Care Home: Meera House Nursing Home

Similar services:

• Henry Nihill House
• Birchwood
• The Infirmary
• Orchard House Nursing Home
• St Josephs Rest Home
• Red Court Nursing Home
• Spinney (The)
• Queen Elizabeth House

What the care home does well What has improved since the last inspection? Since the last inspection changes have been made to the building to increase the communal space in the home. The open plan lounge/dining area on the ground floor has been extended and a spacious conservatory has been added to the open plan lounge/dining area on the lower ground floor. The additional space gives residents more choice in where they can sit and relax and enables them to sit quietly if they do not wish to join in activities. Two additional single bedrooms, with ensuite facilities, have been provided in the home. The bedrooms and the new conservatory have been furnished and decorated to a high standard. Requirements made at the last key inspection in March 2007 have all been met. Replacing the flooring in one of the bedrooms has enabled more effective cleaning and odour control and the bedroom now offers a pleasant place to use during the day, if the residents wish. Documents on staff personnel files show that the recruitment process is thorough and protects the welfare and safety of residents. Offering dementia care training to all carers in the home ensures that informed and understanding carers support residents, wherever they choose to sit. A random inspection took place in September 2007 following a complaint made to the CSCI regarding pressure care in the home. A number of requirements were identified during the inspection and these have now all been met. Records contain all the information necessary to demonstrate what care is being provided, what equipment is being used, that the care provided is kept under review and that pressure care overall in the home is monitored by the manager. This is to be supplemented by training for staff and an intensive training course for the manager. CARE HOMES FOR OLDER PEOPLE Meera House Nursing Home 146-150 Stag Lane Kingsbury London NW9 0QR Lead Inspector Julie Schofield Key Unannounced Inspection 09.00 3 and 19th December 2007 rd X10015.doc Version 1.40 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 DS0000022933.V351706.R03.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 Older People. 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. DS0000022933.V351706.R03.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meera House Nursing Home Address 146-150 Stag Lane Kingsbury London NW9 0QR 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) 020 8204 9140 020 8206 2205 pthakkar@meeranursing.com Meera Nursing Home Limited Anil Kumar Sohun Care Home 54 Category(ies) of Dementia (20), Old age, not falling within any registration, with number other category (34) of places DS0000022933.V351706.R03.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 with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category - Code OP (maximum number of places: 34) Dementia - Code DE (maximum number of places: 20) The maximum number of service users who can be accommodated is: 54 1st March 2007 2. Date of last key inspection Brief Description of the Service: Meera House provides personal and nursing care for up to 54 residents who are elderly. The home predominantly provides a service for Asian elders, who are vegetarian. The home is located a short drive from shops and amenities in Kingsbury and Edgware. It is also close to local transport facilities. There is parking on site and it is possible to park in the street, close to the home. The home has stood on the site since 1989 and has been extended over the years. The last extension in 2003 increased the maximum numbers of service users from 34 to 51 places. An application for registration of another bedroom was approved in 2005 and approval was given for 2 extra bedrooms in 2007. The home now has 44 single bedrooms (27 of which have en-suite facilities) and 5 rooms occupied on a shared basis (4 of which have en-suite facilities). Bedrooms are situated on ground, first and second floors and there are passenger lifts to assist movement. Bathing and toilet facilities are situated on each floor. There are 2 large open plan lounge and dining areas and a spacious conservatory. The home has a well-maintained enclosed and accessible garden, which includes a paved patio area. Information about the services provided by the home is given when a referral or enquiry is made. The home has an information pack including a brochure. There is a notice in the home informing residents, relatives and visitors about how to view the most recent report on Meera House, produced by the Commission for Social Care Inspection. All information provided is printed in both English and Gujarati. DS0000022933.V351706.R03.S.doc Version 5.2 Page 5 The level of fees depends on the needs of the resident and on the service provided and start at £616 per week. The manager should be contacted for individual costings. The manager provided this information in January 2008. DS0000022933.V351706.R03.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The inspection consisted of 2 visits to the home. The first visit was on the 3rd December, starting at 9.00 am and finishing at 3.15 pm. The second visit was on the 19th December, starting at 2.05 pm and finishing at 5.45 pm. During the visits we spoke with the manager, members of staff, residents and people visiting the home. Records were examined, a tour of the building took place and the preparation of a meal was seen. A purpose built Training Centre was opened in August 2007, to be used for staff training purposes. What the service does well: What has improved since the last inspection? DS0000022933.V351706.R03.S.doc Version 5.2 Page 7 Since the last inspection changes have been made to the building to increase the communal space in the home. The open plan lounge/dining area on the ground floor has been extended and a spacious conservatory has been added to the open plan lounge/dining area on the lower ground floor. The additional space gives residents more choice in where they can sit and relax and enables them to sit quietly if they do not wish to join in activities. Two additional single bedrooms, with ensuite facilities, have been provided in the home. The bedrooms and the new conservatory have been furnished and decorated to a high standard. Requirements made at the last key inspection in March 2007 have all been met. Replacing the flooring in one of the bedrooms has enabled more effective cleaning and odour control and the bedroom now offers a pleasant place to use during the day, if the residents wish. Documents on staff personnel files show that the recruitment process is thorough and protects the welfare and safety of residents. Offering dementia care training to all carers in the home ensures that informed and understanding carers support residents, wherever they choose to sit. A random inspection took place in September 2007 following a complaint made to the CSCI regarding pressure care in the home. A number of requirements were identified during the inspection and these have now all been met. Records contain all the information necessary to demonstrate what care is being provided, what equipment is being used, that the care provided is kept under review and that pressure care overall in the home is monitored by the manager. This is to be supplemented by training for staff and an intensive training course for the manager. What they could do better: Records of training are kept but the content of the training programme is in need of review to ensure that sufficient refresher training sessions are included. Training in safe working practice topics needs to be updated on a regular basis so that recommended frequencies be followed. This would ensure that ways of working are based on current good practice and guidance, benefiting both residents and members of staff. Please contact the provider for advice of actions taken in response to this DS0000022933.V351706.R03.S.doc Version 5.2 Page 8 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. DS0000022933.V351706.R03.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000022933.V351706.R03.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4 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. Carrying out an assessment of the resident, prior to admission, ensures that the needs of the resident are identified and that the home is able to determine whether these can be met. Services within the home assure residents that their religious, cultural and dietary needs are met. Standard 6 was not inspected, as the home does not offer an intermediate care service. EVIDENCE: DS0000022933.V351706.R03.S.doc Version 5.2 Page 11 Five residents’ files were selected for case tracking and these included the files of 3 residents that had recently been admitted to the home. Each of the 3 files contained information provided by the funding authority, about the needs of the prospective resident. Where a resident has transferred from a nursing home in another borough information had been provided by the previous placement. The manager said that relatives, and prospective residents, are encouraged to visit the home as part of the pre-admission procedure. When a place is available the manager visits the prospective resident, either at the resident’s home or the hospital (many residents are admitted to the home after a stay in hospital) and carries out an assessment of need. A copy of this assessment was present on each of the 3 files. A service is provided to residents with dementia within Meera House and all carers working in the home receive training in dementia care. A requirement identified during the last key inspection was for all carers on Unit 2 to receive dementia care training but the manager has extended the training to carers working on Unit 1, as well. Prior to the inspection an update training session had been arranged for staff. A discussion took place with the RMN that is responsible for the dementia care unit about how the needs of the resident can be met and about the part that activities can play in maintaining a good quality of life. The layout of the home is helpful with clear signage and photographs assisting movement. Communal space on the lower ground floor consists of 2 separate areas so that residents are able to enjoy their own company, if they wish. Meera House caters for Asian elders and offers a vegetarian diet. The menus and a visit to the kitchen confirmed that this was provided. During the inspection bhajans were taking place. The majority of staff working in the home speak Gujarati and some speak other Asian languages. A relative visiting the home said that language was important and that their relative needed to be able to communicate with the people around her. DS0000022933.V351706.R03.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 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. Assessing the needs of a resident and identifying these in a care plan enables the resident to receive a service tailored to meet their needs. The health and well being of residents is promoted through regular health care checks and appointments. Residents are supported in taking their medication, as prescribed by their GP, in order to maintain their general health. Discreet and caring support is given to residents by staff so that the privacy and dignity of the resident is respected. EVIDENCE: Five residents case files were selected for case tracking. It was noted that files contained a care plan, tailored to the individual needs of the resident, and DS0000022933.V351706.R03.S.doc Version 5.2 Page 13 which identified and addressed the resident’s personal, health and social care needs. Care plans contained a manual handling risk assessment and a nutritional risk assessment. Each component of the care plan was evaluated on a monthly basis and the evaluations were up to date. There was evidence that care plans and the placements were reviewed on a regular basis during meetings convened by the home. Relatives were invited to attend the meetings. The manager confirmed that some local authorities have not reviewed the care plan and placement for over a year. The requirements identified during the random inspection in September when pressure care in the home was reviewed were used as a checklist to measure compliance and good practice. At the time of the inspection there were 2 residents with pressure sores. There is a weekly monitoring by the manager of any resident with a pressure sore and this included a grading system to indicate the condition and extent of the pressure sore. Residents’ case files confirmed that their care plans are kept under review and that the daily records clearly detail the care provided in regard to pressure care. Turning charts were kept and demonstrated that the frequencies were being adhered to. Records were informative and the size of the pressure sores have been measured at regular intervals and photographs taken. A record was kept of the type and make of pressure relieving equipment in use. The manager has arranged training for 2 of the nurses and he is due to start a 6 month “Wound Management Level 3” training course starting in January 2008. The home has a physiotherapist that calls twice weekly and notes are kept of the initial assessment of the resident, their treatment plan (if required) and their progress notes. One of the residents described the exercises that she was encouraged to do and 2 residents said that their mobility had increased since moving into the home. Residents’ case files included evidence that residents have access to dental, optical and chiropody services. The medication policy used in the home has been agreed by the manager, the pharmacist and by the GP. At present none of the residents self medicate. The members of staff responsible for giving medication to residents are the nurses working in the home. Records were inspected and were up to date. The storage of medication was safe and orderly. The home uses a weekly dosette system and medication had been appropriately administered prior to the inspection, according to the day and time that medication was examined. The recording of the administration of controlled drugs was up to date and correct. A relative that was visiting a resident (that had dementia) said that the resident was treated with the respect due to an elderly lady and he said that he would definitely recommend this home to prospective residents and their families. Visits by relatives can take place in the privacy of the resident’s bedroom. For those rooms occupied on a shared basis, screening is provided. Assistance with personal care was offered discreetly and the privacy of the DS0000022933.V351706.R03.S.doc Version 5.2 Page 14 resident is maintained when relatives visit as they are asked to leave the room while this assistance is given. DS0000022933.V351706.R03.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 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 comprehensive programme of activities provides residents with opportunities for stimulation and enjoyment. Residents said that they enjoyed the company of their visitors, who were made welcome by the staff when they visited the home. Residents appreciated the atmosphere in Meera House and said that they were able to exercise choice in their daily lives. Residents’ nutritional needs are met through the provision of a diet that is wholesome and varied and which meets their religious and cultural needs. EVIDENCE: Handicraft sessions are held in the home and some residents use what they have made as items in their bedrooms e.g. small bowls or fruit baskets. One resident proudly showed items that she had made and her supplies of materials. Residents enjoy knitting, puzzles, reading or colouring and DS0000022933.V351706.R03.S.doc Version 5.2 Page 16 examples of their artwork are displayed in the lounge/dining areas. The senior nurse who has responsibility for activities in the home said that the focus was on the “individual” resident rather than groups of residents and that activities that take place are age appropriate and use materials that are culturally appropriate. Prayers and religious observances take place in the home on a regular basis and during one of the inspection visits bhajans were taking place. Residents looked forward to these and said that they appreciated being able to perform their religious observances. The bhajans were well attended by residents and one resident liked to use her own finger cymbals to make music. In August 2006 the Swami Ramdevji visited the home and spent time with residents. Photographs of the visit were on display. Since then another religious leader has visited the home and residents said how much they had enjoyed this visit. Some residents enjoy 1 to 1 support from a carer and carers were seen sitting and talking with residents or singing religious songs with residents. Relatives and school children visiting the home will play board games etc with residents. The reception area of the home provides a welcoming first impression for visitors and all notices or information on display in the home are printed in both English and Gujarati. In the reception area there is seating for visitors and residents, if they wish to use this area. The photographs of everyone working in the home is on display so that relatives or visitors are able to identify who is on duty or whom they have spoken with. A relative that was visiting the home during the inspection said that they were always made welcome when they arrived at the home. Visits can take place in the resident’s bedroom or in the communal areas, according to the wishes of the resident. Residents said that they were pleased to receive visitors. Residents said that their wish to carry out their religious observances was respected. They said that they were able to choose whether to take part in activities or whether to spend time quietly on their own. It was noted that many residents liked to sit together in small groups and enjoyed chatting together. Residents confirmed that they were able to spend time in their rooms during the day, if they wished, and during the site visit some residents were sitting relaxing in their rooms. Residents are able to bring small items of furniture with then when they move into the home and some residents have made their rooms more personal with photographs of family members and religious objects. During the first visit to the home the preparation of the midday meal was seen. The home has a 3 weekly menu on display. The meal consisted of curried vegetables, dahl, rice, chapattis, fresh salad, pickles and buttermilk. Either fruit or an Indian dessert followed this. The home modifies the menu when root vegetables are served so that it can meet the religious and dietary needs of Jain residents. Residents were complimentary about the food served in the home and the meal served looked wholesome and smelt appetising and was DS0000022933.V351706.R03.S.doc Version 5.2 Page 17 well received by residents. The home is able to meet a variety of dietary needs including meals for diabetic residents and for residents that need a pureed or soft food diet. Assistance is provided with feeding if residents need this and meals are unhurried. DS0000022933.V351706.R03.S.doc Version 5.2 Page 18 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 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 complaints procedure was in place to protect the interests of the residents and residents said that they were able to bring any concerns to the attention of the manager or owners. Protection of vulnerable adults training for staff and familiarity with the home’s procedure and the interagency guidelines contribute towards the safety of residents. EVIDENCE: The complaints procedure was on display in the home and a copy is contained in the service user guide. It is written in both English and Gujarati. The procedure informs the complainant of their right to contact the CSCI, local councillor and the Ombudsman. It includes timescales for the acknowledgement of a complaint and for notifying the complainant of the outcome of the investigation. The complaints book was examined. There is a cover sheet at the front and it was noted that records included details of the investigation carried out, when feedback is given to the complainant and the action plan devised, if one was necessary. Eight complaints have been DS0000022933.V351706.R03.S.doc Version 5.2 Page 19 received by the home since the last inspection and where the service provided has not met the standard expected by the complainant the manager has apologised and put forward steps to resolve the matter. Residents said that if there was a problem or if they had any concerns they could speak to someone in the home i.e. the manager or the owners and they knew who these people were. Residents said that the proprietors visited the home on a regular basis and photographs of activities that have taken place in the home confirmed this. During the inspection one of the proprietors was visiting and she took time to speak with residents to ask them if they were satisfied with the service and then to sit with them for a general chat. There is a suggestion box in the entrance hall for the use of residents, staff and visitors to the home. Since the last inspection a complaint was received by the CSCI regarding pressure care and a random inspection was undertaken to review arrangements in the home. There is an adult protection policy, a whistle blowing procedure, a countering bullying procedure, a harassment policy and an aggression towards staff policy in place. The home arranges for members of staff to attend protection of vulnerable adults training offered by the local authority and also holds in house training for members of staff, using a training video. The manager said that no allegations or incidents of abuse have been recorded since the last key inspection. The home does not practice restraint. DS0000022933.V351706.R03.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 26 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 live in a home, which is decorated and maintained to a good standard and which provides them with comfort and ease. A choice of communal areas gives residents the opportunity to socialise or sit quietly according to their wishes. Residents live in a home where high standards of cleanliness provide residents with hygienic surroundings. EVIDENCE: During the last key inspection a requirement was made that the carpet in one of the upstairs bedrooms is cleaned or replaced. During the inspection a tour DS0000022933.V351706.R03.S.doc Version 5.2 Page 21 of the building took place and flooring that was easy to keep clean and odour free had replaced the carpet in this room. Residents agreed that the Meera House was furnished and decorated to a good standard. The temperature in the building during the inspection visits was comfortably warm. It was noted that the maintenance of the home was good and that furnishings and fittings were of a good quality. The décor of the home reflects the culture and religion of the residents. Residents confirmed that they were satisfied with their bedrooms. The home is accessible and handrails, wide corridors and doorways and passenger lifts in the home help residents to maintain their individual levels of independence. Since the last inspection major changes have taken place with the indoor communal areas. On the ground floor the open plan lounge/dining area has been extended. On the lower ground floor the open plan lounge/dining area has had a conservatory added. Both of these changes have included redecoration and refurbishment to a high standard. Communal areas are light and bright and spacious and offer residents more choice in terms of whether they want to sit close to others are more privately. The garden area at the rear of the property is beautifully maintained and has level access from both ground and lower ground floors. During the tour of the building all areas seen were clean and tidy and free from offensive odours. Residents said that the home was always kept clean. The manager confirmed that staff had received infection control training as well as in-house training sessions about MRSA and correct hand washing. DS0000022933.V351706.R03.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 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. Staffing levels were sufficient to meet the needs of residents. The home continues to support staff undertaking NVQ training, as residents benefit from staff that have developed their understanding and awareness of the needs of the residents. Recruitment procedures are thorough and this promotes the safety and welfare of residents. Residents would benefit from staff trained according to current best practice and guidance but the training programme lacks sufficient refresher training to provide this. EVIDENCE: The home has encouraged staff to do NVQ training and is holding a celebration of achievement and appreciation for successful staff members. The manager said that approximately 70 of carers hold an NVQ level 2 or equivalent qualification. As some carers have qualified as nurses outside the EU the manager said that he has included them in the overall figure of 70 , as he would argue that they have an “equivalent qualification”. The home has now exceeded the target of 50 of all carers qualified to an NVQ level 2 standard. DS0000022933.V351706.R03.S.doc Version 5.2 Page 23 Copies of the rotas for week commencing the 9th December were shown during the second inspection visit. There is a rota for each of the 2 units in the home. Each rota has a separate section for nurses and for carers and day staff and night staff are listed in different sections. There is also a rota for support staff e.g. domestic and catering staff. The manager said that 4 carers are allocated to each unit, on each shift during the day and that Unit 1 has an additional carer each morning i.e. 5 carers on duty. There are times, according to the needs of the residents, when staffing levels may be increased. At night 2 carers are allocated to each unit. A nurse is in charge of each unit on each shift during the day and the night. There are male staff working in the home (2 carers and 2 RGN’s) and these will assist male residents with personal care, if the resident wishes. The home also employs finance and administrative staff, laundry staff, a handy person and a gardener. The hours of the manager are supernumerary and although mainly Monday to Friday, 9 am until 5 pm, the manager and the owners call to the home unannounced during the evenings and weekends to monitor the quality of the service. They also provide an on call management rota for when the manager is off duty. Four staff files of members of staff employed since the last key inspection were checked. Each file contained evidence that the recruitment procedure included receiving a satisfactory pova first and then enhanced CRB disclosure, proof of identity i.e. passport details and that the right to reside and to work in the UK had been established. Files also contained 2 satisfactory references so the home has met a requirement identified during the last key inspection. A copy of the staff training programme for 2006-7 was shown. This records the date on which a training course took place and the number of members of staff that attended. The first entry on the programme was at the beginning of February 2006 and the last entry was at the end of November 2007. The number of staff recorded as having received moving and handling training was below what would be required for staff to receive moving and handling training on an annual basis. The manager confirmed that all members of staff have received training in dementia care even if they do not usually work in Unit 2. Individual training records are available to give a profile of the training undertaken by the member of staff. A copy of the induction training package used in the home was seen. It is based on the Common Induction Standards developed by the Sector Skills Council. DS0000022933.V351706.R03.S.doc Version 5.2 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 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. By continuing his personal development, through further training, the manager ensures the efficient and effective running of the home. Quality assurance systems in place enable the future development of the service to reflect the views and needs of the residents (or persons acting on their behalf). Support is given to residents who need assistance in managing their finances so that residents’ financial interests are protected. Training for staff in safe working practice topics promotes the health and safety of residents, staff and visitors to the home. Regular training updates would ensure that the knowledge continues to support the needs of all involved. The testing/servicing of equipment in the home demonstrates that it continues to be safe to use. DS0000022933.V351706.R03.S.doc Version 5.2 Page 25 EVIDENCE: The manager has received his RMA certificate and this was shown. He already holds a DMS, has a masters’ degree in social policy and administration and is a qualified RGN. Since the last inspection he has attended a course update on dementia care and has had Mental Capacity Act training. Copies of the last inspection report by the CSCI are available in the home and a notice reminds visitors and residents of this. As with all printed information in the home, the notice is written both in English and Gujarati. A discussion took place with the manger in respect of quality assurance systems and monitoring in the home. He said that residents have the opportunity to give feedback on a day-to-day basis and residents spoke with him as he walked around the home. Residents also said that when the owners visited the home the owners always spoke with residents and this was seen during the inspection. There was a very comfortable atmosphere between residents and the proprietor that was visiting the home and she was sat in one of the lounges, chatting with residents. The home distributes an annual satisfaction questionnaire to relatives and to funding authorities and the manager said that these are due to be posted on the 5th December. Previously the topics identified on the questionnaire included the accommodation, feeling safe, communication, food and drink, laundry, contact with the managers, activities, respect for the resident’s religion, confidentiality and celebration of religious festivals. The results of the analysis of completed questionnaires are displayed on the residents’ notice boards in the home and there is a comparison with the results from previous years. The manager has started to hold an open afternoon, on a monthly basis, when he makes himself available for relatives to call in to see him, if they wish. During the inspection a relative that was visiting the home said that he was aware of and attended the relatives meetings held by the home. Only 2 residents receive assistance with their finances. All other residents are supported and advised by their families. A member of the company is the appointee for one of these 2 residents and the funding authority provides an appointee for the other resident. Records were checked and these were up to date with receipts to confirm when and how money has been spent. Residents are encouraged to sign the records to confirm that they have received the money that they are given and some of the records are in Gujarati. The savings book for the resident that has a member of the company as their appointee was shown. Since the last inspection a review of how the home meets the needs of residents with disabilities has taken place. In order to make the outside areas DS0000022933.V351706.R03.S.doc Version 5.2 Page 26 safer, edges of pathways and steps have been highlighted with yellow paint. The home already offers level access at the front of the home and at the back, into the garden area, and passenger lifts make all parts of the home accessible. A visit by the Environmental Health Office took place in September 2007 and the home received a scoring of “very good”. Certificates for servicing, checking or inspecting equipment and systems in the home were shown. There were valid certificates for the passenger lifts, the Landlord’s Gas Safety Record, the hoists, the electrical installation, the water sterilisation, the assisted baths, the portable electrical appliances, the fire extinguishers and the fire alarm systems. There were records of weekly fire alarm tests and monthly fire drills being held although it is recommended that a list of those staff on duty when a fire drill is held be kept. The records required for managing health and safety in a large building such as Meera House are extensive and they were kept in an organised manner enabling staff to check when servicing was required. The staff training programme includes training in respect of fire safety, health and safety, moving and handling, food hygiene, and first aid. There are recommended frequencies for renewing some of the safe working practice topics training and it is recommended that individual training profiles highlight these. DS0000022933.V351706.R03.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 DS0000022933.V351706.R03.S.doc Version 5.2 Page 28 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 OP30 Regulation 18(1) Requirement To ensure that residents benefit from a service based on current best practice and guidance a review of the content of the staff training programme is needed so that sufficient refresher training is provided. To ensure that ways of working promote the safety and welfare of the members of staff, residents and visitors to the home all staff must receive regular training updates for safe working practice topics. Timescale for action 01/04/08 2 OP38 18(1) 01/04/08 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 OP7 Good Practice Recommendations That where care plans and placements have not been reviewed by the funding authority for over a year contact a letter is sent requesting that they convene a review meeting. DS0000022933.V351706.R03.S.doc Version 5.2 Page 29 2 3 OP38 OP38 That a list of those staff on duty when a fire drill is held is kept. That individual training profiles highlight the recommended frequency for renewal of training in safe working practice topics. DS0000022933.V351706.R03.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 DS0000022933.V351706.R03.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!