Care Home: Esna House

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What the care home does well The registered manager and staff are working hard to meet the needs of the people living in the home, which the residents appreciate. One resident told us "I don`t want to move from here, I have never been treated so well in my life". Residents are encouraged to be as independent as they can, for example by being supported to take responsibility for shopping for and cooking their own meals. The home works well with relevant community based health and social care professionals. The home is domestic in scale, comfortable and meets the needs of the people living there. The service works with people, at a pace comfortable to them, to encourage them to develop the skills to move on to more independent living situations. What has improved since the last inspection? At the last key inspection nine requirements were made and we were pleased to see that these had all been complied with. The required improvements made were in the following areas: more specific information about the service being available for residents and other people interested in the home; an improvement in the way people are supported to purchase food for themselves; more formal monitoring of the quality of the service to assist ongoing improvement and development; more effective recording of people`s needs and preferences in relation to equalities and diversity in their care plans; better recording of the outcomes of medical appointments; improved monitoring of the temperature of the fridge used to store medication; routine maintenance to the building; further staff training on the needs of people with mental health needs and the frequency of staff supervision. What the care home could do better: One requirement is made at this inspection and this to further improve the records of staff training to help plan more effectively their future training requirements. CARE HOME ADULTS 18-65 Esna House 16 Etloe Road Leyton London E10 7BT Lead Inspector Peter Illes Announced Inspection 29th May 2008 09:30 Esna House DS0000071150.V364739.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 Esna House DS0000071150.V364739.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. Esna House DS0000071150.V364739.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Esna House Address 16 Etloe Road Leyton London E10 7BT 0208 556 1647 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) san@leytonhouse.co.uk Leyton House Community Care Mr Sanawaz Dilmohamed Care Home 4 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (4) of places Esna House DS0000071150.V364739.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Male whose primary care needs on admission to the home are within the following categories: 2. Mental Disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 4 6th September 2007 (prior to new registration) Date of last inspection Brief Description of the Service: Esna House is a privately operated care home, registered to provide personal care and support to four male younger adults who have mental health needs. The registered provider also operates a number of other registered care homes in East London. The home is a converted terrace house with accommodation provided on two floors. The ground floor contains an entrance hall, one bedroom, lounge, kitchen/ diner with access to a small rear yard, a shower room/toilet and an office. The first floor contains three further bedrooms, one with en-suite facilities and a bath room/ toilet. The home is situated in a quiet residential area in Leyton and is close to shops, public transport links and a range of other multi-cultural amenities in the area. A stated aim of the home is to empower people to live, for as long as is required, in a comfortable home with the opportunity of enhancing their quality of life. The home aims to achieve this by providing support and stimulation to help residents maximise their potential physically, intellectually, emotionally and socially all within a homely atmosphere. At the time of the inspection, the weekly fee was from £670 per week. Information about the service, including inspection reports, is available on request from the registered manager/ provider. Esna House DS0000071150.V364739.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The home has been operating for a number of years and was previously known as Etloe Road. However, in January 2008 it was registered as a “new” home with the Commission due to the registered provider forming a limited company, which is legally a “new” provider organisation. The registered manager, staff and residents remain the same and the home is now registered as Esna House. As this was the first key inspection, since the new provider company was registered with the Commission, it was announced, the registered provider being informed in advance, and took approximately six hours. The registered manager was on leave at the time although the responsible individual and another registered manager from the provider organisation were present and available to assist throughout the inspection. Four people were living in the home and there were no vacancies, no new residents have been admitted since the last key inspection. The inspection was undertaken by the lead inspector although terms such as “we”, “our” and “us” are used where appropriate within this report to indicate that the inspection activity was undertaken on behalf of the Commission. The inspection activity included: meeting and speaking independently with two of the people living in the home; detailed discussion with the responsible individual and another provider organisation registered manager; independent discussion with one staff member; independent discussion by telephone with a care coordinator from L.B. of Newham. Further information was obtained from an Annual Quality Assurance Assessment (AQAA) submitted to us before the last key inspection, a tour of the premises and documentation kept at the home. What the service does well: The registered manager and staff are working hard to meet the needs of the people living in the home, which the residents appreciate. One resident told us “I don’t want to move from here, I have never been treated so well in my life”. Residents are encouraged to be as independent as they can, for example by being supported to take responsibility for shopping for and cooking their own meals. The home works well with relevant community based health and social care professionals. The home is domestic in scale, comfortable and meets the needs of the people living there. The service works with people, at a pace comfortable to them, to Esna House DS0000071150.V364739.R01.S.doc Version 5.2 Page 6 encourage them to develop the skills to move on to more independent living situations. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Esna House DS0000071150.V364739.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Esna House DS0000071150.V364739.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Up to date information is available to prospective residents and other interested people to make an informed choice about living in the home. People’s needs are regularly reviewed once they are living in the home to assist staff be aware of any changes in these needs. EVIDENCE: At the last inspection a requirement was restated that the home’s Service Users Guide is personalised to specifically refer to the home, and be in line with National Minimum Standards. This requirement had been complied with. The home has produced an updated Statement of Purpose and Service User Guide that reflect the change in the registration of the provider organisation and both these documents contain the information required in the National Minimum Standards. No new people have been admitted to the home since the last inspection. However, the home has a clear admission’s policy that makes it clear that prospective residents will be given the opportunity of visiting the home before making a decision about moving in. Records seen indicated that this had Esna House DS0000071150.V364739.R01.S.doc Version 5.2 Page 9 occurred for the last person to be admitted to the home and the responsible individual confirmed that this was normal practice. The files of the four people living in the home were inspected and showed that their needs were reviewed on a regular basis to allow staff to properly address their changing needs. This included evidence that enhanced care programmed approach (CPA) meetings were taking place where appropriate. These are formal review meetings required by mental health legislation. Evidence was seen that the home makes appropriate arrangements were a resident’s first language is not English. Key workers also undertake monthly reviews of people’s progress, with the information then being used to update the person’s care plan. Residents spoken to confirmed that they were involved in both CPA and key worker meetings. The care coordinator for one person living at the home was spoken to independently by telephone. She stated that she was pleased with the progress her client was making at the home and that staff were helpful and cooperative. Esna House DS0000071150.V364739.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are consulted when their needs are assessed and both people’s needs and preferences are recorded in their care plans to assist staff in meeting these. People are supported to maximise their independence by making as many decisions as possible for themselves. People are also supported and guided to take appropriate risks in their daily lives to assist them to safely achieve their aspirations. People can be confident that personal information about them is handled sensitively. EVIDENCE: At the last inspection a requirement was made that individual care plans clearly set out how the home is to meet all the needs of residents, including needs around equalities and diversity issues. The care plans of all four residents were inspected and evidence seen that information about people’s needs and preferences regarding equalities and diversity were included within Esna House DS0000071150.V364739.R01.S.doc Version 5.2 Page 11 the plans. For example individual plans included guidance for staff relating to people’s religion, sexuality, dietary preferences and shopping to meet these and other related personal issues as were appropriate. The Commission has recently published key equality and diversity prompts on it’s CSCI Professional website and a hard copy of these were left with the responsible individual for information. The care plans seen were current, based on up to date assessment information, including from multidisciplinary meetings with health and social care professionals, and were being reviewed at least every three months. Residents spoken to independently confirmed that they were involved in reviewing their care plans and in a range of one to one meetings including with their key worker. Residents are encouraged to make as many decisions for themselves as they can. They are encouraged to undertake a range of daily living tasks including shopping for their own food, doing their own laundry and keeping their rooms tidy. The home has a policy on expectations and rules regarding living at the home and a copy of this was seen on the residents files inspected with the copies having been signed by the resident. The home holds monthly house meetings and minutes showed that residents took a full part in these. One resident spoken to independently stated: “I don’t want to move from here, I have never been treated so well in my life”. Despite this the responsible individual told us that the home works hard to enable people to gain or regain the necessary skills and confidence to move on to more independent living settings. He went on to say that the home had a good track record for helping people move on. All residents manage their own finances. All four files inspected contained up to date risk assessments that recorded identified risks that had been identified for the individual. The risk assessments identified each individual risk; factors leading to risk behaviour; indicators that risk may occur and gave risk management guidance to assist staff in reducing the identified risk. Evidence was seen that risk assessments are reviewed regularly; including the person concerned signing their assessment. Residents and staff spoken to independently confirmed that residents are fully involved in the process. The home has a policy in place on confidentiality, which makes clear under what circumstances a confidence may be broken, e.g. the health, safety and of residents and others. Residents sign a “Permission to share information” sheet, which gives the home permission to share confidential information with appropriate persons. Esna House DS0000071150.V364739.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living at the home are encouraged and supported to participate in a range of activities including within the wider community. They also enjoy contact with relatives and friends to the extent that they wish. People are supported to be as independent as possible and are supported to enjoy healthy and nutritious meals. EVIDENCE: Residents make their own choices about what they do on a day-to-day basis, they are able to travel independently and access a range of community resources. One person told us that they enjoyed playing football and attended training sessions in the community twice a week, one session being run by coaches from the nearby Leyton Orient football club. The home organises outings for people and recent trips have included to Madam Tussauds, the cinema and bowling. One person told us that it was the first time they had Esna House DS0000071150.V364739.R01.S.doc Version 5.2 Page 13 been bowling and really enjoyed it. The home encourages and supports people to attend educational and/or employment-based activities if they wish although no one was attending these at the time. One person stated that he had been in part time employment until recently but had chosen not to continue with this. All four residents are supported to develop their skills for independent living by doing their own shopping, cooking, laundry and undertaking other domestic jobs around the house. We were told that one resident may well be able to move on to more independent accommodation in the near future and evidence to support this was seen in that person’s file. Both residents and staff spoken to independently stated that staff interacted with residents in recreational activities within the house such as playing cards, scrabble and watching television/ DVD’s. The home also facilitates an annual holiday for those residents that wish to attend. Residents and staff both stated that a week’s holiday to Clacton in 2007 had been enjoyable. We were also told that plans for a 2008 holiday were being discussed and evidence of this was seen in the minutes of the monthly residents meetings. People living at the home originate from different ethnic communities and their needs and preferences, including in such areas as food and places of worship, were sought from the person and recorded. Although a number of people have different religions recorded on their files the majority of people did not wish to strictly conform to practices regarding diet or worship that may usually be associated with that religion. Residents are able to maintain contact with family and friends to the extent that they wish. People spoken to confirmed that visitors are welcome and that they are able to see visitors in private if they so wish. Both the Service User guide and the home’s policy on expectations and rules state that visitors are welcome and the visiting times are shown as between 10 am and 10pm. Residents have access to a telephone and are given their own mail to open. When people are first admitted to the home an assessment is undertaken regarding their ability to undertake their own catering arrangements and what support is needed for them to be as independent as possible in this area. Following this each resident is provided with £20 a week to manage their own shopping. The individual has the responsibility (with staff support where necessary) for planning their menu, buying the food, cooking it and budgeting. In addition to the £20, the home provides some basics, including tea, coffee, sugar, milk, bread, butter, cooking oil, cereals and rice. The home also provides a weekly communal meal for all residents on an agreed day during the week. At the last inspection a requirement was made that residents are provided with an adequate weekly shopping allowance to ensure they have a healthy diet and enjoyable meals. This was because, although we were satisfied that people had enough money to purchase a healthy diet receipts for shopping sampled at the last inspection indicated that on occasions people Esna House DS0000071150.V364739.R01.S.doc Version 5.2 Page 14 were also buying the “staples” that the home should be providing. This requirement is being complied with and the home has introduced a separate record of what each person eats at each meal to assist in monitoring this. People spoken to independently confirmed that they were happy with their catering arrangements at the home and the way they were supported with these. Evidence was seen that people’s diets are monitored, one person suffers from diabetes, and evidence was seen that a dietician was consulted regarding this. Esna House DS0000071150.V364739.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 & 21 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home receive appropriate personal support in accordance with their needs. They are also supported in meeting their physical, mental and emotional healthcare needs, including by accessing relevant health care professionals. The medication administration procedures within the home safeguard people living there. People also benefit from being consulted on their wishes if they should die or become terminally ill while living at the home. EVIDENCE: All four people are independent with regard to their personal care although identified individuals may need occasional support in this area with specific tasks. Residents spoken to independently indicated that staff were sensitive to any specific support needs they may have regarding personal care tasks. Residents spoken to were appropriately dressed and presented and appreciative of the support they received from staff, one person stated: “the staff are great, just like one extended family”. Esna House DS0000071150.V364739.R01.S.doc Version 5.2 Page 16 People are supported with a range of physical, mental and emotional health needs and all people are registered with a GP. At the last inspection a requirement was made that comprehensive records are maintained of medical appointments, including the reason for the appointment, and details of any follow up action required. At this inspection satisfactory records of appointments with health care professionals were seen on the files inspected that included the reason for the appointment and any other follow up action needed. The records showed evidence of appointments with GP’s, mental health specialists, general hospital outpatient departments, dentist and optician. The home had a satisfactory medication policy that was seen along with written information sheets about a range of different medications used by residents. These explained the reasons the specific medication may be prescribed and any side effects that may occur. Evidence was seen that staff had received training in the safe administration of medication and staff spoken to confirmed this. Medication and medication administration record (MAR) charts were inspected for two people living in the home. These were accurate, indicating medication was being given as prescribed and there were no mishandling or missed doses. One person was being supported to administer their own medication with regard to their diabetes. Up to date records were seen of medication being received into the home and when medication was disposed of. At the last inspection a requirement was made that the temperature is checked at least once a day for any fridges used to store medication and this was seen to be complied with. The responsible individual confirmed that residents would be able to remain in the home with a terminal illness, so long as the home was able to meet their medical needs. The home has sought the wishes of residents on the arrangements they wish to be made in the event of their death and evidence of this was seen on the files inspected. Esna House DS0000071150.V364739.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living at the home are able to express their views and concerns and have these acted on appropriately. The home’s safeguarding adults policy and procedures assist in protecting people from abuse. EVIDENCE: The home has a satisfactory complaints procedure that was seen in the Service User guide and a copy was displayed in the home’s dining room. Residents spoken to felt confident that any complaints they made would be properly dealt with by the home. One resident stated; “If there is a problem just tell them and they sort it out”. No complaints have been recorded at the home and none have been received by the Commission since the last inspection. The home has a satisfactory safeguarding adults policy and also a copy of the L.B. of Waltham Forest’s policy, the local authority for the area the home is located in. There have been no allegations or disclosures of abuse made to the home or to the Commission since the last inspection. Evidence was seen that staff had undertaken training in safeguarding adults and staff spoken to were able to describe what action needs to be taken should an allegation or disclosure of abuse be made to them. The home has a satisfactory whistle blowing policy that gives details of managers within the provider organisation and external bodies that may be Esna House DS0000071150.V364739.R01.S.doc Version 5.2 Page 18 contacted in relation to this. The home does not hold any money on behalf of residents. Esna House DS0000071150.V364739.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, 28 & 30 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a home that is comfortable, well decorated and well maintained and meets their current needs. People who live in the home, staff and visitors benefit from the building being kept clean and tidy. EVIDENCE: The home is a converted terrace house with accommodation provided on two floors. The ground floor contains an entrance hall, one bedroom, lounge, kitchen/ diner with access to a small rear yard, a shower room/toilet and an office. The first floor contains three further bedrooms, one with en-suite facilities and a bath room/ toilet. The home is situated in a quiet residential area in Leyton and is close to shops, public transport links and a range of other multi-cultural amenities in the area. Esna House DS0000071150.V364739.R01.S.doc Version 5.2 Page 20 At the last inspection a requirement was made that the following maintenance issues were addressed: the home must make good the large crack in the kitchen ceiling; missing and broken tiles must be replaced in the shower room and the kitchen and discarded items such as a broken fan and suitcase must be removed from the yard at the rear of the home. During a tour of the home it was noted that the above maintenance items had all been attended to with the shower and bathrooms having been refurbished since the last inspection. The home and its furniture and fittings were comfortable and domestic in nature. The responsible individual stated that the home was able to call on the services of the provider organisation’s handy person and staff spoken to stated that this worked well. The home has a no smoking policy and is working hard to support residents to comply with this. One resident showed us their bedroom, which had been personalised by that person. The resident stated that they had everything they needed in their room including their own television. None of the current residents had needs in relation to continence. The home’s laundry facilities were suitable to meet the current residents needs and in scale for the home. Cleaning materials and other potentially hazardous material are kept locked when not in use. The home was clean and tidy during the inspection and free from unpleasant smells. The responsible individual stated that people living in the home were encouraged and supported by staff in keeping their rooms clean and documentary evidence of a weekly room check was seen. Esna House DS0000071150.V364739.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. A staff team with a range of qualifications and competencies, in sufficient numbers, support people living in the home. The home’s recruitment policy assists in protecting people living in the home. People are supported by staff who have access to a range of appropriate training although further work is needed to ensure that this can be robustly monitored. Staff receive formal supervision and appraisal to assist in further meeting the needs of people living in the home and in their own personal development. EVIDENCE: The home employs a registered manager, a senior support worker, three support workers and the provider organisation has identified bank staff that work when required. All the staff have either achieved or are working towards qualifications that will assist them to further enhance the lives of residents and to further their own career development. We were told by the responsible individual that the registered manager has the required qualifications to undertake that role including a diploma in management, the senior support worker has the national vocational qualification (NVQ) level 3 in care and is Esna House DS0000071150.V364739.R01.S.doc Version 5.2 Page 22 currently working towards NVQ level 4 in care as is one of the support workers, another support worker has NVQ level 2 in care and is working towards NVQ level 4 in care and the third support worker is working towards NVQ level 3 in care. The staff rota was seen, was up to date and accurately reflected the staff on duty on the day. One support worker covers the day shift from 8am to 8pm and one support worker covers the night shift from 8pm to 8am on a waking basis. The registered manager is included on some shifts on the rota each week and there is an on call manager available to the home, including at night time. Given the needs of the current residents this staff ratio was judged to be adequate to keep people safe and meet their needs at this time. No new staff have been appointed to the home since the last inspection although the file of one member of staff was sampled as part of the inspection activity. This showed evidence that the home had obtained all the required documentation to evidence a robust recruitment procedure including: proof of identity with a photograph, two written references; evidence that the person had an enhanced criminal records bureau (CRB) clearance and protection of vulnerable adults (POVA) check that had been applied for by the home and had been received before the person started working there. Evidence was seen that staff receive a satisfactory induction when first employed and that the home provides ongoing training and refresher training. At the last inspection a requirement was made that all care staff working in the home undertake appropriate training on working with adults with mental health needs. Evidence was seen that this requirement had been complied with. Evidence was also seen that the home had provided a range of other training for staff since the last inspection including on the Mental Capacity Act, safe administration of medication and first aid training. The staff member spoken to confirmed that they had undertaken the above training and found it helpful. However, it was not possible for us to verify that all staff had received up to date training in all the mandatory core areas as there was not an overall record of this. A requirement is made at this inspection that the home maintains a current staff training matrix or other overall record of training staff have undertaken to allow managers in the service to monitor who has undertaken what core and other specialist training and when, and to help plan for when further training and refresher training is needed. At the last inspection a requirement was made that all staff receive regular formal one to one supervision, at least six times a year. Evidence was seen that this requirement was being complied with and that staff were provided with individual supervision every two months. Evidence was also seen that staff receive an annual appraisal. The staff member spoken to confirmed this. Esna House DS0000071150.V364739.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from the effective management systems used in the home and their views are sought regarding the quality of life they experience. Health and safety procedures assist in protecting people living at the home, staff and visitors. EVIDENCE: The home’s registered manager has a number of years experience of working in care, including at a management level, and had the required qualifications specified in the national minimum standards when he was registered with the Commission. We were informed that he is also currently undertaking the Registered Managers Award to keep up to date with latest good practice. Esna House DS0000071150.V364739.R01.S.doc Version 5.2 Page 24 Residents and staff spoken to were complimentary about his management style and the way the home is run. Both the responsible individual and other managers in the provider organisation provide management support to the home when the registered manager is on leave. At the last inspection the home was required to seek the views of residents on the running of the home to help inform future planning and this requirement was being complied with. Satisfaction surveys received from residents since the last inspection, and a report compiled with the results of these, were sampled and contained positive feedback about the home. The responsible individual stated that quality monitoring was being expanded to gather the views of other stakeholders. Monthly residents’ meetings and regular staff meetings also contribute to the quality assurance system within the home. At this inspection a range of satisfactory health and safety documentation was seen. This included: a gas safety certificate, electrical installation certificate and portable appliance test. The home’s fire log was inspected and showed that the fire fighting equipment had been serviced, weekly safety checks on fire equipment were being carried and that fire drills were being undertaken every three months. Esna House DS0000071150.V364739.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 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 3 X X 3 X Esna House DS0000071150.V364739.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA35 Regulation 18(1)(c) Requirement The registered persons must ensure that the home maintains a current staff training matrix or other overall record of training staff have undertaken to allow managers in the service to monitor who has undertaken what core and other specialist training and when, and to help plan for when further training and refresher training is needed. Timescale for action 31/07/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Esna House DS0000071150.V364739.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection London Regional Contact Team 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Esna House DS0000071150.V364739.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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