Care Home: Kiver Road (128)

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What the care home does well This is a very individualised service, where choice, dignity, respect and rights are given a high priority. We noticed that the staff and people living in the home have a warm relationship. The core staff team are knowledgeable about people`s needs, and how they prefer them to be met. There was lots of evidence that people are helped to make decisions about their daily life. Assessment and care planning is of a high quality, as is daily record keeping. Thought is given to helping people be as independent as they can. An example is the use of contrasting colours for the seats and the carpet in the lounge. This means that one person, who can`t see very well, can move round safely, and independently. Staff feel that they, and the people living in the home, are listened to and that their views are acted upon. They receive regular, structured, supervision and have access to training appropriate to their jobs. The home is well managed with good systems for health and safety checks and quality assurance. The person who we were able to talk with us said, "This is my home." What has improved since the last inspection? At the last inspection we said that the rules about how staff help people with their money needed to be improved. At this inspection we found that these things had been improved. We also said that the bathroom needed to be made better so that people could choose between having a bath or a shower. However, this hasn`t been done yet. What the care home could do better: At this inspection one requirement is made. This is about making sure that the staff personal records include all the necessary documentation. A number of recommendations are made and these include making the contract more accessible to the people using the service, reviewing peoples` risk assessments, seeking advice from an occupational therapist about the use of bedrails, providing staff with more training about safeguarding people from abuse and food handling and hygiene. It is also recommended that the shared areas of the house be redecorated, and in particular the hall and kitchen. CARE HOME ADULTS 18-65 Kiver Road (128) 128 Kiver Road Finsbury Park London N19 4PQ Lead Inspector Caroline Mitchell Unannounced Inspection 27/08, 11/09 & 07/10/2008 07:00 Kiver Road (128) DS0000020965.V370164.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 Kiver Road (128) DS0000020965.V370164.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. Kiver Road (128) DS0000020965.V370164.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kiver Road (128) Address 128 Kiver Road Finsbury Park London N19 4PQ 020 7700 2807 0207 700 0085 housingservice@centre404.org.uk 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) Centre 404 Ms Rachel Wallis Care Home 3 Category(ies) of Learning disability (3), Physical disability (3) registration, with number of places Kiver Road (128) DS0000020965.V370164.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th August 2006 Brief Description of the Service: Kiver Road is a registered care home for three people with learning disabilities and physical disabilities. The home is a small family-type home, and aims to provide a ‘home for life’. The property is owned by Mosaic Homes, and is managed by Centre 404, a local voluntary agency. Centre 404 provides other services, which residents can access, for example a Family Support Service and ‘Clubs’. Kiver Road is managed under the organisation’s housing section. During daytime hours two staff are on duty on each shift. A member of staff ‘sleeping in’ covers night hours. The property is a flat on the ground floor of a purpose built block situated in a close, just off Holloway Road, North London. There are three bedrooms, laundry room, an adapted shower, a bathroom, kitchen/diner, a lounge and a staff room. There is an enclosed garden to the rear. All parts of the building have disabled access. The home is close to public transport; thought the level of disability of the people living in the home restricts their access. Holloway Road and the surrounding area have a range of shops, cinema, restaurants and cafes, leisure centre, and public houses. The charge is £324.88 per week, with people contributing £62.35, and the local authority paying the remainder. People using the service pay for their own toiletries, outings and holidays, and clothing. Following “Inspecting for Better Lives” the provider must make information available about the service, including inspection reports, to the people who use the services and other stakeholders. Kiver Road (128) DS0000020965.V370164.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. This inspection was undertaken in three separate visits. We visited to meet the people living in the home and spent some time with them, returned to meet members of the management team and look at the written records kept in the home. We looked around the building and talked with members of the management team and the care staff. We looked at the things we asked the home to do at the last inspection to see if these had been done. We also visited the head office to look at the staff personnel files. Staff were observed with the three people living in the home on all three visits. The service sent us their annual quality assurance assessment (AQAA) when we asked for it. It was clear and gave us the information we asked for. The AQAA is a selfassessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. It gave us useful information and helped us to plan our visit. Information from the home since the last inspection, like incident reports, was also looked at before the inspection. Three women were living in the home at the time of the inspection. Two of the three people who live in the home communicate mainly by sound and behaviour, because of their disabilities. This means that some of the judgements in this report have to be made based on the views of others, such as staff and on the written records kept by the home. Observation of staff when they were working with people has also been used. We looked at care plans and daily records, and compared to the care being provided. Staff were asked about recent training and what support and supervision they have had. They were also asked what they thought the home did well, and what could be done better. What the service does well: This is a very individualised service, where choice, dignity, respect and rights are given a high priority. We noticed that the staff and people living in the home have a warm relationship. The core staff team are knowledgeable about people’s needs, and how they prefer them to be met. There was lots of evidence that people are helped to make decisions about their daily life. Assessment and care planning is of a high quality, as is daily record keeping. Thought is given to helping people be as independent as they can. An example is the use of contrasting colours for the seats and the carpet in the lounge. This means that one person, who can’t see very well, can move round safely, and independently. Staff feel that they, and the people living in the home, are listened to and that their views are acted upon. They receive regular, structured, supervision and have access to training appropriate to their jobs. Kiver Road (128) DS0000020965.V370164.R01.S.doc Version 5.2 Page 6 The home is well managed with good systems for health and safety checks and quality assurance. The person who we were able to talk with us said, “This is my home.” 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. Kiver Road (128) DS0000020965.V370164.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 Kiver Road (128) DS0000020965.V370164.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, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. EVIDENCE: The three people living in the home moved in together in 1990. Nobody new has moved in since then. At this inspection we looked at the written records for all three people. Their assessments and care plans were very good. It is reasonable to assume that a similar standard would be applied to the assessment of any future prospective residents. The service user guide is in an easy read format, with pictures to help the people living in the home to understand it. At the last inspection a requirement was made for the full details of all extras chargeable to people living in the home to be included in the service user guide. At this inspection we found that this had been addressed. There is room for improvement in making the information in the contract more Kiver Road (128) DS0000020965.V370164.R01.S.doc Version 5.2 Page 9 accessible to each person. The manager told us that there are plans to individualise the service user guide and include the contract for each person within it. These will be more accessible to each person and, depending on their needs, be in easy read format with pictures or on video or audiotape. A recommendation is made about this. In the AQAA the manager told us that there are plans to review the referral policy to make them more ‘user friendly.’ Kiver Road (128) DS0000020965.V370164.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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 the support they need. This is because the staff promote their rights and choices. People are supported to take risks to enable them to be as independent as they can. This is because the staff have appropriate information on which to base decisions. The staff help people to make decisions. People can be confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. EVIDENCE: We looked at the written records for all three people living in the home. The assessment and care planning system is very good. It is very person centred and looks at people’s strengths and needs. We also saw the review reports that the service does for people on a six monthly basis. The manager said that she is planning to improve people’s plans further, so that they are more Kiver Road (128) DS0000020965.V370164.R01.S.doc Version 5.2 Page 11 accessible, with audio or video versions for the people for whom this would be beneficial. The manager had talked about this in the AQAA. The risk assessment format is particularly good as it uses a cost/benefit, system. This weighs up the benefits of one course of action against another. The risk assessments and care plans focussed very much on people’s dignity, choice, independence, and respect. For example, privacy in using the toilet is well balanced with risk of falling. Although the risk assessments were generally of a very high standard, there were some minor changes that were needed and a recommendation is made about this. As part of the inspection we spent an evening in the home, just sitting and talking with the people who live there. We noticed that, because two of the people who live in the home do not communicate in conventional ways, staff are creative in finding ways to provide them with choices. There were programmes in place to help people to be as independent as possible, with input from members of the community learning disability team, such as occupational, and speech and language therapists. There was very detailed guidance for staff about how to support each person and this takes account of people’s ways of communicating, their choices and any risks. Kiver Road (128) DS0000020965.V370164.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, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each person is treated as an individual and the home is responsive to 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 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, wellpresented 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. EVIDENCE: Kiver Road (128) DS0000020965.V370164.R01.S.doc Version 5.2 Page 13 People regularly attend a local specialist day service, although one person is getting older now, has become a little frail and has a lot of staff input at home. There was evidence that there is good communication between the centre and the home, via a written record which goes between the two services. The manager also said that she talks to the key worker at the centre every month and we saw the reports the centre contribute to people’s reviews. We saw detailed notes of weekly discussion about each person and what they have been doing. The write ups of these are very detailed, and give a good picture of each person’s lifestyle. Activities includes going out locally to the pub, having massage, attending BBQs and attending religious services. One person told us that she goes to the day centre everyday from Monday to Friday and likes the art sessions. She said that the group goes to the pub on Fridays and other times they go to a local café. Activities are arranged for every weekend and people can join in if they want to. The logs of each shift also detail what each staff member has done with each person. Staff referred to the three people living in the home as either the tenants or the ladies, or by their first name. Staff were very respectful. There was a warmth observed between staff and the people living in the home and people seemed happy and relaxed in their home. Personal development, dignity, respect and choice were very much part of people’s care plans and risk assessments as were people’s cultural needs. There were also regular tenants’ meetings and the staff team were creative in finding ways to make sure each person is represented. As this is a small home the staff team can offer a very individual service. On the second inspection visit one person was at home, while the others were at the day centre and this person seemed to be enjoying to opportunity of having the two staff members, who were on duty, to themselves. There were photos on the board in the kitchen from a holiday where staff had arranged for one person to meet up with her mother and other relatives in the Carribean and others of a trip people had been on to Paris. There were other photos of one person’s 60th birthday party. From one person’s records we saw that staff enable weekly phone calls to her mother and assist her to visit her mother regularly. We saw the menu and it was varied and staff were made aware of people’s likes and dislikes regarding food because there was a very clear, person centered record of this in their plans. People’s special dietary needs are taken into account and the manager said the service is working on giving people more chances to try food from different culturs. On the evening of the first inspection visit staff were preparing the evening meal while we spent time talking and sitting with the residents and one person said that they were having sausages, adding that she liked sausages. Kiver Road (128) DS0000020965.V370164.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. As people cannot manage their medicine, the home supports them with it in a safe way. EVIDENCE: As stated earlier in this report the risk assessments and care plans were very detailed. They included input from professionals, such as occupational therapists, speech and language therapists and district nurses. Guidelines for staff about how to give personal care reflect people’s dignity, choice and independence. People had healtrh care plans and there were good records of people’s health care needs and the appointments and other health care input people had received. One person’s health has not been good over the past year and there was evidence ofthe health care provided to her and support and information provided to the staff team. Where there were physical and health care risks, such as vulnerability to choking or pressure sores, these were identified in the care plans and risk assessments. There was input from the appropriate health care professionals. Kiver Road (128) DS0000020965.V370164.R01.S.doc Version 5.2 Page 15 Staff were provided with clear guidance and, where necessary, people were provided with the necessary equipment to any minimise risks. Generally, if there were restrictions to a person’s personal freedom the risk assessment were well considered and part of a multi-disciplinary approach. Bed rails were being used for one person and a risk assessment was in place. However, there was room to improve it by expanding the guidance for staff about safe use, with advice from an occupational therapist. A recommendation is made about this. Specialist agencies, such as the Royal National Institute for the Blind have been involved in assessments, and the advice followed. The people using wheelchairs have support through the occupational therapists. The manager said that as one person becomes older it is time to give staff training about working with people with dementia and she is organising this through MENCAP so the training takes people’s learning disabilities into account. Risk assessment are in place for people around the support they need with any medication that they are prescribed. There are, locked cabinets in each bedroom for keeping people’s medicines in. One person is more independent and is supervised with their medication and encouraged to be as independent as they can within this. We saw the records of medication administered, coming into the house and returned to the chemist. We saw evidence that the management team undertake regular audits to make sure the medication system is working and that staff are following the proper procedures. Kiver Road (128) DS0000020965.V370164.R01.S.doc Version 5.2 Page 16 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. EVIDENCE: There was a clear complaints policy. There had been no complaints recieved in the last 12 months. The level of disability of the people living in the home means that it is unlikely they will use a formal complaint procedure. The manager said that no complaints had been made by people’s relatives or representatives and that there is an advocacy service that people can use. No safeguarding issues have arisen in the last 12 months. The records we saw showed that part of the inductioon given to new staff included watching a training video about abuse, and whilst longer term staff had some external training in safeguarding people from abuse, this was a while ago and most needed an update. A recommendation is made about this. At the last inspection the registered person was required to make sure that the process and procedures for taking decisions on the spending of peoples’ monies provide protection from financial abuse. At this inspection we found that this had been addressed. Everyone living in the home has lots of support with managing their money and this is provided by the home. This is included in their risk assessments. As the previous manager had left, new signaturies were being arranged for people’s accounts and extra safeguards built in around Kiver Road (128) DS0000020965.V370164.R01.S.doc Version 5.2 Page 17 this. One person’s account was checked and the money counted. There were clear written accounts of all of the money spent and the sum held corresponded with the written account. The responsible individual checks the accounts on her monthly visit. At the last inspection it was recommended that independent audits be carried out, including checks of people’s bank accounts, in addition to the checks made at the monthly visits. At this inspection we found that this had been done. Kiver Road (128) DS0000020965.V370164.R01.S.doc Version 5.2 Page 18 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, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People stay in a safe and reasonably well-maintained home that is homely, clean, comfortable and pleasant. The home 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. EVIDENCE: Maintenance and repair are the responsibility of the housing association. The manager said that there has been n improvement in the time it takes to undertake any necessary work since the last inspection. The lower walls and door frames in the corridor had been redecorated, but have sustained further wear and tear and are starting to look quite scuffed again. This is damage mostly caused by wheelchairs. The kitchen, although very homely, is also in need of redecoration. Kiver Road (128) DS0000020965.V370164.R01.S.doc Version 5.2 Page 19 One of the tenants showed us around the house and said how much they liked their room. The shower room has been refurbished and disabled access improved, but the bath remains unsuitable for two of the people living in the home. It is only accessible from one side so a hoist cannot be used. It is also unsuitable for staff to use in assisting people to bathe, as it is very low. This means that two people have to have showers. An assisted bath has been requested, and it is recommended that the registered person look into the option of providing a hoist that works with a ceiling track. The house is furnished in a homely fashion. Peoples bedrooms have been personalised so that they reflect their backgrounds, personalities and interests. Attention has been given to how the environment may impact on people’s independence. For example, having carpeting and furniture in contrasting colours in the lounge. This has been done with the people who have a visual imparment in mind. Kiver Road (128) DS0000020965.V370164.R01.S.doc Version 5.2 Page 20 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): 31, 34, 35, 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although there was an unsettled period because of staff changes, new staff have been recruited and people have safe and appropriate support as there are enough competent, qualified staff on duty. They can have confidence in the staff at the home because checks have been done to make sure that they are suitable, although the records of these could be improved. 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. EVIDENCE: The home has had some changes in staffing since the last inspection. This led to the need to use bank staff and agency workers to cover vacancies. However, we found that the situation was improving because new staff had been recruited. Some had had the necessary pre-employment checks and had recently started work in the home and others were waiting for Criminal Records Bureau checks (CRB) and references so that they could be given clearance to start work. The manager was pleased that the new staff were starting work as the consistency of staff was improving for the tenants. We looked at the personnel records for three staff members, two of whom were Kiver Road (128) DS0000020965.V370164.R01.S.doc Version 5.2 Page 21 new starters. Whereas they included details of CRB clearance and references, so it was clear that the necessary pre-employment checks were being done, not all files included the necessary proof of identity or a recent photograph and a requirement is made about this. The staff rota showed that there is a minimum of two staff on duty during waking hours, and a member of staff sleeping in covers at night. The staff we spoke to showed a sound knowledge of the needs of people living in the home and a good understanding of the unique ways that each person expressed their needs and likes and dislikes. Staff members were observed following care plans, including offering choices where possible. Staff files showed the home has a very thorough induction programme based on the TOPSS induction. The initial induction taking around two weeks and including training videos. Records also showed that, in addition to a very good induction, new staff members were being provided with the core training, as soon as possible after they were recruited, given clear job descriptions and copies of the General Social Care Council’s Code of Conduct. All staff were being provided with very regular 1-1 supervision and good clear records kept of this. The three staff members spoken to said that they get lots of opportunities to share ideas and discuss issues with their supervisor and get lots of support. Staff meeting records showed that they are interactive and inclusive. Staff feel able to raise issues and feel that they get fully discussed. They described the manager and the housing manager as very approachable. The manager had a training record for staff and was adding the new starters as they started work. The plan showed the training that staff have had and highlighted people’s training needs. We noted that whilst staff have had some food hygiene training, this was a while ago and most needed to be provided with an update. Kiver Road (128) DS0000020965.V370164.R01.S.doc Version 5.2 Page 22 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have confidence in the care home because it is run and managed appropriately. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the home because the management team run 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. EVIDENCE: There are very good systems in place for induction, supervision, risk assessment, care planning, and shift management. The previous manager has left and we met the current manager, who also has the responsibility to manage another, similar service in the area. She was knowledgable about the needs of people living in the home and committed to putting their needs first.. It was clear that the management team and staff promote people’s dignity, Kiver Road (128) DS0000020965.V370164.R01.S.doc Version 5.2 Page 23 choice, privacy and rights being as the foundation of the service. the new deputy who was very informative and helpful. We also met We saw the records of a number of in house health & safety checks. These included fire alarm tests and health and safety audits. These checks were done regularly and clear records kept. We also had sight of various safety certificates provided by specialist contractors, such gas safety, portable appliances testing (PAT) and the hoist. The Responsible Individual sends monthly reports to the Commission. There was evidence that surveys are done regularly by the organisation to get feedback from the people who use the service and their representatives and the results collated and used as part of quality assurance. There is an overall report to the Housing Committee and funders and a copy of the previous report is presented as part of the service user guide. Kiver Road (128) DS0000020965.V370164.R01.S.doc Version 5.2 Page 24 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 3 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 3 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 X 33 X 34 2 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Kiver Road (128) DS0000020965.V370164.R01.S.doc Version 5.2 Page 25 NO 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 YA34 Regulation 19 Schedule 2 Requirement The registered person must make sure that all of the necessary documentation, as set out in Schedule 2, is kept on staff personnel files. Timescale for action 31/12/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA5 Good Practice Recommendations It is recommended that the work to make the contract more accessible to the people using the service be completed. It is recommended that peoples’ risk assessments are reviewed and amended to reflect the changes in people’s needs. It is recommended that the risk assessment about the use of bedrails be reviewed to include guidance for staff about their safe use, with advice from an occupational therapist. It is recommended that staff be provided with updated DS0000020965.V370164.R01.S.doc Version 5.2 Page 26 2. YA9 3. YA19 4. YA23 Kiver Road (128) 5. 6. YA24 YA27 training in safeguarding people from abuse. It is recommended that the shared areas of the house be redecorated, and in particular the hall and kitchen. The registered persons consider further modifying the facilities in the bathroom to enable the two people who are wheelchair users to have a bath. This includes looking into fitting ceiling tracking and an assisted bath. It is recommended that staff be provided with updated training in food handling and hygiene. 7. YA35 Kiver Road (128) DS0000020965.V370164.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection London Regional Office 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 Kiver Road (128) DS0000020965.V370164.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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