Inspection on 04/09/06 for The Bungalow

This inspection was carried out on 4th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Bungalow 28/11/05

The Bungalow 13/09/05

The Bungalow 03/02/05

The Bungalow 26/07/04

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 The Bungalow Rear Of Lyon Court, Lyon Park Ave Wembley Middlesex HA0 4DN Lead Inspector Julie Schofield Key Unannounced Inspection 4th September and 22 September 2006 08:30 nd The Bungalow DS0000017464.V307146.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 The Bungalow DS0000017464.V307146.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. The Bungalow DS0000017464.V307146.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Bungalow Address Rear Of Lyon Court, Lyon Park Ave Wembley Middlesex HA0 4DN 020 8902 3443 020 8903 9860 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) Residential Care Services Ltd DR FRANK ERIBO Post Vacant Care Home 4 Category(ies) of Learning disability (4) registration, with number of places The Bungalow DS0000017464.V307146.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th November 2005 Brief Description of the Service: The Bungalow is a care home providing personal care for up to 4 adults with learning disabilities. At the time of the inspection there was 1 vacancy. The bungalow is in a residential part of Wembley, close to Ealing Road and with easy access to the shops on Wembley High Road. There are bus routes along Ealing Road and there are underground stations relatively near by (Wembley Central and Alperton). The property is set behind the houses and flats on Lyon Park Avenue and access is along a pathway, which is sufficient in width for a car to drive along. There are wrought iron gates at the end of the pathway and the parking area at the front of the property is behind the gates. The off street parking area can accommodate approximately 4 cars. The bungalow consists of an open plan lounge and dining area, another open plan area, a bathroom, 4 bedrooms (2 of which are ensuite), a kitchen and an office. The laundry room is situated in a separate building to the side of the bungalow, which also houses a day centre. There is a large garden at the rear of the property, with a large patio area. The Bungalow DS0000017464.V307146.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 in September 2006 and began with 2 visits to the home, on the same day. The first visit started at 8.30 am and finished at 10.00 am. The second visit started at 3 pm and finished at 6 pm. At the time of the inspection the post of registered manager was vacant. The Inspector would like to thank the deputy manager and member of staff for their assistance during the inspection. During the inspection discussions with the deputy manager and staff took place, records were examined, the preparation of a meal was seen and a site visit was carried out. The Inspector met each of the 3 residents. Residents varied in their ability to give verbal feedback and so part of the inspection included observation of residents and staff and of care practices. The Inspector would like to thank the residents for their participation in the inspection. A visit was made to the head office to view records, which are held centrally, and the Inspector would like to thank the Operations Manager for her assistance. Details of the fees charged for the service may be obtained, on request, from the home. What the service does well: One of the residents said that the staff were helpful and that he was satisfied with the service. He said that “its great here”. Another resident was also satisfied with the care received and there was a good rapport between this resident and their key worker. Not only do residents living in the Bungalow have access to activities/facilities organised by the home but they also have access to company organised activities/facilities. Residents had enjoyed their recent annual holiday. Residents seem at home in the Bungalow and move around the home and the garden as they wish. Residents are proud of their rooms, which they have personalised and they enjoy relaxing there, listening to music or watching videos or television. Residents are satisfied with the accommodation and said that the home is comfortably furnished and clean. They also said that they liked the meals served. The company’s training programme for staff provides a package of training that includes NVQ training, training in areas specific to the client group and training in safe working practices. The training needs or individual members of The Bungalow DS0000017464.V307146.R01.S.doc Version 5.2 Page 6 staff are identified and recorded in personal development plans. Deputy managers within the company are encouraged to undertake NVQ level 4 training. What has improved since the last inspection? What they could do better: A statutory requirement was identified in the previous inspection that a resident’s clothing must be protected from excessive saliva in a manner that promotes the dignity of the resident. This remains outstanding. Meetings to review the care plan and placement must be held at least every 6 months and a copy of the minutes of the meeting kept on file. When an alternative main meal is served the content of this meal must not duplicate the meal served the previous day. Some minor redecoration is required in the bathroom and in the dining area. The home needs to meet the target of 50 of carers (permanent, bank or agency staff) achieving an NVQ level 2 or 3 qualification and be able to demonstrate this. Therefore the home needs to hold a record of the training undertaken by agency or bank staff working in the Bungalow. The names of individual members of staff working in the home need to be recorded on the rota. The company must appoint a new manager and forward an application for the new manager’s registration by the Commission for Social Care Inspection. The Bungalow DS0000017464.V307146.R01.S.doc Version 5.2 Page 7 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 Bungalow DS0000017464.V307146.R01.S.doc Version 5.2 Page 8 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 The Bungalow DS0000017464.V307146.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 This standard was not inspected as no admissions have been made to the home for several years. EVIDENCE: The Bungalow DS0000017464.V307146.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Overall quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans and the placement must be reviewed on a regular basis to ensure that changes in the needs of residents are identified and can be addressed. Residents exercise choice in their daily lives and take part in the day-to-day running of the home. Staff support residents to take responsible risks so that residents can enjoy an independent lifestyle. EVIDENCE: Each of the 3 case files were examined. Each contained an assessment for a care plan and copies of care plans and reviews. There was evidence that the placing authorities, representative from the day centre and relatives attended review meetings. However although there were minutes of external and internal review meetings none of these were dated 2006. The home completes a brief summary of the care plan and progress made on a weekly basis. The home has a system of key workers and meetings are held between the resident and their key worker on a monthly basis. The minutes of these meetings were available. The Bungalow DS0000017464.V307146.R01.S.doc Version 5.2 Page 11 A discussion took place with the deputy manager in respect of the opportunities for residents to be involved in decision making and to make choices. Examples given included involvement in menu planning, choosing what to eat, choosing what activities to take part in, deciding when to spend time alone, deciding what to wear, choosing when to go to bed and when to get up in the morning. During the inspection it was noted that residents were offered choices and that they made choices, which were respected. The family of one of the residents advocates on the resident’s behalf and another resident has a counsellor who attends the case review of the resident etc. The home supports 2 residents with their personal allowances and the family of the third resident give money to the home to be held in safekeeping and used to purchase items on behalf of the resident. Financial records relating to each resident were examined. These were up to date and included details of items of expenditure. It is recommended that when the family of the third resident look at the record book they sign to acknowledge that they have seen the book. It was noted that the bankbook of one resident showed a falling balance over the last 12 months, as there had been few credits. It is recommended that the home checks whether all the benefits have been paid into this account. Case files contained risk assessments, which varied according to the needs of the residents. One file included risk assessments in respect of absconding, the provision or non-provision of door keys, coming into contact with traffic, taking part in activities in the community, choking etc. Risk assessments included risk management strategies. A missing persons policy is included in the manual of policies and procedures. The Bungalow DS0000017464.V307146.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17 Overall quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Taking part in activities, developing new skills and using community resources gives residents the opportunity to enjoy an interesting and stimulating lifestyle. By maintaining contact with their family and friends the resident’s need for company and fellowship is met. Residents are encouraged to become more independent by making decisions and by having their wishes respected. Residents are offered a varied diet to promote their well-being although staff need to encourage residents to maintain a healthy balance in their choice of meals. EVIDENCE: On the day of the inspection all 3 residents went to attend a day centre, as part of their weekly day care programme. One resident went to Strathcona and 2 residents went to London Road (a day centre which is owned by the company). Two of the residents do college courses as part of their day centre attendance and these include music and arts & crafts. On their return home residents said that they had enjoyed their day at the centre. The Bungalow DS0000017464.V307146.R01.S.doc Version 5.2 Page 13 There is evidence in the daily recordings that residents use community resources and these include the shops, library, sports centre, restaurants, pubs, parks and street markets. A resident also confirmed using these resources. One of the residents said that he enjoys going to church and he has purchased religious prints for his room. There was evidence that each residents’ name was entered on the electoral roll and that they received postal voting forms. Each resident’s case file contained an individual weekly programme of activities. There is evidence in the daily recordings that residents attend the Apple and Gateway clubs and the leisure club run by the company. Residents went on an annual holiday to Minehead in July and said that they had enjoyed themselves. They liked the accommodation, the on site facilities, the entertainment provided and the day out to a castle. They had also taken part in a day trip to Margate in the summer and barbecues. One resident enjoys walking to the local station and watching the trains go past. Within the home residents it was noted that residents like to do puzzles, colouring, watch TV and walk in the garden. Although visitors are welcomed into the home they are advised to end their visits by 10.30pm. Visits by family members and by a counsellor are recorded in the visitors’ book. A resident confirmed that visitors are made welcome when they come to the home and that visits can take place in the lounge areas or in the privacy of the resident’s room. It was noted that staff knock on the bedroom door of residents and wait until the resident invites them in. If the resident is unable to do this the member of staff will look at the resident to see if their visit is welcome. Residents’ privacy is respected and it was noted that residents were able to choose to spend time alone in their rooms, if they wished. One of the residents likes to use a key and to lock their bedroom door when they are using the lounge/dining areas. Residents are called by the name of their choice and one resident sometimes likes to be called by their first name and at other times by a shortened version of their first name. It was a warm day during the inspection and the door was open into the garden and a resident walked around the garden to relax. It was noted that residents help to set the table and to clear their plates away and to help with their laundry, under supervision. Residents said that they were satisfied with the meals served in the home. It was noted in the kitchen that the recommendations of the Environmental Health Officer, made as a result of their visit in December 2004, had been implemented. The member of staff preparing the meal was wearing protective clothing, the damaged work surface had been repaired and soap and paper towels were provided at the wash hand basin for the use of food handlers. The member of staff confirmed that they had undertaken food hygiene training and the deputy manager said that he had recently undertaken training in food The Bungalow DS0000017464.V307146.R01.S.doc Version 5.2 Page 14 safety practices. The menu was inspected and it was varied. The food records were inspected and it was noted that the main meal on Saturday and the main meal on Sunday of the previous weekend were primarily the same, apart from the method of cooking the potatoes. Residents confirmed that they were asked before a meal was prepared whether they wished to have the meal listed on the menu or whether they would prefer an alternative. It was a warm day when the inspection took place and on his return from day centre a resident said that he would prefer sandwiches to Shepherd’s Pie. The other residents were also pleased with this alternative option and enjoyed the tuna or ham sandwiches, served with spaghetti. A monthly record is kept of the individual records of residents. The book was up to date. A bowl of fruit is available for residents to help themselves from. The Bungalow DS0000017464.V307146.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Overall quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive assistance with or prompting with personal care in a manner, which respects their dignity and privacy. However there is an outstanding issue in respect of protecting clothing from excessive saliva in a manner, which maintains the resident’s dignity. Residents’ health care needs are met through access to 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 resident’s GP. Training the staff that administer medication to the residents minimises the risk of an error occurring. EVIDENCE: A statutory requirement was identified during the previous inspection that when a resident’s clothing needs to be protected from excessive saliva a suitable means is used which promotes the dignity of the resident. It was noted during the morning visit that the resident still continues to wear a baby’s bib and so this requirement remains outstanding. Assistance and prompting with personal care tasks is offered discreetly. Advice is also given by staff in respect of wearing clothing that is appropriate for the season. The Bungalow DS0000017464.V307146.R01.S.doc Version 5.2 Page 16 There was evidence in the visitors’ book of regular, 6 weekly visits by the chiropodist. The dentist and the optician had made visits to the home in June 2006. The deputy manager said that these were to see one resident and that other residents visited the appropriate surgeries. Case files contained evidence of hospital out patient appointments, appointments with the GP and appointments with the psychiatrist. Residents also had access to routine health screening e.g. blood tests and to preventative medicine e.g. a flu jab last autumn. The storage of medication was inspected. It is kept in a locked facility. Weekly dosette boxes are supplied by the pharmacist. These are identified by the residents’ names. The empty compartments in the boxes were appropriate for the time of day and for the day of the week on which the inspection visit took place. Records of the administration of medication were inspected. They were up to date and complete. The deputy manager said that staff involved in the administration of medication have received training and staff on duty, and training records, confirmed this. There was evidence that the pharmacist does regular audits of the system of administering medication within the home. The Bungalow DS0000017464.V307146.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available 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: A copy of the complaints procedure was on display in the home. The simple procedure included timescales for each stage of the procedure and referred complainants to the directors of the company, if the home’s manager could not resolve matters. Information regarding access to other agencies e.g. the CSCI was included, with the address and telephone number of the local office. A suggestions box was on display in the entrance lobby. The deputy manager said that no complaints have been recorded since the last inspection. Two residents confirmed that if they had any complaints they could speak to some one in the home and both identified the deputy manager. It was noted during the inspection that residents appeared to be confident in expressing their likes and dislikes to the staff on duty. A requirement was identified during the previous inspection that all staff undertake protection of vulnerable adults training. The deputy manager said that this had taken place and both members of staff on duty during the inspection confirmed that they had completed this training. The policies and procedures manual contains a copy of the home’s adult protection procedure. The deputy manager said that no allegations or incidents of abuse have been recorded since the last inspection. The Bungalow DS0000017464.V307146.R01.S.doc Version 5.2 Page 18 The Bungalow DS0000017464.V307146.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Overall quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy a comfortable and “homely” environment with pleasant communal and private facilities in which to relax. Some minor redecoration is needed. Residents live in a home where standards of cleanliness are good. EVIDENCE: A statutory requirement was identified during the previous inspection that there is a working bell by the gates to the property. A new bell has been installed, which is operational, and so this requirement is now met. A statutory requirement was also identified that the seat cushions of the dining chairs needed to be cleaned. New dining chairs have been purchased so this requirement is now met. Statutory requirements were identified that the curtain rail in one of the bedrooms must be secured to the wall and that the fireplace opening in this room must have a suitable covering. There is now compliance. A site visit took place. The home is comfortably furnished and decorated and residents said that they were satisfied with their rooms. Each bedroom reflects The Bungalow DS0000017464.V307146.R01.S.doc Version 5.2 Page 20 the personality of its occupant. Two residents enjoy spending time and relaxing in their rooms. It was noted that there were some marks on the ceiling above the dining area, the enamel on the side of the bath was chipped away and the top of the radiator cover and window sill in the bathroom need making good and repainting. Net curtains need to be washed. A site visit took place during the inspection and it was noted that all areas were clean and tidy and free from offensive odours. Cleaning schedules were available and they listed tasks to be carried out on a daily, weekly and monthly basis but did not include a record that these had been carried out. The home also keeps a cleaning diary in respect of the kitchen and the Environmental Health Officer checked this on their last visit. An infection control policy is included in the manual of policies and procedures. The deputy manager said that all the staff working in the home have undertaken infection control training and the members of staff on duty during the inspection confirmed this. Laundry facilities are situated in a room at the rear of the adjacent building and soiled clothing can be taken there without walking through the area where food is prepared or eaten. The Bungalow DS0000017464.V307146.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 Overall quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. NVQ training enhances the general skills and knowledge of carers and the home needs to be able to demonstrate whether it meets the target of at least 50 of carers (permanent or bank/agency staff) achieving an NVQ level 2 or 3 qualification. The rota demonstrated that there were sufficient staff on duty to support the residents and to meet their needs but the names of all the members of staff working in the home had not been recorded. Recruitment practices, which include checks and references, protect the welfare and safety of residents. Residents benefit by being supported by staff that have access to a comprehensive range of training courses. EVIDENCE: Of the 4 permanent members of staff on the rota, the deputy manager has completed their NVQ level 3 training (and is currently undertaking NVQ level 4 training). One of the support workers has completed their NVQ level 2 training. Another member of staff confirmed that they would start their NVQ level 2 training in 2006. The fourth member of staff is doing an access to nursing training course. There was no information available in the home in respect of the qualifications of agency staff. Residents said that the staff that worked in the home were very helpful and a resident said that the staff listened to them. A member of staff described how a resident, who was The Bungalow DS0000017464.V307146.R01.S.doc Version 5.2 Page 22 unable to speak, communicated their wishes. The home has received advice and support from CIS (crisis intervention service) who have recommended the use of Makaton and pictures as aids to communication. The pictures used for this purpose were available. The staffing rota was available for inspection. It was noted that there are 2 members of staff on duty both on the morning shift i.e. 7am to 10am and on the afternoon/evening shift i.e. 3pm to 10pm. At night one member of staff carries out sleeping in duties. Staffing levels remain the same at the weekend and this enables a member of staff to accompany a resident in the community. There are 4 permanent members of staff on the rota, including the deputy manager, and where necessary, agency staff provide the remaining cover, including sleeping in duties. Although the deputy manager said that agency staff working in the home have worked there on a regular basis and are known to the residents, it is recommended that the home recruit permanent staff to cover the remaining shifts. On the rota the word “agency” is used rather than the name of the individual agency worker, although the deputy manager said that agency staff sign the staff signing in book. The home currently accommodates male residents and the staff team consists of both male and female members of staff. Staff confirmed that regular staff meetings took place (minutes available) and said that they were encouraged to put forward their ideas. Staffing records are kept at head office and a visit was made there to inspect 3 files of members of staff working at the Bungalow. Each file contained evidence of a satisfactory enhanced CRB disclosure, proof of ID, evidence of right to work, 2 satisfactory references and a contract. The deputy manager said that currently training is concentrated on NVQ training and refresher courses for safe working practices. A member of staff on duty said that they had been working in the home for approximately a year and that they had undertaken training in health and safety, food hygiene, fire safety, first aid, manual handling, infection control, medication, epilepsy and protection of vulnerable adults. While visiting head office the Inspector viewed the 2005-6 training plan for the Bungalow. This included both statutory training and courses, which enabled staff to fulfil the aims of the home and to meet the needs of the residents. Staff undertake equal opportunities and disability awareness training. The plan listed the names of the four permanent members of staff working in the Bungalow and there was an up to date record of training courses attended. Staff files contained copies of certificates of attendance or achievement. Personal Development Plan forms were available. The Bungalow DS0000017464.V307146.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Overall quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. By establishing good working practices and monitoring the quality of care in the home a registered manager promotes a safe and enjoyable environment for residents. Therefore the appointment of a manager must be a priority for the home. Service satisfaction questionnaires, meetings and individual discussions with residents help to monitor the quality of the service provided to residents and contribute towards the development of the service. The training that staff receive in safe working practice topics enables them to safeguard the health, safety and welfare of the residents. Regular servicing and checking of equipment used in the home ensures that items are in working order and safe to use. EVIDENCE: The post of registered manager is vacant. The deputy manage is covering these duties. The deputy manager has worked in the home for several years The Bungalow DS0000017464.V307146.R01.S.doc Version 5.2 Page 24 at a senior level and is currently undertaking RMA (registered manager’s award) training. Residents are able to give feedback on the quality of the service during discussions with members of staff, at their review meetings, at meetings with their key workers and at residents’ meetings, which are held on a monthly basis. The minutes of residents’ meetings were available for inspection. The last meeting had been held on the 28/8/06. Family members and representatives of the placing authorities can give verbal feedback during visits to the home and at review meetings. Comments made at review meetings are recorded in the minutes. In addition quarterly questionnaires are distributed to residents, relatives and representatives. A copy of the questionnaire was available. It consisted of several pages of questions. The operations manager said that few responses had been received. A requirement was identified during the previous inspection that the work required in respect of the electrical installation is carried out. A certificate dated 2/12/05 confirmed that the faults had been remedied and so this requirement is now met. Valid certificates for the servicing/checking of the portable electrical appliances, the Landlord’s Gas Safety record, the fire extinguishers and for the smoke detectors, emergency lighting etc were available. There was also a certificate for testing the water for any trace of Legionella, no trace found. The record of weekly fire alarm tests and of fire drills was available for inspection and was up to date. A risk assessment in respect of fire safety and an assessment in respect of food hygiene were available. There is a locked COSHH cupboard in the home. Records of daily readings of fridge and freezer temperatures were up to date. Records of daily readings of the temperature for the hot water of showers and baths were up to date. The members of staff on duty confirmed that they had received training in safe working practice topics i.e. fire safety, food hygiene, first aid, manual handling and infection control. The deputy manager said that no accidents have been recorded since the last inspection. The Bungalow DS0000017464.V307146.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 2 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 X 2 X 3 X X 3 X The Bungalow DS0000017464.V307146.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 15.2 Requirement That reviews of the placement and care plan are carried out at least every 6 months and that a copy of the minutes of these meetings (whether convened by the home or by the placing authority) are kept on file. That when an alternative main dish is served the content of the meal does not duplicate the main dish consumed on the previous day. That when clothing needs to be protected from excessive saliva a suitable means is used which promotes the dignity of the resident. (Previous timescale of 1st February 2006 not met). That the marks on the ceiling above the dining area, the chipped enamel on the side of the bath and the top of the radiator cover and window sill in the bathroom are made good and/or repainted. That net curtains are washed. That 50 of carers working in the home (both permanent staff and agency or bank staff) have DS0000017464.V307146.R01.S.doc Timescale for action 01/11/06 2 YA17 16.2 01/10/06 3 YA18 12.4 01/10/06 4 YA24 23.2 01/11/06 5 YA32 18.1 01/08/07 The Bungalow Version 5.2 Page 27 6 7 YA32 YA33 18.1 17.2S4.7 8 YA37 8.1 achieved an NVQ level 2 qualification. That the home has a record of 01/11/06 training undertaken by agency or bank staff working in the home. That the rota is a record is all 01/10/06 staff working in the home and that individual members of staff are identified by name. That the proprietor appoints a 01/02/07 manager and that the manager applies to the CSCI for registration. 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 YA7 YA7 YA17 YA33 YA39 Good Practice Recommendations That when the family have looked at the records of money spent on behalf of the resident they sign to acknowledge that they have viewed the records. That the home reviews the benefits paid into the bankbook of one of the residents to check that the payments are correct. That although residents are able to choose an alternative to the dish listed on the menu the home encourages residents to maintain a varied and balanced diet. That permanent staff are recruited to fill the gaps on the rota. That the quarterly quality assurance questionnaire is reduced in length (2 sides of A4 paper would be a suggested maximum). It should include the opportunity for the person completing the questionnaire to add their name, if they wish. The Bungalow DS0000017464.V307146.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Bungalow DS0000017464.V307146.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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