs, likes and dislikes. Assessments have been undertaken by the registered manager and directors. The deputy manager informed us that once the home is receiving referrals for new residents the referring authority is asked to fill out a referral form, detailing personal information about the prospective resident. Based on this referral the organization is visiting the person in their home and is undertaken a needs assessment on the person. Residents spoken to told us that they know about the assessment and that they have been involved in the process. The assessment is done holistically and looks at the persons mental and physical health, convictions, religious and cultural needs, etc. Care Homes for Adults (18-65 years) Page 10 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We assessed National Minimum Standard 6, 7 and 9 during this inspection. The service involves individuals in the planning of care, which affects their lifestyle and quality of life. Care plans are person centred and are agreed with the individual. The care plan is a working document reviewed regularly involving the person and their representatives, as appropriate. The home ensures that residents are consulted regularly to gather information about the home. Evidence: We assessed two care plans during this inspection. All care plans were detailed and included information about peoples needs and what procedures are put into place to support residents in meeting their needs. Care plans have been reviewed in regular intervals and reviews have been attended by the person using the service, their social worker, registered manager, psychiatrist and any significant others. The frequency of care plan reviews is depending on the needs of the individual, for example a person Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: who moved in recently, the home is planning to review the care plan on the 2nd January 2009. The second care plan we looked at has been reviewed in August 2008 and June 2008. People using the service tell us that they know about their care plans and regularly meet with their key worker to discuss care plan objectives. Care plans viewed address cultural, spiritual needs, mental health needs, medication, activities, etc. Care staff told us that they meet monthly with their key client to discuss care plan objectives and progress. Care plan files viewed did not confirm this. We recommend holding monthly key worker meetings regularly to allow residents to review their progress and up date any changes. The home is undertaken annual surveys, which enables residents to comment on the support and care provided. All residents living at Ruby Home provide positive feed back in the surveys. We observed residents coming and going during this inspection. People using the service told us that the home has no curfew. Each person has a community risk assessment, which states what actions the person has to take when out late at night. In most cases the person has to contact the home and inform the home of their whereabouts. Residents told us that they have regular meetings to discuss meals, activities and issues with co-tenants. We spoke to two people using the service all told us that they can choose what they would like to do, provided it is safe and it does not conflict with their mental health. The home does not manage peoples finances. Staff told us that they would however support people to manage their budget, if they have difficulties doing this independently. All assessed files had detailed risk assessments in place, issues around health, medication, accessing the community, behaviour, etc are assessed and guidance to manage the risk is given to staff. The deputy manager informed us that risk assessments are reviewed during the care plan review process or if risks have changed. We spoke to one person who told us that she was involved in the risk assessment process and said she knows why the risk assessments are in place. Care Homes for Adults (18-65 years) Page 12 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We looked at National Minimum Standards 12, 13, 15, 16 and 17 during this inspection. The service has a strong commitment enabling people using the service to develop or maintain their skills. People who use the services have the opportunity to develop and maintain important personal and family relationships. Clients are involved in meaningful daytime activities of their own choice and according to their individual interests. People using the service are involved in the domestic routines of the home. They take responsibility for their own room, menu planning and cooking meals, making sure that they are able to enjoy the food they prefer and like. The meals are balanced and nutritious and cater for the varying cultural and dietary needs of individuals. Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: We found in all care folders weekly activity plans; people using the service informed us that they have been involved in choosing the activities. One person is going to music classes at a local college, he told us that he is very happy there and want to continue with this. Another person told us that she is currently looking into a flower arranging course at local colleges. Activities are based on teaching and maintaining residents day to day skills such as cleaning their room, launder clothes, cook meals, etc. All people using the service spoken to tell us hat they are happy with the activities provided by the home. We noted that daily records do not reflect peoples participation in activities. This however should be possible once the new Ashton Care programme is working properly.The home is located on Kilburn High Road. The home fits in with buildings in the local community. People using the service use public transport facilities, this was observed during this inspection. One resident told us that she can vote in elections, but is not interested to do so. Currently two staff support the residents during each shift, we judge the current ratio as appropriate. The home is supporting people from different ethnic minorities and has employed staff from the same cultural background, to support communication. We noted that one of the care plans states that the person wants to go to church, this was confirmed by the person during this inspection. People using the service tell us that they have relationships and records in the visitors book showed us that families visit frequently. One of the residents has regular contact with her boyfriend and the home has put procedures in place to maintain safe contact. People using the service access the community freely, this enables them to make and maintain relationships with people outside the service. All residents living at the home have their own keys and can access their rooms and communal facilities whenever they wish to do so. We observed mail given to residents unopened. People using the service tell us that staff treat them with respect and interaction observed during this inspection were professional. People using the service are encouraged to maintain their own room, do their own cooking and laundry. One of the people living in the home is able to cook in her room independently, this has been risk assessed involving the person in this process. All of this has been observed during this inspection. The home has a non smoking policy. Residents can smoke outside or in a room specially build to smoke. We observed residents cooking the meals in the home. People using the service tell us that everybody has an allocated day to do the cooking. The meals provided reflect residents cultural, ethnic and religious background and wishes. We observed dinner preparation during this inspection, which was prepared by one resident and noted the nice smell going around the building. The fridge and freezer was well stocked and Care Homes for Adults (18-65 years) Page 14 of 31 Evidence: residents told us that they take part in purchasing ingredients and food. Care Homes for Adults (18-65 years) Page 15 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We looked at National Minimum Standards 18,19 and 20 during this inspection. People receive personal and health care support using a person centred approach. Personal support is responsive to the varied individual needs and preferences. Residents have access to health care and remedial services. Staff makes sure that those who are fit and well enough are encouraged to be independent, have regular appointments and visit local health care services. Staff have access to training in health care matters. The home has a medication policy which is accessible to staff. Medication records are generally up to date for each resident and medicines received, administered and disposed of are recorded. There is evidence of some people administering their own medication safely. Evidence: People living at Ruby Home are self-managing in their personal care; staff tell us that people using the service occasionally need to be reminded having a shower. All residents were nicely dressed during this key inspection. We observed people getting up in their own time. Staff contact people through a call system. Residents explained Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: to us that they are happy with this and that it helps them to get up if they have any appointments. The home has good links with the local Community Mental Health Team and health care professionals visit people using the service for care plan reviews and in emergencies. All residents have a designated key worker. Key workers liaise with significant others and meet with residents regularly. All files viewed had a detailed health action plan in place and visits to health care professionals are recorded. People using the service tell us that they have been involved in the health action plan and their wishes have been taken into consideration. The home is reporting significant events such as hospital admission to the Commission for Social Care Inspection. All residents are registered with a local General Practitioner. The home is arranging regular Care Plan Approach meetings (CPA), which are attended by psychiatrist, community psychiatric nurse (CPN), person, key worker, etc. Medication is stored in the office. Two people using the service self administer their medication, this has been risk assessed. People using the service told us that they have been involved in the risk assessment process. We observed staff asking a person to come to the office to take her medication in front of staff. Staff tell us that this part of the persons risk assessment to ensure she fully complies with the administration of medication. The medication administration sheet is handwritten, but does not include requirements from the the Royal Pharmaceutical Society, such as dose, allergies, name of drug, strengths, etc. The home must ensure to include this. The medication policy is of good standard. Staff attended medication training and a signatory list of staff competent to administer medication is available. The registered manager is undertaken regular medication audits. The home is not storing controlled drugs. Care Homes for Adults (18-65 years) Page 17 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has an open culture of dealing with complaints and residents are supported and encouraged to raise their satisfaction and dissatisfaction about the home. Adult protection guidance is robust and residents are protected from abuse, neglect and self harm. Evidence: The home did not receive any complaints since changing their registration with the CSCI. We looked at complaints records, which confirmed this. Previous complaints have been investigated and the registered manager has recorded outcomes as well actions taken. People using the service tell us that they would complain to manager, if they had any concerns. The complaints policy is detailed and compliant with National Minimum Standards. We viewed the incident file; incidences are clearly recorded and dealt with by the manager. Residents told us that they satisfied with the actions taken by the home. The home has a safeguarding adults policy in place. Training is ongoing, with the last training being done in June 2008. We looked at five staffing files, two of the files had evidence of safeguarding adults training. The home must ensure that safeguarding adults training is provided to all staff. The home had no safeguarding adults referrals since changing their registration. Staff spoken to demonstrated good understanding of whom and how to report safeguarding adults allegations. One member of staff told us Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: that he would record it and report it to the manager. The homes safeguarding adults procedure is compliant with National Minimum Standards. Care Homes for Adults (18-65 years) Page 19 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We looked at National Minimum Standard 24 and 30 during this inspection. People using the service live in a well maintained, clean and odour free home, which is fit for purpose and is meeting their needs. Evidence: A member of staff showed us around the building. On the ground floor of the home is a lounge/dining room. The kitchen is small, but all residents have a built in kitchen in their room. The home has extended the office space, this allows staff to do paper work and creates extra space for private meetings. Rooms are on three floors and all have en-suite and cooking facilities. Rooms exceed minimum requirements regarding space and are nicely decorated. One of the residents invited me to her room, which was comfortable, clean and decorated according to her choice. She told us that she is very happy with her room and bought furnitures, bedding by herself. We noted that there were no paper towels and soap in the communal toilet and kitchen, this is required. On the ground floor is the laundry room; the home is providing a washing machine/dryer for each room. People using the service have a rota of when to do their washing. Cleaning materials are locked away in the boiler cabinet. The home was Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: overall clean and free from any offensive odours during the day of this key inspection. Records show that the home was visited by the environmental health officer, requirements made have been implemented. The home has Health and Safety, infection control policies, etc. in place. Staff has received Health and Safety training. Care Homes for Adults (18-65 years) Page 21 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We looked at National Minimum Standard 32, 34, 35 and 36 during this inspection. People are generally satisfied that the care they receive is meeting their needs. The service recognizes the importance of training, and tries to deliver a programme that meets statutory requirements and the National Minimum Standards, records of these must be updated. The home is aware that there are some gaps in the training programme and plans to deal with this. People using the service report that staff working with them knows what they are meant to do, and that they meet their individual needs in a way that they are satisfied with. The service has a recruitment procedure that meets statutory requirements, but at times there are slippages, which could put people using the service in danger. Evidence: The home has four permanent support workers, one senior support worker, and one domestic help (21 hours) and one registered manager employed. We looked at the rota for the last two weeks. The home has two staff during the morning, two staff during the afternoon and one staff during the night on duty. The registered manager and senior support worker, work on opposite shifts, to ensure staff are appropriately supervised and supported. During the day of this inspection the registered manager Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: was on holiday. We found that on some occasions staff work on their own. This is quite concerning and can put staff and people using the service at risk. We discussed this with the director, asking him to forward an action plan to the CSCI. The following information was provided by the director: The home has over the past three months made significant attempts to recruit staff to the vacant positions within the home. Over the past three weeks we have interviewed three potential employees; unfortunately none of these were suitable for the home. The home continues to use various agencies, Job seekers, Reed Employment agency, to recruit the necessary staff for the home. We are confident that we will get the staffing level up to the required two staff each day time shift and one waking night by the end of January 2009. We have at this time five bank staff for Maceile Care Management Ltd, all are willing to provide cover over the Xmas and new year period. The team leader Mr Jama is on call for Ruby Home and will step in to cover in an emergency. Staff told us that they are happy with the staffing ratio and observations during this inspection showed that staff are not rushed off their feet and are able to attend to residents needs. Two staff are currently in the process of obtaining their National Vocational Qualification in Care and one member of staff and the registered manager completed this qualification. We spoke to one member of staff during this key inspection, who told us that he has completed his National Vocational Qualification in Care. We looked at five staff files during this key inspection, all but one file contained the required documentations such as Enhanced Criminal Records Bureau checks (CRB), two references, copy of passport, application form, in place. The file of the domestic assistant did not include a CRB check, we discussed this with the team leader and asked the home to forward a copy of the CRB check to the CSCI. Staff told us that they had to provide documentation for their CRB check and that he had an interview. The home has clear recruitment procedures in place, which are followed. We looked at training records, which were incomplete or not in place. We discussed this with the director who informed us in writing: During the last six months there has been a significant change in the staff team. The manager and team leader have been working on the training and development of staff but have fallen short of achieving the set timescales required for induction and mandatory training. As a company we have a commitment to training and developing our workforce. - All staff to receive a new updated training plan. - All staff to complete Mandatory Training via RED CRIER. Those staff that have not completed Induction to be assisted in completing by the end of January 2009. - Training Development Plan to be devised for the home to reflect the training needs of the home, staff and Organization. - On completion of Induction and mandatory courses staff to undertake level 3 NVQ. - Also staff to complete other recommended training via RED CRIER. Staff told us they had received Health and Safety training, Food Hygiene training, Fire training and induction training. We looked Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: at four induction records during this inspection; two of the records were completed. The home forwarded a training plan to the CSCI, the plan shows not all staff have received appropriate training. The CSCI was informed that plans are made to provide mandatory training to staff. We looked at supervision records during this inspection, which evidenced that supervisions are provided, a member of staff confirmed that he has received a supervision recently. His records showed that he has received three supervisions during 2008. This does not meet minimum requirements and we informed the team leader that the home must ensure to provide a minimum of six planned supervision per year. Care Homes for Adults (18-65 years) Page 24 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We looked at National Minimum Standards 37, 39 and 42 during this inspection. The manager has the required qualifications and experience and is competent to run the home. The manager has a clear understanding of the key principles and focus of the service, based on organizational values and priorities. They work to continuously improve services. Regular random checks take place to ensure that people live in a safe environment. Evidence: The manager informed us previously that she has completed her Registered Managers Award. She has attended internal Mental Health Training. Staff and people using the service spoke very positively about the help and support they receive from the manager. One staff told us that she is available when I need to ask any questions or I am not sure what to do. The company has changed to Maceile Care Management Ltd in July 2008 and has re-registered with the CSCI. Two new directors have been appointed, who have a proven track record in managing and running mental health Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: services. The home is conducting annual service users surveys; we sampled some of these surveys, which have been very positive about the care and service provided by the home. The home does not have an annual development plan in place. We looked at staff meeting records, staff meetings are done monthly. Issues such as service users progress, religious beliefs and observances are discussed during these meetings. Residents decided that they dont want to have regular meetings. We send on 19 August 2008 a Annual Quality Assurance Assessment reminder to the home, asking to have the AQAA returned by 4 November 2008. We did not receive a completed AQAA, which is required. We looked at a number of Health and Safety certificates during this inspection; all certificates are up to date and valid. Fire records are up to date and regular fire drills and fire safety checks are undertaken and records are of good standard. A fire risk assessment is in place and staff receives regular fire talks. Policies and procedures have been reviewed and updated and are compliant with National Minimum Standards. The home has done monthly Health and Safety checks in September and October 2008. The Health and Safety policy states that this should be done monthly, which is recommended. Care Homes for Adults (18-65 years) Page 26 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 The responsible person must 01/02/2009 ensure that Medication Administration Records contain information about strengths, dose, allergies, etc. As stated by the Royal Pharmaceutical Society. This is to ensure people using the service are safely administered their medication. 2 23 13 The responsible person must 01/02/2009 ensure all staff receive safeguarding adults training. This ensures all staff know how to report and record safeguarding adults allegation and people are protected from abuse. 3 24 13 The responsible person must 01/02/2009 ensure paper towels and soap is provided. Care Homes for Adults (18-65 years) Page 28 of 31 This reduces the risk of infections spreading and people using the service are appropriately protected. 4 34 19 The responsible person must 01/02/2009 ensure every body employed at Ruby Homes has an enhanced Criminal Records Check. This ensures people using the service are protected from unsuitable staff. 5 35 18 The responsible person must 01/02/2009 ensure that staff are provided with mandatory training. This ensures staff is skilled and trained to support and improve the outcomes for people using the service. 6 35 18 The responsible person must 01/02/2009 ensure induction training is completed within the 12week timescale. This ensures only skilled and trained staff work with people using the service. 7 35 18 The responsible person must 01/02/2009 provide an up to date training and development plan for all staff. This ensures training can be planned in advance and people using the service are provided with skilled and trained staff. Care Homes for Adults (18-65 years) Page 29 of 31 8 36 18 The responsible person must 01/02/2009 provided at least six planned supervision per year. This ensures staff are supported to improve the outcomes for people using the service. 9 39 24 The home must forward a completed Annual Quality Assurance Assessment to the CSCI, when asked for. This ensures the CSCI can make a judgment on the outcomes for people using the service. 01/02/2009 10 39 24 The responsible person must 15/02/2009 compile and provide an annual development plan to the CSCI. This is to ensure peoples views are taken into account when providing care and support. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 We recommend holding monthly key worker meetings regularly allowing people using the service to review their progress and up date any changes. The responsible person should ensure that the monthly Health and Safety check is undertaken regularly. 2 42 Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 31 of 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!