Care Home: St Andrew`s Home

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What the care home does well The home is environment is comfortable, clean and well decorated. There is easy access to local shops and transport links. Residents enjoy the meals and they have a chance to shop and cook for themselves. This helps in rehabilitation. Assessed and changing needs and goals are reflected in written plans for how care is to be provided to each resident. Residents are consulted about their personal plans and about wider house issues. Personal information is stored securely and staff understand the need for confidentiality. There is regular consultation with residents and their views and suggestions are acted upon. Residents are able to enjoy the lifestyle of their choosing within the confines of shared living and house rules. Residents receive personal care in the way they need and in the way that they prefer. Physical and emotional health is well monitored and staff assist residents to make and attend appointments if necessary. Medication is handled well by staff and residents are encouraged to take responsibility for their own medication where possible. Staff are trained to recognise abuse and they know what to do if they suspect someone is unsafe or being abused. Comments from current residents include: "They take care of my everyday needs and support me in my everyday living" "It`s alright" "They make sure that our appointments to the GP and Dentist are met, and look after our personal needs" "The staff take care of us very well" "I practise shopping for the home" "There are balanced meals and good laundry service, and personal care is emphasised" Comments from a health professional involved in the care of one of the residents are also positive, "We are very pleased with the service". What has improved since the last inspection? A new home manager has been appointed and has registered with the Commission. The manager is qualified and experienced and is currently updating his qualifications and taking a management course as well. Records relating to the money that staff hold in safekeeping for residents have improved. This helps to safeguard residents from financial abuse. CARE HOME ADULTS 18-65 St Andrew`s Home 92 Drewstead Road Streatham London SW16 1AG Lead Inspector Sonia McKay Unannounced Inspection 26 September 2008 08:30 th DS0000022753.V353766.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000022753.V353766.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000022753.V353766.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Andrew`s Home Address 92 Drewstead Road Streatham London SW16 1AG 0208-769-0668 0208 769 0668 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) Crown Wise Limited Mr Eugene Owusu Care Home 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (0), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (0) DS0000022753.V353766.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. up to three persons only can be aged 65 years and above Date of last inspection 25th July 2006 Brief Description of the Service: St Andrews Home is a private home registered for eight adults with mental health needs. It was first registered in January 1995. The home is in a residential street near a park, within walking distance of Streatham High Road with all its transport and other facilities. It is decorated and furnished to a high standard. The home provides residents with the various degrees of support that they need with daily living. Where appropriate, the home also helps to prepare residents for more independent living. Fees range between £494.78 and £785.10 per week. There is a written guide to the services provided in the home and a copy of the most recent Commission inspection report is available on request. DS0000022753.V353766.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience Good quality outcomes. This inspection was carried out in 7.5 hours. The methods used to assess the quality of service being provided were: • • Talking with the registered home manager and the registered provider Looking at the ‘Annual Quality Assurance Audit’ which was completed by the registered home manager before the inspection (this document is sometimes called an ‘AQAA’ and it provides the Commission with information about the service) Talking with residents individually and in a small group over lunch Talking with a visiting Community Psychiatric Nurse (CPN) A tour of the communal areas of the premises Looking at records about the care provided to three of the residents Looking at records relating to recent staff recruitment and training Looking at the way medicines are handled by staff in the home Looking at issues that the Commission has been notified about since the last inspection and how they were handled Sending surveys to residents, relatives, staff and visiting professionals Completed surveys were received from eight residents • • • • • • • • • The Commission would like to thank all who kindly contributed their time, views and experiences to the inspection process. What the service does well: The home is environment is comfortable, clean and well decorated. There is easy access to local shops and transport links. Residents enjoy the meals and they have a chance to shop and cook for themselves. This helps in rehabilitation. Assessed and changing needs and goals are reflected in written plans for how care is to be provided to each resident. Residents are consulted about their personal plans and about wider house issues. Personal information is stored securely and staff understand the need for confidentiality. There is regular consultation with residents and their views and suggestions are acted upon. DS0000022753.V353766.R01.S.doc Version 5.2 Page 6 Residents are able to enjoy the lifestyle of their choosing within the confines of shared living and house rules. Residents receive personal care in the way they need and in the way that they prefer. Physical and emotional health is well monitored and staff assist residents to make and attend appointments if necessary. Medication is handled well by staff and residents are encouraged to take responsibility for their own medication where possible. Staff are trained to recognise abuse and they know what to do if they suspect someone is unsafe or being abused. Comments from current residents include: “They take care of my everyday needs and support me in my everyday living” “It’s alright” “They make sure that our appointments to the GP and Dentist are met, and look after our personal needs” “The staff take care of us very well” “I practise shopping for the home” “There are balanced meals and good laundry service, and personal care is emphasised” Comments from a health professional involved in the care of one of the residents are also positive, “We are very pleased with the service”. What has improved since the last inspection? What they could do better: The residents guide does not contain enough information about how the fees are spent. The service is legally required to provide a breakdown of fees. The DS0000022753.V353766.R01.S.doc Version 5.2 Page 7 statement of purpose must also be reviewed to include all information required by regulation and up to date staffing information. The nature of support required by each resident to manage their money should be developed into a specific care plan so that it can reviewed by the placing authority along with other areas of care delivery. The registered person should try and arrange annual holidays for each resident. Care plans should be more person centred and should include the aspirations and life goals of the resident themselves. Cultural needs are addressed but recording them in a written plan will ensure that staff share their knowledge and increase it. When a failure in safe recruitment practice was identified during this inspection, the registered provider took immediate action. In future, staff recruitment procedures must be followed properly to ensure that all the necessary checks are satisfactory and in place before new staff start to work in the home. This provides better protection for residents. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. DS0000022753.V353766.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000022753.V353766.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 4. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. There is good information about the home but it must be updated to include recent changes in staffing and additional information about how fees are spent. This will provide prospective residents with better information. The needs of prospective residents are assessed and plans are put in place for how these needs will be met, before a placement is offered. This ensures that the home does not admit people whose needs cannot be met by this service. Prospective residents are given an opportunity to visit the home before they have to make a decision as to whether they will move in for a trial period. EVIDENCE: There are two documents that provide information about the services provided, a statement of purpose and a service users guide. The statement of purpose must be revised to include all areas identified in Schedule 1 of the Care Homes Regulations. For example, recent changes in home management, fire evacuation procedures and information about the size of the rooms in the home. (See requirement 1) DS0000022753.V353766.R01.S.doc Version 5.2 Page 10 The service users guide was revised in June 2008 and now contains colour photographs of the home and symbols. This makes it more accessible and interesting. The terms and conditions (including fee levels) that apply to key services (both personal care and food) and the payment arrangements (resident contribution/local authority contribution) are not specified in the service users guide. The guide must also state whether the terms and conditions (including fees) would be different in circumstances where a person’s care is funded, in whole or in part, by someone other than the resident. (See requirement 2) There has been one person admitted to the service since the last inspection visit. Records show that the service obtained a satisfactory amount of information about the persons needs before offering a placement in the home. The service obtained various assessments of psychiatric need, a completed application form and a hospital discharge summary. The resident had an opportunity to visit the home before making a decision to move in for a trial period. The trial period is over and the placement is confirmed and going well. DS0000022753.V353766.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 & 10. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Written plans are in place for how each persons assessed needs will be met. Residents will benefit from a more holistic approach to planning their lives, by inclusion of their own aspirations and life goals as well. Residents are supported to take risks within a risk management framework. Residents are regularly consulted about how things are going for them and about life in the home. EVIDENCE: Confidential written information is stored securely in the staff office. Each resident has a file containing information about their needs. There is a key working system in place and each resident has two key workers from within the staff team. Key workers meet with the resident regularly and have responsibility for organising appointments and keeping records up to date. There are records of the regular discussions that key workers have had with each resident. This is an opportunity for residents to be consulted about how the plans are being implemented. DS0000022753.V353766.R01.S.doc Version 5.2 Page 12 The two sets of plans examined show that there are adequate plans in place to address each persons needs. There are also assessments of any risks involved and how these risks are to be minimised. There are contingency plans for when a person’s mental health deteriorates and good information about other health professionals involved and how and when they should be contacted. The files are well organised and current information is easily located. Care plans and risk assessments have been reviewed regularly and amended as necessary. The areas of planned care documented are rather ‘problem’ based. Residents would benefit from a more holistic and person centred approach to care planning with some of their life aspirations and personal goals also considered and documented. It is noted that one resident has refused to sign her agreement to the plans and a more accessible and interesting plan, less focussed on ‘problem areas’ alone may help. (See recommendation 1) Observation of how the service is provided and discussion with the manager and provider indicates an understanding of the cultural needs of each resident. This is considered in areas such as meal planning and by recognising special days in the year for each resident. This important information should be developed in to a specific cultural needs care plan so that staff who are less familiar with a culture can have access to, and add to, the cumulative knowledge that the team has built up. (See recommendation 2) Residents are regularly consulted about their personal plans and about life in the home. This is done in a variety of ways. There are individual and group meetings, satisfaction surveys. There is also a men’s group and women’s group and general meetings to discuss current affairs. This is positive. DS0000022753.V353766.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents have an opportunity to develop and to take part in enjoyable activities. They are part of their local community and are encouraged to access it. Residents enjoy the meals and cultural and health needs are considered in the menu choices available. EVIDENCE: Residents are able to maintain their friendships and relationships. Family and friends are welcomed, and with the resident’s agreement are involved in meetings and activities. Many residents have lived in the homes for a long time and a social network has developed with residents in two other care homes in the area (also owned by the registered provider). Records are kept of the activities that each person is involved in and how they are enjoying them. Some of the activities are recorded in an Activities file for staff and resident reference. There is also a file with information about DS0000022753.V353766.R01.S.doc Version 5.2 Page 14 rehabilitation and the activities that residents are doing to develop in this important area. Things like cooking and shopping. The home has an attractive sauna room and there are special ‘Spa’ days when residents can have a sauna and relax with a massage, special snacks and if they wish, a glass of wine. The activities currently on offer include: Men’s talk group Woman’s talk group Manicure and pedicure sessions Baking and cooking sessions Going for meals at cafes and restaurants and having take-away meals Daytrips to places of interest and the seaside Some residents attend church Art class (at another home owned by the registered provider) Walks Attending day services Annual holidays are not part of the package of care provided by the home. (See recommendation 3) All residents are registered on the electoral role and can vote if they wish to. Records are kept of all main meals served in the home. Meals are prepared by the staff and are served in the communal dining room at reasonably set times, although residents wishing to have a meal later can do so. Some resident were observed to be preparing their own lunch in a newly appointed second kitchen and food preparation area. Staff prepared meals for resident who were not preparing their own. One resident was cooking himself some kippers for lunch. I had lunch with a group of residents in the pleasant communal dining room. The atmosphere is that of a small hotel, with well-laid tables and flowers. There were several options available and the food tasted good. Staff eat the same meals, but in their breaks. Residents said that they enjoyed the food. A resident explained, “ We have a four week rolling menu. But we can add things to it and change it. We make sure we don’t have the same thing all the time!” A reasonably varied range of meals is provided, including some culturally appropriate meal options and themed menus for social evenings, such as Indian, Irish, African and Caribbean. There is consideration of health needs, such as diabetes, and appropriate choices are available and encouraged. The kitchen is clean and food is stored hygienically. There are plenty of fresh fruit and vegetables. DS0000022753.V353766.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staff support residents to maintain their physical and mental health and can provide support with personal care if necessary. Medication is handled well by trained staff and residents are encouraged to take responsibility for looking after and taking their own medication where possible. EVIDENCE: People are generally able to manage their own personal care with little more than occasional reminders or advice. When a resident needs assistance with things like washing and bathing, the nature of the support required by staff is carefully detailed in a written care plan. Assistance with personal care is given in the privacy of bedrooms or bathrooms. There are both male and female staff and staff from a diverse range of cultures. This is reflective of the resident group and local population. There is a record of the physical and psychiatric healthcare attended by each resident. The cases tracked during this inspection show that an appropriate DS0000022753.V353766.R01.S.doc Version 5.2 Page 16 range of healthcare professionals are involved and residents also receive support to make and attend appointments if necessary. All residents are registered with a local GP practice and most have input from community based psychiatric nurses. A CPN (Community Psychiatric Nurse) visited a resident in the home during the inspection. He spoke positively about staff support for the resident. Accidents are recorded in an accident book that is in accordance with Data Protection legislation. Staff seek emergency medical advise as necessary. Medication is stored in a secure medicine cabinet in the office and is administered by staff. Medicines are supplied by a local pharmacy, mostly in blister packs. The supplying pharmacist regularly inspects the handling of medication in the home and the most recent report of February 2008 indicates that the pharmacist is satisfied with the arrangements in place. Only staff that have been trained in safe administration can administer medication. A sample signature list of trained staff is available. There is a clear audit trail of medication entering and leaving the home. There are no controlled drugs in use, but safe storage is available should any be prescribed. Justified stock checks are not being done. This is a check on whether medication is being administered correctly by staff. A justified medication stock check of one prescribed medication (not stored in a blister pack) was carried out during this inspection. This check indicated that the item has been administered correctly and the record is accurate. (Recommendation 4) There are no gaps in recordings on the MAR charts examined during this inspection (Medication Administration Records). However, a member of staff had accidentally made an incorrect entry. A check on medication stocks indicates that the medication (which was stored in a blister pack) had been administered correctly. Staff must be vigilant in making accurate recordings to ensure safety. Staff retain a record of medications such as depot injections and insulin administered by others (CPN and District Nurses). This ensures that staff have an accurate record of what medication people have had and when. This information is critical in a medical emergency. Two of the residents are self-medicating. There is a lockable storage area available in their bedrooms. DS0000022753.V353766.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Residents are encouraged to use the complaints procedure and to raise any concerns that they might have. Complaints are investigated and any necessary action is taken promptly. Staff are trained to recognise abuse and what to do if they suspect someone is unsafe or being abused. Record keeping and recruitment practise must be improved to ensure that adequate safeguards are in place. EVIDENCE: There is a complaints procedure, which includes timescales for investigation and feedback. The complaints procedure is given to each resident in the written guide to the home. A copy of which is available in each bedroom. The record of complaints shows that have been three complaints made since the last inspection visit. Appropriate action was taken to address each complaint and to advise the complainant of what was being done. There are opportunities for residents to raise concerns in individual and group meetings and in regular satisfaction surveys. Procedures are in place for responding to suspicion or evidence of abuse or neglect (including whistle-blowing) and for referring staff that may be unsuitable to work with vulnerable adults for inclusion on the protection of vulnerable adults register. DS0000022753.V353766.R01.S.doc Version 5.2 Page 18 There have been no adult protection issues referred to the local authority safeguarding adults team since the last inspection visit. Staff demonstrate an understanding of the occasional verbal aggression by residents and deal with it appropriately. Physical intervention is not used. Staff have received training in the protection of vulnerable adults. Most residents are able to manage their own finances. The registered provider acts as the state benefit appointee for some residents and residents can also ask staff to keep their money in safe-keeping to help them with budgeting. Good records are kept of these accounts and receipts are obtained for expenditures. A spot check of money held in safekeeping showed that, as required in the previous inspection report, detailed and accurate records are maintained. However, there is still room for improvement as bank balances and the movement of money between the home and the bank is more complicated to track. The arrangements in place of how staff support each resident to manage their finances are best developed into a specific financial support care plan. Then the arrangements can be reviewed along with other elements of care delivery, with advise and input from the placing authority, as necessary. (See recommendation 5) There is no inventory of personal possessions. A record must be kept to ensure ownership of items is clear. (See requirement 3) Records are kept of any accidents and incidents. A member of staff has been recruited without satisfactory checks in place. This failure in recruitment has implications for the safety of residents. DS0000022753.V353766.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 28 & 30. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home is warm, comfortable, clean and well decorated. EVIDENCE: The home is on a street of private residencies, and is indistinguishable as a care home. It is close to shops and transport links and there is open green space close by. The communal areas of the home are on the ground floor. There is a dining room that leads onto a conservatory. The conservatory has a little, but well appointed, kitchen area for residents to make meals and drinks. There is a small kitchen where staff cook the main meals. The registered provider plans to refit this kitchen soon. All areas of the home are well decorated, furnished to a high standard and clean. The garden is well maintained and there is night lighting and a fountain. DS0000022753.V353766.R01.S.doc Version 5.2 Page 20 There is a Jacuzzi bath and a sauna. The standard of the environment is high. Some of the bedrooms are a bit smaller than current standards require, but the bedrooms seen were well decorated and personalised. Residents said that the rooms were warm enough and that they were comfortable. DS0000022753.V353766.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The staff team are well trained but recruitment practise is not robust enough to safeguard residents. The registered provider took immediate action to address this but future recruitment checks must be more robust. EVIDENCE: The AQAA completed by the home manager shows that nearly all staff have now attained a vocational qualification in care at level 2 or above (NVQ). New staff are supported to gain the qualification and regular review of the home training plan ensures that staff are kept up to date with refresher courses and mandatory training, such as health and safety. Recruitment records for three new members of staff were looked at. One member of staff had all required evidence of required checks, for example two references, proof of identity, a POVA first check and a CRB (Criminal records Bureau enhanced disclose). There is a completed application form and health disclosure and a record of the interview outcomes. DS0000022753.V353766.R01.S.doc Version 5.2 Page 22 Another member of staff had all required documents in place but was currently working with only a POVA First check in place. Discussion with senior staff indicates that they were unaware of the need for additional supervision and restricted duties during the period when only a POVA First check is in place. An immediate requirement was issued as a third member of staff was working with neither a CRB or a POVA First check in place. The registered provider had received a response to a POVA check request and retained it without checking it properly. The POVA query e-mail response had been printed off but indicated that the check was not done, as full documents for the CRB had not been received at that time. The immediate requirement stated ‘Staff cannot work in the home without a POVA first check and/or a satisfactory criminal records check.’ Regulation 19. The registered manager took immediate action and removed the member of staff from active duty in the home until the checks are received and deemed to be satisfactory. Future recruitment checks must be more robust. (See requirement 4) DS0000022753.V353766.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. There is new registered manager, who is qualified and experienced. Residents are regularly consulted about the service and the running of the home and the views of other stakeholders are also considered. Record keeping and recruitment procedures must be improved to ensure residents are adequately safeguarded. EVIDENCE: The registered manager was appointed and registered with the Commission in 2008. He is registered to manager St Andrews and another small home owned by the provider. Both homes are in the Streatham area. DS0000022753.V353766.R01.S.doc Version 5.2 Page 24 The manager is experienced and has an NVQ at level 4. He is currently undertaking the Registered Managers Award (RMA) and a refresher in the NVQ as he did it a while ago. There is also a deputy home manager, who assisted in this inspection. Records are well organised and feedback from a health professional indicates that the home is well organised and run. There are quality-monitoring systems in place that are based on seeking the views of the residents. The results of these topical surveys are published and made available to residents, along with the action that is being taken to address any specific issues identified in the consultation. The views of other stakeholders (for example health professionals, families and advocates) in regard to how the home is achieving goals for service users are also sought. The registered provider completes monthly home monitoring visits and provides the manager with written feedback about the outcomes of these inspections. A record is kept of any accident, and action taken as a result. This includes use of emergency services as required (for example, calling an ambulance). Employers Liability Insurance is in place and the certificate is displayed in the staff office. The registration certificate is up to date and is also displayed. The service has met all requirements from the previous inspection report. As mentioned earlier in this report, there are some areas of record keeping that need improvement. There is no record of each resident’s valuable personal possessions. This record should be kept to ensure ownership of items is clear. (See requirement 3) Records relating to safe staff recruitment were the subject of an immediate requirement during this inspection. The registered manager took immediate action as a result and the immediate requirement is met. Future recruitment must be more robust. (See requirement 4) DS0000022753.V353766.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 1 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 4 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X 2 X X DS0000022753.V353766.R01.S.doc Version 5.2 Page 26 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA1 Regulation 4 Schedule 1 5 Requirement The statement of purpose must be revised to include all information required in Regulation 4 and Schedule 1 of the Care Homes Regulations. The service users guide must be revised to include all information required by recent changes in Regulation 5 of the Care Homes Regulations. Each resident must have an inventory of possessions (including bankbooks, valuable documents, aids, furniture and valuables) so that ownership is clear and there is record of any safekeeping arrangement. Staff recruitment procedures must be robust and evidence of all required checks and required records must be in place. Timescale for action 31/12/08 2. YA1 31/12/08 3. YA41 YA23 17 31/12/08 4. YA34 19 30/11/08 DS0000022753.V353766.R01.S.doc Version 5.2 Page 27 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. 2. 3 4. Refer to Standard YA6 YA6 YA14 YA20 Good Practice Recommendations Care plans should be more person centred and should include aspirations and goals of the resident themselves also. Cultural needs and how they are to be met should also be documented in care plans. The registered person should try and arrange annual holidays for each resident. Annual holidays are not part of the package of care provided by the home. There should be regular and justified medication stock checks to monitor whether staff are administering medication correctly. The outcomes of these checks should be recorded, along with any actions taken if any discrepancy is identified. The nature of support required by each resident to manage their money should be developed into a specific care plan so that it can reviewed by the placing authority along with other areas of care delivery. 5. YA23 DS0000022753.V353766.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 DS0000022753.V353766.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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