Care Home: Micado Homes Ltd Drayton Lodge

What the care home does well The home has been refurbished to a very high standard throughout. The quality of the decor, fixtures and fittings and furnishings is excellent. The Responsible Individual and Registered Manager administer the home in a structured and organized manner. This is evident in the high standard of record keeping. The documents used to record care from initial assessment to the care plan and risk assessments are designed to capture all the necessary information. We assessed the Key National Minimum Standards and which are al met for Drayton Lodge. The care outcomes for people living at the home was judged on the systems in place to deliver and monitor the care as the first person to live at the home had only done so for a matter of weeks. What has improved since the last inspection? This is the first Inspection of the home and assessment of the Key Minimum Standards for Younger Adults. There are no previous recommendations and requirements. What the care home could do better: We did not make any good practice recommendations or requirements as a result of this visit to the home. Key inspection report Care homes for adults (18-65 years) Name: Address: Micado Homes Ltd Drayton Lodge 47 West Drayton Road Uxbridge Middx UB8 3LB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Susan Woolnough-Singh     Date: 0 4 0 2 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Adults (18-65 years) Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Micado Homes Ltd Drayton Lodge 47 West Drayton Road Uxbridge Middx UB8 3LB 02087073803 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): micadohomes@yahoo.co.uk Micado Homes Ltd Drayton Lodge Name of registered manager (if applicable) Evelyn Adoma Adu Type of registration: Number of places registered: care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: Five The registered person may provide the following category /ies 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: Mental disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home Drayton Lodge is a new Care Home for people who have enduring mental health issues and require support with daily living. One of the main aims of the home is to provide people with the life skills and confidence required to enable them to eventually move into independent accomodation. The building is a semi-detached property, on a corner plot. There is gated off street Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 5 Brief description of the care home parking to the front, and unrestricted parking to the side of the home. The home is located in an area of Hillingdon with reasonable public transport links into Uxbridge, Hayes and other areas of West London. The property has been completely gutted and fully refurbished. The overall impression is of a spacious pleasant and well equipped home. There are no separate sleep in facilities as Micado Homes Ltd only employs waking night staff. There are five bedrooms all are of good size and attractively furnished. There are two communal wash rooms, one with a bath and the other with a shower. There is a spacious rear garden with a games room. Care Homes for Adults (18-65 years) Page 5 of 27 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: We inspected the home on the 16th December 2009 and met and spoke with the Responsible Individual the Registered Manager and one person living at the home. The home was registered in October 2009 and the person residing at Drayton Lodge had only done so for a short period or time. The inspection took place between 11.30 and 15.45. We toured the building and looked at records pertaining to care, staff recruitment and health and safety. The Responsible Individual and Registered Manager are owners of Micado Care Home another care home in the London Borough of Hillingdon. This care home also provides care and accommodation for people with mental health needs. We established with the Registered Manager that the key policies, procedures, care plan and assessment formats were the same. The Registered Manager and Responsible Individual are working in the home with a Care Homes for Adults (18-65 years) Page 6 of 27 member of staff from Micado. New staff recruited for Drayton Lodge will be receiving their induction and experience in Micado Care Home. Care Homes for Adults (18-65 years) Page 7 of 27 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 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 9 of 27 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. The Statement of Purpose and Service Users Guide provide people with the information they need to make a choice about the home. The information sought by the home on the needs of the person prior to moving in is of a good standard. Associated professionals are consulted and the necessary information is submitted. Evidence: The home has produced a Statement of Purpose and Service Users Guide for people who are considering moving into the home. The Guides give all the information required by the National Minimum Standards with regard to facilities and the aims of the home. The home provided information with regard to need assessment and moving into the home, in the Annual Quality Assurance Assessment . The home ensures people are assessed prior to moving in and requests an information summary from associated Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: professionals involved with the person. A New Client Information pack is completed for each person with information requested from the health or social services commissioning team. We sampled the file (care records) of one person. The New Client Application Pack contains recent reports from health care professionals, a Needs Assessment carried out by a social worker, risk assessments and CPA (Care Plan Approach) information. Care Homes for Adults (18-65 years) Page 11 of 27 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. A care plan is formulated and sets out the individual requirements for care and support. Risks are assessed and these are supported by guidance. Evidence: We looked at the care plan and records of one person who had recently moved into the home. People initially stay at the home on a trail basis to begin with to ensure that the placement is correct and meets the persons identified care needs. We were able to see an up to date care plan. This contained information on general health, mental health and assessed risk. The admission records contained information on the Registered Managers meetings with associated professionals and the induction into the home carried out with people who have recently moved in. A form is in place to record and monitor contact with Multi Disciplinary Teams. We were able to see that risk assessments had been carried out and a risk Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: management plan was in place. A crisis management plan is also in place and gives clear guidelines on procedures to be followed. Care Homes for Adults (18-65 years) Page 13 of 27 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. The care plan provides information on the personal support people need to maintain health, and develop. Support is given to people to maintain family and community contact. Evidence: The Statement of Purpose states that the main aim of the home is to develop people and to help them progress. We talked with one person who had recently moved: heshe indicated satisfaction with the service and care provided, and the facilities in the home. The weekly activity programme is incorporated into the care plan. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: On the day of the inspection a Christmas meal had been booked, the person living at Drayton Lodge was going to this with the Registered Person, staff and people from Micado Care Home. We were able to see that art material and games/puzzles had been purchased. The home also benefits room a games room in a double garage to the rear of the building in the back garden. At the time of this inspection meals were being planned on a daily basis. The kitchen is very modern and spacious, people are able to help themselves and use the facilities. Care Homes for Adults (18-65 years) Page 15 of 27 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. Health care needs are covered in the care plan and there is a system in place for monitoring these. There are policies and procedures in place for the safe administration of medication. Evidence: Guidance on health care is contained in the care plan and covers all aspects of the persons mental and physical health. A multi disciplinary contact form is in place and this covers all health care appointments, reviews and any educational appointments. In conjunction with this is a form to be used for contact with professionals and the outcomes. As this was a new registration and the person living at the home had only done so for less than a month it was not possible to evidence the frequency and monitoring of health care appointments. However, the documentation is in place for the required recording of these. The AQQA informed us that the home has comprehensive policies in the administration of medication and that staff are familiar with these and have Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: received the required training. Care Homes for Adults (18-65 years) Page 17 of 27 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. The home has the correct policies and procedures in place for the reporting and investigation of complaints and allegations. Evidence: We looked at the information on complaints and safeguarding adults contained in the Annual Quality Assurance Assessment. This told us that that a Complaints Procedure is available in the Service Users Guide and this contains the stages of complaint and external agencies that can be contacted. This has been updated to include the new contact details for Care Quality Commission. The (AQAA) informs us that all staff have received a copy of the Whistle Blowing policy and are receiving training in Safeguarding Adults. There have been no complaints or adult safeguarding referrals to the Local Authority since the home had been registered and opened. Care Homes for Adults (18-65 years) Page 18 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is spacious, attractively deorated and furnished and well mainted. The standard of hygiene in the home is high. Evidence: We toured the building with the Registered Manager and could see that the home has been refurbished to a very high standard. The property has been completely gutted and fully refurbished. The overall impression is of a spacious pleasant and well equipped home. There is an office on the ground floor, this is big enough to hold meetings, and the usual range of office equipment is in place. There are no separate sleep in facilities the home only employs waking night staff. There are five bedrooms. We were able to see all of the bedrooms including the bedroom being utilized at the time of the inspection. They were all decorated and furnished to a very good standard and are of a good size. There are two communal wash rooms, one with a bath and the other with a shower. Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: The main communal space is impressive. There is a large lounge with a flat screen TV with Sky, Nintendo Wii and various other pieces of technology had been installed. There is sufficient comfortable seating in the lounge. There is another lounge on the first floor which is a quieter area. Additionally, there is a double garage in the rear garden which has been converted to an activity room. Three main pieces of equipment have already been provided (large pool table, football table and a table tennis table). Arts and crafts material provided. The kitchen/dining room is a big open plan space. It has been refurbished in a clean modern style. There is more than enough equipment, all of which is of good quality. There is sufficient seating for people who use the service and staff and staff to sit together for meals. The home was found to be clean and tidy on the day of the inspection. Care Homes for Adults (18-65 years) Page 20 of 27 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. People who use the service are supported by staff who are recruited and trained to the required standard. Evidence: At the time of the inspection the Responsible Individual for the home, the Registered Manager and and an experienced member of staff and a night care worker from Micado Care Home were working at Drayton Lodge. The full complement of staff had not been rostered on to the duty rota as one person was living at the home. Recruitment had started to take place, the staffing levels planned for the home are two members of staff on duty during waking hours and one waking night staff with a member of staff on call. We looked at four recruitment files which were all at different stages due to the recent registration of the home and short period of operating. The files and paperwork were very well organized with sections for the required documents such as the application form, references, Work Visa Home Office Documentation, Identity Verification and Criminal Records Bureau Check. Two members of staff recruited had been accepted for the post but had not started work. The Registered Manager reported that for the time being new staff will undertake their induction at Micado Home, as Drayton Lodge is not fully operational, and they will receive the experience they need in working with Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: people at Micado Home. The recruitment file of a member of staff working at the home contained the required recruitment documentation including references and a CRB check. Training for this person included Food Hygiene, Health and Safety, Medication, Protection of Vulnerable Adults and NVQ Level 2. The Skills for Care Induction Course if offered for all new staff who are subject to a six month probationary period of employment. Care Homes for Adults (18-65 years) Page 22 of 27 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. People who use the service benefit from a well run home. A system is in place for reviewing the quality of the service and care offered to people. The health and safety of people who use the service and staff is promoted and monitored. Evidence: The Registered Manager and her partner are provider owners of Micado Homes. The Registered Manager is a Registered Mental Health Nurse with experience in the community and impatient settings. The Registered Manager is responsible for auditing and monitoring the quality of care in the home and also works with people who use the service supporting them on a daily basis. A system is in place for reviewing the quality of the service offered. This comprises of questionnaires sent to people who live in the home as well as health a social care professionals. A folder of policies and procedures are available covering the National Minimum Standards for younger adults and the standards to which the home aims to Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: work. Due to the short period the home had been operating quality had not been formally reviewed. We looked at a number of health and safety documents. We looked at fire records and were able to see that fire systems and equipment are regularly checked. Fire systems, fire doors an emergency lighting had all been checked since the home had been opened. The Managers of the home had employed an independent risk assessment company to carry out a risk assessment of the premises. This had been done prior to the registration of the home. We did not identify any health and safety hazards as part of our tour of the building. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 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 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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) Care Quality Commission (CQC). 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. 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