Inspection on 21/10/08 for St Mungos Association

This inspection was carried out on 21st October 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

St Mungos Association 06/11/06

St Mungos Association 25/10/05

St Mungos Association 19/07/05

St Mungos Association 19/01/05

St Mungos Association 03/09/04

Similar services:

Agar Grove & St Augustine`s Alcohol Treatment & Rehab

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Haven (The)

Charis

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Rugby House Project

City Roads Crisis Intervention

Extracts from inspection reports are licensed from CQC, this page was updated on 17/12/2008.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: St Mungos Association 53 Chichester Road London NW6 5QW     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: Julie Schofield     Date: 3 1 1 0 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 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 30 Information about the care home Name of care home: Address: St Mungos Association 53 Chichester Road London NW6 5QW 02076244453 02073282438 mick.dunne@mungos.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Micheal Dunne Type of registration: Number of places registered: St Mungo Association care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 past or present alcohol dependence Additional conditions: The maximum number of service users who can be accommodated is: 27 The registered person may provide the following category 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: Past or present alcohol dependence - Code A Date of last inspection Brief description of the care home Chichester Road is one of a number of projects run by St Mungos Association. It is a wet home for men and women with alcohol dependency needs and is registered to accommodate 27 service users, many of whom have been rough sleepers. Staff provide encouragement and support, including assistance with personal care and help with managing finances. Staff give information and support in respect of the service users health care needs and advice regarding the importance of eating well is supplemented by the appetising meals offered. There is a life skills worker who organises a programme of activities, both inside and outside the home. There are bedrooms and bathrooms on the ground, first and second floor. There is a lift that links Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 27 Brief description of the care home the ground and first floor and there is a TV room, where drinking alcohol is prohibited, a games room, where drinking alcohol is permitted, and a dining room on the ground floor. Service users use the garden areas at the front and the back of the building when the weather is fine. Details regarding fees may be obtained from the home, on request. Care Homes for Adults (18-65 years) Page 5 of 30 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: The inspection took place over 2 visits to the home in October 2008. The first visit started at 8.45am on a Tuesday and finished at 12.30pm. The second visit started at 9.00am on a Friday and finished at 1.35pm. The Inspector would like to thank the manager, deputy manager, members of staff and residents who took part in the inspection. During the visits discussions took place with managers, staff and with residents. An examination of records took place. The care pathways of a number of residents were case tracked. An inspection of the premises took place. Compliance with the statutory requirements identified during the previous key inspection was checked and a plan of changes for the future was discussed. At the time of writing this report we had received 7 completed survey forms from residents. Care Homes for Adults (18-65 years) Page 6 of 30 Care Homes for Adults (18-65 years) Page 7 of 30 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 8 of 30 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 9 of 30 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. A comprehensive assessment of the needs of the resident, prior to admission to the home, enables the home to determine whether a service tailored to the individual needs of the resident can be provided. A trial visit to the home gives the prospective resident an opportunity to sample life in the home and to decide whether the service provided is suitable. A full recording of the observations made during the trial visit would enable the home to demonstrate that the decision to confirm the placement took into account all available information. Evidence: Two case files relating to residents that had moved into the home during the 12 months prior to this inspection were examined. It was noted that each file contained information provided, prior to the admission of the resident. Referral forms were accompanied by information from health care and social care professionals, including a report from the social worker and a copy of the FACE overview assessment. There was evidence that residents had been involved in the assessment process. The manager of the home also carried out a pre admission assessment of the prospective resident Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: before a decision was made regarding whether the trial placement could be confirmed. Before a resident is admitted to the home the resident visits the home for a 3 day trial period. At the end of the trial period the resident may stay if the resident, the home and the funding authority are satisfied that the placement is able to meet the needs of the resident. A record is kept of the trial period and a copy of this was present on each of the case files examined. The form consists of recordings on each of the 3 days and includes comments in respect of diet, personal care, finances, interpersonal skills, alcohol use, mental health and medication. However, we saw that although one of the files contained observations made on each of the 3 days the other file contained a record where observations had been recorded on only 1 day. Five of the 7 residents that completed a survey form said that they had been asked if they wanted to move to this home but 2 residents said that they had not been asked. Only 2 of the 7 residents said that they had received enough information about the home before they moved in so that they could decide if it was the right place for them. Care Homes for Adults (18-65 years) Page 11 of 30 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. Residents needs are identified in care plans, which are subject to review. The residents right to make decisions about their life in the home is respected. Staff support residents to take responsible risks so that residents can enjoy an independent lifestyle. Evidence: We looked at the case files of 3 residents that were not new admissions to the home. We saw that each file contained a care plan, that had been signed by the resident. There was evidence that these were subject to review by the funding authority although in 1 case this was after the service had contacted the funding authority to request a review, as a review meeting was overdue. Two files contained copies of letters to funding authorities requesting a copy of the minutes of the most recent review meeting. There was a record on file of review meetings convened by the care home. Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: Residents are encouraged to make decisions in respect of their day to day living and examples of this were observed during the inspection. Most residents are assisted with the management of their finances and this is one of agreements made, prior to the residents admission to the home. Although an agreed daily budget ensures that there is some money each day for the resident it is not necessarily a popular rule. While 5 of the 7 residents that completed a survey form said that they always made decisions about what they did each day, 2 residents said that they sometimes did. Six of the 7 residents said that they could do what they wanted during the day, in the evening and at the weekend. Each case file contained a risk assessment, as part of the admission process. This considered the residents physical health, ability to climb stairs, medication, diet, continence, toileting, dressing, bathing, epilepsy, hearing, sight, diabetes, breathing, medical conditions, mental health issues, substance use and behaviour. Each file also contained a recent comprehensive risk management form. The form had a record of a number of areas where risks could be identified, including diet and financial exploitation. The likelihood of risk was assessed as low, medium or high. Details of the nature of the risk and risk management strategies were recorded. Risk assessments were tailored to meet the individual needs of the resident and were subject to regular review. Care Homes for Adults (18-65 years) Page 13 of 30 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. Providing activities for residents, both inside and outside the home, offers residents the opportunity to develop their social and communication skills and to enjoy an interesting and stimulating lifestyle. The support of staff enables residents to maintain family contact. Respect for the residents right of choice was demonstrated in the way in which residents lived their lives, as they wished. A varied and balanced menu is available in the home and staff encourage residents to purchase meals in the home in order to improve the general health of residents. Respecting the cultural and religious needs of residents is an integral part of the service provided. Evidence: The home has a commitment to providing a programme of valued and fulfilling activities. Some of the activities may help the resident develop their literacy or numeracy skills. Residents have become involved in dog walking at an animal rescue Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: centre. Staff will assist a resident if the resident has problems with their benefits or finances. Residents are encouraged to use facilities in the community and outings have been arranged to museums, parks and to places of interest. Residents are able to access local transport facilities or the home is able to provide transport, if necessary. A resident told us that he had a freedom pass that he used to travel independently. The home maintains links with cultural organisations within the local community. During the inspection we spoke with residents about the activity programme and with the Life Skills worker who is responsible for co-ordinating this. A resident described her as great. A copy of the activities timetable is on display in the home and it covers activities that take place during the day and the evening and during the week and at the weekends. Some activities take place inside the home and some take place else where or outdoors. Activities arranged include those that meet religious needs e.g. visits from a priest or vicar and those that meet cultural needs. The inspection took place during the celebration of the Black History month and one of the residents was attending a Black History Day event. Recently 5 residents had attended an Irish Festival at the Camden Irish Centre. Residents told us about the the glass painting sessions held at the Salvation Army and in the games room there were beautiful items that one of the residents had made. While we were visiting the home foot massages were taking place. Some of the residents like pets and a volunteer from Pets for Therapy visits the home with their dog. Recently the cat that lived in the home died and residents helped to chose a new cat from a range of photographs of cats at the local animal rescue society that were in need of a good home. The home now has a computer for its Life Skills activities and residents have access to tthis. Some residents have set up email accounts so that they can maintain links with their families. We saw photographs of a group of residents enjoying a holiday at Centre Parcs, that had been arranged by the home, and we were told that residents can also join in days out arranged by the Irish Centre Housing. Within the home a literature group meets, there is a library box to encourage residents to read, there are quizzes, bingo sesions and pizza and DVD nights. The range of activities on offer is varied and interesting. The manager told us that relatives of the residents are welcome to come and visit the residents, if the resident wishes. Residents are able to entertain their visitors in their rooms, if they wish. Some residents enjoy contact with their family and the relatives take the resident out with them for a meal. Residents now have the facility to email Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: their family members in addition to the use of the telephone to contact them. Due to the vulnerability of residents staff on duty have to be careful in respect of visitors who are unknown to the home. The admission process includes acceptance of the house rules. Although this is an establishment where alcohol may be consumed on the premises, there are parts of the home where alcohol consumption is not allowed and residents must abide by this. A copy of the house rules, signed by the resident and dated, was present on each of the files examined. A copy is also provided in the information file that is placed in each of the bedrooms. Residents have previously told us that the rules are discussed with them before they sign the form. Although rules are in place freedoms are still promoted and these included residents having a key to their room and being able to choose whether they wish to socialise or to take part in activities. They are able to maintain their chosen lifestyle. The catering services in the home are contracted out. We looked at the 4 week menu cycle and menus demonstrated a varied and wholesome diet. The menu includes Irish and African Caribbean dishes. Alternatives are prepared for an Asian resident after asking the resident what they would like. The content of the menus is discussed at the residents meetings where changes are made at the request of residents. Breakfast in the home is provided free of charge and can be either a continental or full cooked breakfast, according to choice. The main meal of the day is served at lunch time and consists of 3 courses with choice of main meal. The evening meal consists of a choice of hot snacks, soup, sandwiches and fresh fruit. The daily menu is displayed on a board in the dining room and as the second visit to the home took place on the 31st October a special Halloween menu was on display. The cost of the midday and evening meals is very reasonable and members of staff encourage residents to eat and help them to budget their money so that there is sufficient money to spend on food. Residents comments about the food included OK and good. Care Homes for Adults (18-65 years) Page 16 of 30 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. Residents receive assistance with or prompting with personal care in a manner, which respects their privacy and dignity. Residents health care needs are identified and staff support residents, where necessary, to access health care services in the community. Residents general health and well being is promoted by staff that assist the resident to take prescribed medication in accordance with the instructions of the residents GP. Up to date and complete records would confirm that this takes place. Evidence: The home employs both project workers and care assistants as some residents need assitance with personal care tasks. This may take the form of prompting or may be direct assistance. There are both male and female care assistants. Tact and sensitivity is needed when assisting residents as residents may be reluctant to maintain good standards of hygiene. Residents are encouraged to bathe and to change their clothing on a regular basis. The home uses a system of key workers and meetings take place between residents and their key workers. When we looked at the residents case files we saw evidence that residents had access Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: to health care facilities in the community. Where necessary, project workers accompany residents on their appointments, particularly when these are at hospital out patient clinics. Due to their personal histories residents often suffer with poor health and each case file examined noted access to a range of health care services within the community. There were appointments at the audiology, chest and allergy, endocrinology, trauma and orthopaedic clinics. There were prescriptions for optical services. There was a record of dental appointments. Residents also had blood tests, x-rays, flu jabs and ultrasound imaging. Referrals had been made to the psychologist and to the dietician. A medication policy is in place in the home and members of staff administering medication have received training. Medication is kept in a locked cabinet, which is kept within a locked medication room. A weekly blister pack system is in place and these were checked and the blisters had been appropriately popped according to the day of the week and the time of day that the inspection took place. Medication that is not part of the blister pack system is stored in trays that are labeled with the name of the resident. If medication remains in the blister, as the resident refuses to take it, we were told that this would be recorded on the administration sheets. We checked the records and saw that this had happened for the medication that we saw remaining in the blister packs. We looked at all of the records of the administration of medication and saw that for one occasion, although the medication had been given the member of staff had not initialed the sheet to confirm this. Care Homes for Adults (18-65 years) Page 18 of 30 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. Residents are aware of their right to complain if the care that they receive is not satisfactory. An adult protection policy and protection of vulnerable adults training for staff contribute towards the safety of residents. Evidence: The home has a complaints policy, which includes timescales for each stage of the process and which gives information regarding other agencies, including the CSCI, which the complainant may wish to contact. The residents handbook, a copy of which is given to each resident on their admission to the home, includes details of the complaints procedure. The complaints records were inspected. Records include the investigation undertaken and subsequent actions. Complainants are notified of the outcome of their complaint. Dates are attached to each stage of the process. Four complaints have been recorded during the previous 12 month period. Each complaint had involved another resident and had been upheld. Appropriate follow up action had been taken. When speaking with residents they said that if they had a complaint they would speak to some one in the office. If this did not resolve matters they would speak to one of the managers. One of the 7 residents that completed a survey form said that they did not know how to make a complaint. There are opportunities to try to resolve issues before they become complaints and a residents meeting is held every 2 weeks. A resident told us that the manager attends this meeting. The home has a policy for the protection of vulnerable adults. Residents confirmed that Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: they were confident to speak to some one in the home if there was something that they were unhappy about. The manager said that no allegations or incidents of abuse have been recorded during the previous 12 month period. Two member of staff on duty confirmed that they had received protection of vulnerable adults training. They were aware of their responsibilities in the event of a disclosure being made or if an incident occurred. They were familiar with the whistle blowing procedure and the need to protect the residents. One of the senior project workers has recently attended a training course in institutional abuse and the deputy manager has attended a training course about the deprivation of liberty. Care Homes for Adults (18-65 years) Page 20 of 30 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. Residents live in a home, which is furnished in a homely manner and is well maintained. Residents enjoy comfortable communal areas in which they can relax, socialise or take part in activities. Residents live in a home where standards of cleanliness are good. Evidence: A partial site visit took place. Some residents had locked their bedroom doors before going out and some residents were using their bedrooms and did not want to be disturbed. Their privacy was respected. During the previous key inspection the need to replace some of the combined vanity unit and fitted wardrobes had been identified. The manager confirmed that the replacement had taken place and a resident very kindly let us look at the new unit in his bedroom. Generally residents said that the bedrooms were good and 1 resident said that the rooms were fine. Another resident said that he had a very nice room at the top. During the site visit the improvements that have been made since the last key inspection were noted. The interior of some of the bedrooms has been upgraded with new furniture, flooring and tiling. There is a programme currently for repainting bedrooms. Bathrooms and toilets have also been repainted and there is new carpet in some of the communal areas. The residents tea bar in the games room has been upgraded. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: Communal facilities in the home consist of a television room, where the consumption of alcohol is not allowed, and a games room, where the consumption of alcohol is allowed. The games room contains a pool table. Communal rooms are decorated and furnished in a homely manner. What ever the time of year residents sit outside the house when they want to smoke a cigarette and they tend to use the benches at the front of the building that are under cover but open at the side. Since the last key inspection a new landscaped garden has been created at the front and to the side of the building and the official opening of the garden was marked by a multi cultural day in the home. Residents said that the garden was good and that it would continue to develop as the shrubs and trees grew. A new gazebo will be installed in one part of the garden as an additional smoking area. During both visits to the home, including a tour of the premises, it was noted that all areas seen were clean and tidy and free from offensive odours. Residents that we spoke with confirmed that the home was kept clean. Six of the 7 residents that completed a survey form said that the home was always fresh and clean and 1 resident said usually. Laundry facilities are situated on the ground floor, away from the kitchen or dining room. The washing machine has a sluicing cycle. There is an infection control policy in place and staff receive infection control training. Care Homes for Adults (18-65 years) Page 22 of 30 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A programme of NVQ training for members of staff assures residents that care practices are based on an understanding of the residents needs. Staffing levels in the home assure residents that there are sufficient members of staff on duty each day to support the residents and to meet their needs. Recruitment practices generally promote the welfare of residents although documentation may need updating. Residents benefit from support given by members of staff that receive training to develop their skills and knowledge. Evidence: The manager confirmed that all of the members of staff working in the home, with the exception of a new member of staff, have completed or are currently working towards an NVQ level 2 or 3 in care qualification. He confirmed that more than 50 of the staff team have achieved either an NVQ level 2 or 3 qualification. Each of the 4 members of staff that we spoke with during the inspection said that they held an NVQ qualification and this included 2 agency members of staff. When we spoke with members of staff they demonstrated a commitment and an interest in their work. We saw that they communicated well with residents. When we spoke with residents they said that they were satisfied with the support received from members of staff and said that the members of staff were good. One resident said that it was brilliant in the home at Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: Christmas and compared this to a Christmas in the past when he had been lonely. Five of the 7 residents that completed a survey form said that the staff always treated them well and 2 residents said usually. We looked at the rota on display and discussed staffing levels. During the day there are 2 project workers on duty on the early shift. There are 2 project workers on the late shift and 1 of these members of staff carries out a sleeping in but on call shift during the night. There is one member of staff on waking night duties. In addition to the project workers there are 1 or 2 care assistants on duty during the day to assist residents with personal care tasks. The Life Skills worker is on duty Mondays to Fridays and there is a janitor on duty each day. There is a manager and a deputy manager for the service and the manager covers an occasional evening or weekend shift to enable him to monitor the quality of the service throughout the week. Despite the size of the home and the complex needs of the residents the home does not have any administrative support staff. We looked at 6 staff files, including those belonging to members of staff that had been recruited since the last key inspection. Although records are kept at head office the home also keeps a file that contains the information required in Schedule 2 of the Care Homes Regulations 2001. We saw that each member of staff had details of an enhanced CRB disclosure, 2 satisfactory references and proof of identity (passport details). We noted that 1 members of staff had a student permit that had expired although after the inspection we received confirmation from head office that an updated permit had been received for the member of staff. When we looked at staff files we noted that 1 member of staff was a recent appointment to the home and that their file contained a completed Skills for Care Common Induction Standards booklet. It also contained the managers assessment. There is a training department at head office and the home is notified of the courses that are being offered. A record is kept of the training undertaken by members of staff and there is a training and development plan for the home. When we spoke with members of staff they confirmed that they had received training in safe working practice topics, medication, protection of vulnerable adults, epilepsy and mental health. Care Homes for Adults (18-65 years) Page 24 of 30 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. Residents are assured of a quality service by the overall direction of a competent and knowledgeable manager. Quality assurance systems identify satisfaction with current services and changes in the needs and expectations of residents. This information shapes the development of the service as it is incorporated into business planning. The health and safety of residents is promoted through staff awareness and training. Regular servicing of equipment and systems in the home ensure that they continue to be safe to use. Evidence: The registered manager has a diploma in social work and has an NVQ level 4 in management. He has completed his B.Sc in Social Work and has almost completed a managers course in Health and Safety. He continues to attend short training courses to update his skills and knowledge and during the previous 12 month period he has attended master classes for managers in risk assessment and in adult protection procedures. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: We discussed quality assurance systems and we were shown a copy of the 2007 Survey Results. The survey is carried out across St Mungos services and invites residents to comment on the quality of the service. Questions are around food, safety and comfort, staff competence, access to health care facilities and access to the complaints procedure. The 2008 Survey was completed and the information is being analysed at head office, prior to being published. The results for each individual service are sent out and there are comparisons between levels of satisfaction during the year that the survey takes place and with previous years. As a result of the survey each service produces an annual plan, to address any issues, and the manager said that he discusses the annual plan with the residents and with the staff team. In addition to the annual residents survey the company also carries out an annual staff survey. We discussed opportunities for feedback throughout the year and review meetings, a comments and suggestions box, residents meetings, relatives visits to the home, staff meetings and staff appraisals were all given as examples for receiving feedback. We saw that when we walked around the care home there was a copy of the Employers Liability Insurance certificate on display and that it was valid until the end of March 2009. We examined records and noted that the fire risk assessment had been reviewed in March 2008. A letter from the LFEPA confirmed that on their last inspection of the home the service was deemed to comply with the legislation. There was evidence that regular fire drills take place and that that the fire alarms and smoke detectors are tested on a weekly basis. There were valid certificates for the servicing and checking of the portable electrical appliances, the Landlords Gas Safety Record, the fire precautionary systems in the home and the fire extinguishers. The lift is inspected on a regular basis. Members of staff that we spoke with confirmed that they received training in safe working practice topics and that the training was updated on a regular basis. Care Homes for Adults (18-65 years) Page 26 of 30 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 30 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 4 14 When the trial visit takes place a full record of the observations made must be kept. This will enable the manager to review all available information before making a decision on whether to confirm the placement. 01/01/2009 2 20 13 When medication is administered to a resident the member of staff must initial the record sheet. This will enable the home to confirm that the medication has been given. 01/01/2009 3 34 19 When updated permits are 01/01/2009 received a copy is to be sent to the care home. This will enable the home to demonstrate that the right to live and to work in the UK has been established. Care Homes for Adults (18-65 years) Page 28 of 30 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 2 That the pre-admission procedure includes asking the prospective resident whther they want to move into the home. That a review takes place of what information about the home is provided to prospective residents as part of the admission procedure. That a reminder is given about how to make a complaint during the residents meeting. That administrative support is provided to the staff team, on site so that project workers have more time to spend in direct contact with residents. 2 2 3 4 22 33 Care Homes for Adults (18-65 years) Page 29 of 30 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 © (2008) 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 30 of 30 - 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!