Care Home: Matthew Residential Care Limited

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What the care home does well During the inspection the residents expressed satisfaction with living in the home and 1 resident said that they liked living at Woodgrange Avenue and wanted to live there for ever. We saw that during review meetings convened by the funding authority the resident was asked for their comments about the placement and 1 resident said that "they are treated with respect and given opportunities to make choices in their daily activities". Another resident said that they "had all their needs met in the current placement". Positive remarks were made by the resident`s care manager and one care manager noted that the residents attendance at the day centre and their personal appearance had improved since living at Woodgrange Avenue. A health care professional told us that the home "provides a warm and friendly atmosphere, provides detailed written reports and records as required, engages with external professionals and acts on advice given". During the inspection we noted the support given to residents in respect of their cultural, religious and dietary needs and in meeting their wishes and preferences. What has improved since the last inspection? Redecoration and some refurbishment has taken place since the last key inspection. This helps to maintain the overall good upkeep of the home. The weekly activity programmes of residents have been enhanced and the number of days at day centre during the week has increased for 1 resident and more varied activities have been included for the resident that prefers not to attend a day centre. Residents benefit from a programme of interesting and stimulating activities. Members of staff working in the home are continuing with their NVQ studies after completing one level e.g. the deputy manager has commenced NVQ level 4 training after achieving her NVQ level 3 qualification. What the care home could do better: Some minor repairs are needed in the bathroom and kitchen and the flooring in the bathroom needs replacing so that residents continue to enjoy a well kept and smart living environment. A resident needs help to store belongings safely in their room so that the piles on the floor do not present a health and safety hazard. The training plan needs to include Mental Capacity Act training for the manager so that under his guidance the service provided meets legislative requirements. Although members of staff have undertaken training in safe working practice topics they need to refresh this training at regular intervals so that current best practice is followed. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Matthew Residential Care Limited 59 Woodgrange Avenue Kenton Harrow Middlesex HA3 0XG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Julie Schofield     Date: 2 8 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Matthew Residential Care Limited 59 Woodgrange Avenue Kenton Harrow Middlesex HA3 0XG 02089078435 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Matthew Residential Care Limited care home 3 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 3 The maximum number of service users who can be accommodated is:: 3 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home 59 Woodgrange Avenue is situated in a turning off Kenton Road and is a short walk away from local shops and bus routes. The property accommodates 3 residents with learning disabilities and at the time of the inspection there were no vacancies. There is a spacious lounge and a separate dining room on the ground floor and a kitchen. In addition there is also a shower room, with basin and toilet. On the first floor there are 3 single bedrooms, each with a wash hand basin. There is a bathroom with a wash hand basin and bath and there is a separate toilet. There is a room on the first floor, which is used for some storage of records, staff sleeping in facilities and as the laundry room. There is an office in the garden, adjacent to the house. The area of the front of the property has been paved to provide off street parking and there is an attractive Care Homes for Adults (18-65 years) Page 4 of 31 Brief description of the care home garden at the rear of the property. Information regarding the level of fees charged is available, on request, from the manager of the home. Care Homes for Adults (18-65 years) Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The inspection took place on a Tuesday in October. It started at 8.10 am and finished at 2 pm. During the inspection we spoke with the deputy manager and with the manager, who joined us after the inspection had started. We met and spoke with the residents and would like to thank them for their comments. Records were examined and the care of residents was case tracked, a tour of the building took place and compliance with the statutory requirements identified during the previous key inspection in 2006 was checked. We sent survey forms to health care professionals and stakeholders and at the time of writing the report we had received replies from 1 health care professional. We would like to thank everyone for their assistance and for their comments during the Care Homes for Adults (18-65 years) Page 6 of 31 inspection. We have also received the Annual Quality Assurance Assessment (AQAA) that the CSCI sends to services for the service to complete. The information contained has also been used during this inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 31 Care Homes for Adults (18-65 years) Page 9 of 31 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A comprehensive assessment of the needs of the resident, prior to admission to the home, enables the manager to determine whether a service tailored to the individual needs of the resident can be provided. Evidence: No new residents have been admitted to the home since the last key inspection. The most recent admission to the home was in 2005. The home has an admission policy and procedure and this includes obtaining the relevant information and copies of documents from the funding authority. The manager also carries out an assessment of need during a visit to the prospective resident. The assessment of the prospective resident continues during a programme of pre-admission visits to the home. The resident (and their representative) is fully involved throughout the process. The gathering of information and the assessment of need enables a decision to be made on the suitability of the placement and by visiting the home the prospective resident has an opportunity to confirm this. Care Homes for Adults (18-65 years) Page 11 of 31 Care Homes for Adults (18-65 years) Page 12 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Comprehensive care plans have been drawn up for each resident so that the service provided can meet the individual needs of the resident. The home is able to demonstrate that changes in the needs of residents are identified and addressed through a system of regular review meetings. The residents right to make decisions about their life in the home is respected. Responsible risk taking contributes towards the resident leading an independent lifestyle and reviewing these on a regular basis ensures that the changing needs of residents are identified and addressed. Evidence: Care plans were inspected. The care plan is based on an assessment of need and the assessment is updated from time to time. The plan identifies social, personal and health care needs. Within each need potential hazards were identified. Care plans also include behavioural guidelines. Care plans were signed and dated and the resident also signed the care plan. Case files included evidence of regular review meetings convened by the funding authority and by the care home. These are attended by the resident Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: and by their relatives, if the resident wishes. There are agreements on file that are signed by the resident when there are restrictions on choice and freedom. Examples of these agreements include cleaning the residents room if the resident is absent and what behaviour is not acceptable in the home. Residents gave examples of their right to make decisions and these included when they got up in the morning and when they went to bed, what they ate, what activities they took part in, where they went on holiday, what clothes they wore, how they spent their money, whether they wanted to socialise in the home or enjoy the privacy of their own room and how they spent their time. Information about an advocacy scheme run by Harrow Mencap was on display in the home. Residents receive benefits directly. They may request assistance in withdrawing money from their account, budgeting or saving for a holiday etc. Those receiving assistance have a record book and these were available for inspection. Records were up to date and complete and included details of any money held in savings accounts. Risk assessments were tailored to the individual needs of residents. They included stranger danger, using electrical items and getting home after dark. The risk assessment included pro active intervention. There was evidence that risk assessments had been reviewed. Care Homes for Adults (18-65 years) Page 14 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Taking part in activities and using community resources gives residents the opportunity to enjoy an interesting and stimulating lifestyle. Residents are encouraged to maintain contact with their families, to establish relationships and to observe their religious practices so that their social and spiritual needs are met. Residents are encouraged to become more independent by making decisions and by having their wishes respected. Residents are offered a balanced diet to promote their well being and the diet respects their religious and cultural needs. Evidence: We looked at each of the residents case files and talked with residents and with members of staff about activity programmes. Two of the residents have an activity programme that includes day centre attendance. One resident attends a day centre on 4 days per week and the other resident attends their day centre on 5 days per week. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: The first resident has gradually built up their number of days and was pleased that they were doing something that they enjoyed. At the day centre there is work with computers and work on literacy skills. The third resident has chosen not to go to a day centre and a programme of activities, both inside and outside the home, has been agreed with the resident. Activities include personal shopping, visits to the library, visits to places of interest, cookery, attending college on one day per week and art therapy sessions. One of the residents attends the Temple, which meets his spiritual needs. He has also taken part in the Asian Outreach Summer Project. All of the residents are mobile and use public transport or taxis if they need transport. Two of the residents are able to travel independently. Residents make use of community resources including shops, restaurants, pubs, cinemas, the library, cultural centres, places of worship and clubs. Residents names are entered on the electoral roll and information about postal voting has been received. The manager previously told us that as the residents have their own individual interests they prefer not to take part in group activities and there was evidence that residents were able to pursue their own individual interests. Residents attend clubs, dances and social events. One of the residents, who is Asian, attends clubs that meet his cultural and religious needs. Residents have had the opportunity to enjoy an annual holiday and one of residents told us that they had been on a holiday in Brighton in September, with one of the other residents. The third resident does not like to be out of the house overnight so a programme of days out was arranged including trips to Buckingham Palace, a boat ride on the Thames and visiting the area where the resident had been born. Residents are able to entertain their visitors in their room, if they wish. They said that when relatives visit the home the staff on duty make the relatives welcome. Two residents also visit their families independently and 1 resident occasionally stays the night with them, when they wish. The third resident has a member of staff to accompany them to visit their relative and they go by taxi. Residents confirmed that the privacy of their room is respected and residents are offered a key to their bedroom. Two of the residents chose to use these. Residents are encouraged to take part in the daily routines of the home by helping to load the washing machine and clearing away their crockery after a meal. Residents are expected to keep their rooms clean and tidy and residents have the opportunity to do some cooking or ironing, with supervision. One of the residents said that they liked cooking a pasta bake or spaghetti bolognese. During the inspection one of the residents prepared their breakfast. Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: The home has a 5 week menu system. The menus were varied and wholesome. Fresh fruit, vegetables and salad were included and there was variety amongst the protein and carbohydrate groups. Fresh fruit is also available to residents between meals. There is a separate menu of Asian foods, to meet the cultural and religious needs of a Hindu resident and the resident is able to choose an alternative to the main menu, when they wish. Individual food records are kept. Residents said that they liked the meals served in the home and that the members of staff were good cooks. The fridge and freezer were checked. It was noted that in the past food items in the freezer and in the cupboards had been opened and not securely fastened after use. We saw on this inspection that bags were now secured after use. Care Homes for Adults (18-65 years) Page 17 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive prompting with personal care in a manner which respects their privacy and 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 members of staff that assist the resident to take prescribed medication in accordance with the instructions of the residents GP. Evidence: The level of assistance with personal care varies according to the needs of each resident and ranges from prompting to direct assistance. Progress has been made to ensure that residents maintain good standards of personal hygiene. Within the staff team (including the manager) there are male and female members of staff so that assistance with personal care can be provided by a person of the same gender as the resident. Routines in relation to getting up in the morning and going to bed at night are flexible and we saw that on the day of the inspection. However, residents are encouraged to keep regular hours so that they are able to get up in time to attend day centres etc. Residents choose what they wear each day and we noted that residents were clean and tidy and smartly dressed. When we visited the care home it was Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: shortly before Diwali and a resident and 1 of the members of staff had been shopping in Wembley and the resident had purchased 2 traditional outfits to wear for celebrating the festival. The member of staff said that the residents family were very happy that the resident had new clothing that was culturally appropriate for celebrating festivals with the family. When we looked at the residents case files we saw that each file contained a health action plan. There was also evidence that residents had access to health care services in the community including the optician, dentist, GP, psychiatrist and psychologist. There was access to routing screening e.g. blood tests. There was also access to specialist support e.g. the speech and language therapist and the dietician. A reference was made in a letter regarding a member of staff escorting the resident to attend an out patient appointment at the hospital. A medication policy and procedure is in place. None of the residents self-medicate. Medication is kept in a locked cabinet and within the cabinet the storage is orderly and neat and there are designated areas for the storage of a particular residents medication. We saw the deputy manager prepare the medication for a resident, prior to its administration and noted that she followed safe working practice procedures e.g. carrying out a number of checks to ensure that the resident receives their correct medication. Medication is taken from the box or packet and placed in a small plastic cup. A record is kept of the balance of medication remaining so that ordering of a repeat prescription can be done in good time. After a resident receives their medication the medication for another resident is prepared. The records kept of the administration of medication were up to date and complete. The manager confirmed that all of the members of staff that were responsible for administering medication had received appropriate training. We saw that copies of training certificates are kept on the staff files. Care Homes for Adults (18-65 years) Page 19 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A complaints procedure is in place to protect the rights of residents. An adult protection procedure and training in protection of vulnerable adults procedures help to promote and protect the welfare and safety of residents. Evidence: A complaints procedure is in place in the home. It includes a description of the stages of the procedure and the timescales involved. It refers to the CSCI. The manager confirmed that no complaints have been recorded since the last inspection. Residents said that they were satisfied with the service provided but if there was anything that they were not satisfied with they felt able to speak to someone in the home. They named their key worker or the deputy manager or the manager as someone that they could talk to. We have been told that as part of the admission procedure the complaints procedure is discussed with the resident. The home has developed a userfriendly format for this purpose. None of the residents wish to keep a copy of the complaints procedure in their room and there is a statement regarding this in their file and it has been signed by the resident. However, there is a copy of the complaints procedure on display in the kitchen. This is a care home for 3 residents and they are encouraged to give feedback on a daily basis so there are opportunities for residents to make comments or to voice any dissatisfaction. A protection of vulnerable adults procedure is in place. There is also a whistle blowing Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: procedure. A copy of the interagency guidelines in the event of abuse is kept in the home. A member of staff on duty confirmed that she had undertaken protection of vulnerable adults training and was able to explain what would happen in the event of a disclosure being made or incident occurring. She was clear about what her responsibilities would be. Staff files examined confirmed that all staff receive training in the protection of vulnerable adults procedures and that the training is up to date. There are also policies and procedures in place in respect of physical and verbal aggression by a resident and for the management of residents monies. Care Homes for Adults (18-65 years) Page 21 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a home, which is comfortably furnished and provides a pleasing environment for residents to relax in and to enjoy. Residents live in a home where the standards of cleanliness are good. Evidence: A site visit took place, although we did not see one of the bedrooms as the resident had locked their room and did not want to have any visitors. This was respected. Residents said that they were pleased with their rooms and that they were of a good size. Since the last key inspection some refurbishment and redecoration has taken place. There is a new carpet in the lounge and a new storage unit and a new table and chairs in the dining room. The washing machine, tumble drier and dishwasher have all been replaced. The communal and private areas have been repainted. Although the general upkeep of the building is good, some minor repairs were needed. We saw that the flooring in the first floor bathroom was damaged and that the sealant above the edge of the tiles was becoming detached. The wallpaper in the bathroom was lifting from the wall in places. We noted that the carpet on the stairs and landing was marked and the deputy manager said that this had happened when the old washing machine had been removed and the new one installed. In the kitchen there were a couple of tiles near the oven that were cracked and the sealant was becoming detached in this Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: area. We have previously seen a letter on a residents file. It confirmed that a visit had been made by a social worker who acknowledged that the resident had damaged their wash hand basin when they tried to remove it from the wall. An agreement had been made with the home, that for health and safety reasons, a new basin would not be installed. The resident is still able to use the wash hand basin in the bathroom or in the shower room. It was noted during the site inspection that the home was clean and tidy and free from offensive odours. Laundry facilities are accommodated in a room on the first floor and are suitable for the needs of the 3 residents. The washing machine and tumble drier have recently been replaced. Staff have undertaken infection control training and an infection control policy is in place. Care Homes for Adults (18-65 years) Page 23 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A programme of NVQ training for members of staff assures residents that care practices are based on an understanding of the residents needs. Staffing levels in the home assure residents that there are sufficient members of staff on duty each day to support the residents and to meet their needs. Recruitment practices promote the welfare of residents. Residents benefit from support given by members of staff that are skilled and trained. Evidence: We discussed NVQ training for the staff team. We were told that the deputy manager was undertaking NVQ level 4 training and that of the other 4 members of staff, 1 person had completed their level 3 training, 1 person was undertaking level 3 training, 1 person had completed their level 2 training and 1 person was undertaking level 2 training. Therefore the team had met the target of 50 of carers achieving an NVQ level 2 or 3 qualification. When we were in the care home we saw that carers had a good rapport with the residents and that they demonstrated a commitment to their work. They were knowledgeable about the individual needs of each resident. We discussed staffing levels with the deputy manager and the levels that we saw when we were in the care home were in accordance with these. There are usually 2 Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: members of staff on duty throughout the day, until 9pm. After this time and until 8am the next morning there is 1 member of staff on duty at night, that sleeps in but is on call. The managers hours are supernumerary and there are details of the management on call rota available to the staff team, in case of an emergency. The staff team consists of female carers and a male manager and there are 2 female residents and 1 male resident living in the home. The manager would respond if the male resident requests assistance with personal care tasks. Two of the residents travel independently in the community. Staffing levels are sufficient so that residents can take part in different activities or residents can have the choice of staying in the care home or going out with an escort, if necessary. One of the residents is Asian and members of staff speak with him in English, as he is bilingual. We looked at the staff files of 3 members of staff. We saw that they each contained an application form, a statement regarding the applicants medical history and fitness for work, 2 references, proof of identity (passport details) and an enhanced CRB disclosure. Where necessary, the right to reside and to work in the UK had been established. Files also contained a statement of the terms of employment. We discussed the training available to members of staff working in the care home with the deputy manager. Three staff files were examined. We saw that the home uses the Skills for Care Common Induction Standards for use with new members of staff. Each staff file contained a training profile, which lists all the courses that the member of staff has attended. Staff had undertaken training in safe working practice topics e.g. health and safety, infection control, manual handling, food hygiene and first aid. Some members of staff had undertaken training in equalities and diversity. There were attendance certificates for courses in epilepsy, medication, autism and protection of vulnerable adults procedures. Care Homes for Adults (18-65 years) Page 25 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered manager continues to develop his knowledge through further training and this contributes towards understanding the needs of residents and staff. Undertaking Mental Capacity Act training assures residents that the manager is aware of his responsibilities under the legislation. Systems are in place to gather feedback on the quality of the service provided to enable the service to develop in ways that meet the changing needs of the residents. Comprehensive policies and procedures are in place to support members of staff and to assist with the smooth running of the service. Training in safe working practice topics enables members of staff to safeguard the health, safety and welfare of the residents. Refreshing this at regular intervals would assure residents that current best practice is understood and in use. Regular servicing and checking of equipment used in the home ensures that items are in working order and safe to use. Evidence: Since the last key inspection the previous deputy manager has become the registered manager. He has had experience of working in a care home, at a senior level, with this Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: client group. He has successfully completed his RMA (Registered Managers Award) and has done short courses to update his skills and knowledge, including attending training in safeguarding adults. He has undertaken Mental Capacity Act training. A discussion took place with the manager regarding obtaining feedback on the quality of the service provided. This is a care home for 3 residents and it was acknowledged that verbal feedback is obtained from residents on a daily basis. Meetings between a resident and their key worker or the manager are also held and recorded. The manager encourages an open door policy so that residents can make any comments. Due to the small number of residents living in the home the manager prefers to speak to the residents on an individual basis rather than hold residents meetings. Feedback is obtained more formally at review meetings and copies of the minutes of these were on the residents case files. We read positive comments about the service provided in the home, from the residents perspective. Verbal feedback may also be obtained from relatives when they visit the home or if they attend review meetings. It is obtained from placing authorities when social workers visit the home or when review meetings are held. Members of staff have an opportunity to comment on the service provided during their supervision sessions or at staff meetings. The manager said that he has check lists to complete on a regular basis to assess the quality of the service. The manual of policies and procedures was available for inspection. It was comprehensive and we saw that the policies and procedures had all been reviewed and updated in April 2007 by the proprietor. The manual is kept in the office and is available for reference by members of staff. The manual had a good, clear index to help with its use. We saw that there was a valid Employers Liability Insurance certificate on display in the home. We noted that there were attendance certificates on the staff files examined for training in safe working practice topics. However, certificates were not always available to demonstrate that some of these had been refreshed at regular intervals. The testing or servicing of the fire precautionary equipment and systems, the Landlords Gas Safety Record, the portable electrical appliances and the electrical installation was up to date. There was evidence that the fire alarms and smoke detectors are tested at weekly intervals and that monthly fire drills are held. When we carried out the site visit and spoke with a resident in their room we noted that piles of belongings were being stored on the floor, restricting circulation space within the room. The resident said that members of staff had spoken with them about this and they agreed to let a member of staff help them to store their belongings safely. Care Homes for Adults (18-65 years) Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 24 23 A number of minor repairs in 01/01/2009 the bathroom and in the kitchen must be carried out. This will make sure that residents continue to enjoy a property that is well maintained. 2 24 23 The flooring in the bathroom 01/02/2009 must be replaced. This will ensure that residents continue to enjoy a property that is well maintained. 3 42 18 Attendance certificates must 01/04/2009 be kept on file to demonstrate that training in safe working practice topics is refreshed at regular intervals. To ensure that members of staff are aware of and implement current best practice, 4 42 13 Members of staff continue to 01/12/2008 encourage the resident to Page 29 of 31 Care Homes for Adults (18-65 years) store their belongings in drawers or cupboards and not left in piles on the bedroom floor. To ensure that residents are not exposed to a fire or a health and safety risk in their room. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 24 That the carpet on the stairs and first floor landing is cleaned to remove the marks made when the washing machine was replaced. Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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