Care Home: Tooting Bec Gardens, 11

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What the care home does well These are some of the things that people who live at the home told us: `I have been always happy with the staff`. `Staff treat you well`. `I am happy here at no. 11`. Other people involved with the home told us: `It is a safe and friendly place to live, with very good care.` `It is a homely environment and the residents are happy and sociable.` The service `supports self esteem and confidence in their residents......carry on the good work.` When asked what the service does well one person commented that the service `supports individuals with their emotional and spiritual well being`. These are some of the things that we found the service does well.Tooting Bec Gardens, 11DS0000022770.V375129.R01.S.docVersion 5.2The people who live at the home are encouraged and supported to take part in activities that they enjoy and help them to learn new skills. Some of the activities are in the house, some in the community. Everyone who wants to goes on holiday each year. The people who live at the home know who to talk to if they want to complain, they are confident that any complaint will be listened to. The Manager and staff make sure that the people who live at the home get good medical care. The people who live at the home are encouraged to take part in decisions about the home and how it runs. When staff are recruited the people who live at the home are part of deciding who will work there. Each person has their own bedroom which is attractively decorated, private and clean. The home is very comfortable, homely, clean and well decorated. There are several different rooms where people can sit together, do activities or eat their meals. There is an attractive garden at the back of the house. The people who work at the home are well trained so that they can look after well the people who live there. The home is well managed and this benefits the people who live there. What has improved since the last inspection? The requirement and recommendations of the last inspection have been met. This means that when people come to work at the home all of the necessary checks are made. Also the care plans are reviewed regularly; the risk assessments are up to date and changes have been made to the entrance to the conservatory to help make sure no-one is at risk of falling. Staff have now received training in aging and end of life issues. What the care home could do better: We found two matters that need to be improved, these are that the medication administration sheets all need to have allergies noted on them. Also the list of `homely remedies` needs to be approved by the GP each year. These matters should be easily achieved. Key inspection report CARE HOME ADULTS 18-65 Tooting Bec Gardens, 11 Streatham London SW16 1QY Lead Inspector Ms Alison Pritchard Unannounced Inspection 16th March 2009 10:00 Tooting Bec Gardens, 11 DS0000022770.V375129.R01.S.doc Version 5.2 Page 1 This report is a review of the 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. 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 home adults 18-65 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. Tooting Bec Gardens, 11 DS0000022770.V375129.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Tooting Bec Gardens, 11 DS0000022770.V375129.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tooting Bec Gardens, 11 Address Streatham London SW16 1QY 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 8769 1235 0208 769 9160 jacky_warrick01@yahoo.co.uk www.ftf.org.uk Frances Taylor Foundation Mrs Jacqueline Warrick Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Tooting Bec Gardens, 11 DS0000022770.V375129.R01.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 Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is: 8 17th March 2007 Date of last inspection Brief Description of the Service: 11 Tooting Bec Gardens is one of a number of homes owned and managed by Frances Taylor Foundation, a registered charity. It is a large detached house set on a busy route in Streatham. The large garden located at the rear of the property leads into the very pleasant grounds of the residential home next door. The home is fully double glazed to reduce traffic noise. The home is a minutes walk from the large shopping centre of Streatham. It is conveniently situated to bus and rail links to Central London and other suburban shopping centres. There is a very large park/common a short walk away. The home currently provides residential care for 7 women with learning difficulties. Accommodation provided comprises of single bedrooms for all service users as well as ample communal space. Charges range from £486 to £692 per week. Additional support may be subject to individual funding arrangements. Tooting Bec Gardens, 11 DS0000022770.V375129.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 three stars. This means the people who use this service experience excellent quality outcomes. This inspection was unannounced and carried out over one day in mid March 2009. The inspection methods included observation of care practice, discussion with the people who live in the home and with staff and inspection of a range of records. Care plans were checked and aspects of care were examined by case tracking. The views of service users, relatives, staff and involved professionals were sought and taken into account in compiling this report. We are grateful for the contributions of everyone who responded to surveys and all of the people who spoke to us during the inspection visits. The CQC has access to information gathered through notifications from the home. A document called an ‘Annual Quality Assurance Assessment’ (AQAA) was completed by the Registered Manager of the home in advance of the inspection and returned to us. The document provides information about how the home is addressing the National Minimum Standards along with factual information about the operation of the home. All of this information has been taken into account in compiling this report. The Registered Manager and staff from the home facilitated the inspection visit; they were helpful and courteous throughout the process. What the service does well: These are some of the things that people who live at the home told us: ‘I have been always happy with the staff’. ‘Staff treat you well’. ‘I am happy here at no. 11’. Other people involved with the home told us: ‘It is a safe and friendly place to live, with very good care.’ ‘It is a homely environment and the residents are happy and sociable.’ The service ‘supports self esteem and confidence in their residents……carry on the good work.’ When asked what the service does well one person commented that the service ‘supports individuals with their emotional and spiritual well being’. These are some of the things that we found the service does well. Tooting Bec Gardens, 11 DS0000022770.V375129.R01.S.doc Version 5.2 Page 6 The people who live at the home are encouraged and supported to take part in activities that they enjoy and help them to learn new skills. Some of the activities are in the house, some in the community. Everyone who wants to goes on holiday each year. The people who live at the home know who to talk to if they want to complain, they are confident that any complaint will be listened to. The Manager and staff make sure that the people who live at the home get good medical care. The people who live at the home are encouraged to take part in decisions about the home and how it runs. When staff are recruited the people who live at the home are part of deciding who will work there. Each person has their own bedroom which is attractively decorated, private and clean. The home is very comfortable, homely, clean and well decorated. There are several different rooms where people can sit together, do activities or eat their meals. There is an attractive garden at the back of the house. The people who work at the home are well trained so that they can look after well the people who live there. The home is well managed and this benefits the people who live there. 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. Tooting Bec Gardens, 11 DS0000022770.V375129.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Tooting Bec Gardens, 11 DS0000022770.V375129.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4, 5. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Both the home and the potential service user have the opportunity to gather enough information to make sure that the placement will be appropriate. EVIDENCE: Before someone comes to live at the home information is gathered about the their needs. Assessments by social workers are completed and full information gathered from the person themselves and others who know them well and are concerned with their welfare. One person who lives at the home said that she had the chance to visit along with family members before she moved in. The number of visits is not restricted and can include visits at different times of day, meals and overnight stays. She confirmed that she has a copy of the service user guide and a contract. She said that she had been helped to get to know the home and commented ‘The people are nice ….I’m settled here’. The documents about the home are produced in an ‘easy to read’ format, using photographs. Tooting Bec Gardens, 11 DS0000022770.V375129.R01.S.doc Version 5.2 Page 9 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, 10. People using the 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 people who live at the home are fully included in planning their care, and in decisions about their lives. They are consulted about aspects of life at the home, and their views taken into account. Risks are managed to ensure that service users’ activities are not restricted unnecessarily. EVIDENCE: The home uses a ‘person centred’ approach to identify service users’ goals and plan their care. We looked at a range of care plans, some of the service users showed their plans to us. We found that the plans were all drawn up with the involvement of the service users and that they reflected their needs and wishes. The care plans are reviewed regularly and service users confirmed that they are involved in reviews, and invited to make comments for the meetings. In describing the person centred planning process in the statement of purpose it is stated that ‘emphasis is placed on individual needs, increasing Tooting Bec Gardens, 11 DS0000022770.V375129.R01.S.doc Version 5.2 Page 10 independence and involvement in daily living skills’. This was apparent in the care plans that we looked at. The service users keep the copies of important documents such as care plans in their rooms and they are encouraged to make comments to be recorded on the care plans. They indicate their agreement with the care plan by adding their signature. We were told that the care plan format is being reviewed to make more use of photographs and make them even more accessible to the service users. This is an admirable goal and shows commitment to increasing further the service users’ active involvement in the care planning process. Staff have received training in person centred planning and more is planned. Meetings take place with all of the service users to discuss issues of general concern and our observation showed that there is informal discussion with service users about daily activities. The service users are involved with a range of matters, which are important for the day to day running of the home – these include staff recruitment and menu planning. Personalised risk assessments were seen on service users’ files. They showed that an individualised approach to managing risk is used. Examples were assessments of a service user’s ability to manage money and to go out alone in the local community. The risk management system assists service users to lead the lives they wish. Lockable storage facilities are available for files. Staff demonstrated awareness of the need to treat personal information carefully and with due regard for confidentiality. Tooting Bec Gardens, 11 DS0000022770.V375129.R01.S.doc Version 5.2 Page 11 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): This is what people staying in this care home experience: 12, 13, 14, 15, 16, 17. People using the 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 people who live at the home have opportunities to follow a range of activities which are of interest to them and help them to develop skills. The meals are good and meet service users’ cultural and nutritional needs. EVIDENCE: We heard from service users that they take part in a range of activities which they have chosen and which they enjoy. The activities arranged take into account service users’ cultural needs, their interests and skills. Several of the service users go to college, courses they study include computing and cookery. Other activities that service users take part in include going to dance classes; using the local library; photography; music and drama; shopping in the local area and working with a self advocacy group (People First). Tooting Bec Gardens, 11 DS0000022770.V375129.R01.S.doc Version 5.2 Page 12 In the home there are plenty of resources available for service users’ leisure interests. There are materials for art activities; watch television; listen to music; play games and cook. A horticulture project has recently started with the assistance of a staff member with particular skills in this area. It is planned that a computer is soon to be installed in the activity room for service users. Trips have been arranged over the last year, including to the theatre; to a safari park; to the coast; to gardens and to castles and museums. We also heard that special days such as St Patrick’s Day are celebrated. Several of the service users, who choose to do so, attend church locally. Barbecues and birthday parties are held if this meets service users’ wishes. One person was supported to go to a Cliff Richard concert recently, as a birthday celebration. This was a particularly special treat for her and we heard how much she had enjoyed it. Service users are supported to go on holidays; they are involved in choosing venues. The staff at the home support the service users to maintain contact with family members and other people important to them. We heard from one service user that she is planning to go on holiday with relatives and that she is looking forward to that. Visits are made to and from the home by relatives and friends. A relative confirmed that they are kept up to date with important matters to do with their relative who lives at the home and that they are supported to live the life they choose. The daily routines are flexible, according to service users’ activities, wishes and needs. Some service users prefer to spend some time in their rooms following their individual activities such as doing jigsaws, and letter writing. We were told that staff respect their privacy. We noted that there was warm interaction between staff and between and with the group of service users. The atmosphere of the home is relaxed, warm and friendly. Meals are planned by the service user group taking into account each person’s preferences and nutritional needs. Staff cook the meals with the assistance of service users. The menu that we saw also reflected the cultural backgrounds of the group. The menu was varied and included fresh items. It is planned that in the next year staff will receive training nutrition to increase their understanding if this area of care. Tooting Bec Gardens, 11 DS0000022770.V375129.R01.S.doc Version 5.2 Page 13 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. People using the 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 people who live at the home benefit from careful attention to their health care needs. Professionals involved with the home have told us that the health care arrangements are very good. The list of ‘homely remedies’ approved by the GP should be reviewed to ensure it is still appropriate. All of the medication administration records need to have information about service users’ allergies noted on them. EVIDENCE: Each of the service users has a key worker, who co-ordinates their care. The service users are involved with choosing who will be their key worker. Female members of the staff team provide any necessary assistance with personal care. The service users said that they are happy with the care that they receive, one person said ‘I have been always happy here with the staff’, a relative described the care as ‘very good’. A professional involved with the home said that the service keeps good records of their client’s health needs and she is encouraged to play a part in monitoring her own health care. Tooting Bec Gardens, 11 DS0000022770.V375129.R01.S.doc Version 5.2 Page 14 Each of the service users has a file which includes details of their health care needs. The records were clear and well kept and showed that there is careful attendance to health care needs. Appropriate referrals had been made when specialist advice was necessary and there was information that demonstrated good relationships with health care professionals from which service users had benefited. As the staff know the service users well they are alert to any changes in their conditions. In recent months the manager and staff had been persistent in ensuring that appropriate investigations were undertaken when one service user was unwell. This was also commented on by a health care professional who praised the way that the home had ‘advocated strongly’ on behalf of the service user and described the service as ‘very committed and innovative’. We looked at the arrangements for medication. One of the service users looks after her own medication, this has been subject to risk assessment and a range of people were involved in ensuring that this was a suitable step for her to take. Staff are responsible for other service users’ medication. Only staff who have been assessed as competent are able be involved with medication. In the medication file each of the service users has a photograph for identification purposes. On some, but not all, of the medication administration records (MAR) there was no entry made to indicate whether the service user had any allergies. This information must be added consistently to all service users’ records. We have been informed since the inspection that this issue has now been addressed. The MAR sheets currently used are hand written as the pharmacy that the home uses does not produce printed sheets. The Registered Manager stated that she would approach the pharmacist to see if this arrangement could be changed. We looked at homely remedies which had been approved by the GP for the service users to take and found that the approval was last gained in 2005. It is required that this approval is sought annually to take account of any relevant changes. See requirement. As recommended at the last inspection staff have received training in aging and end of life issues. Tooting Bec Gardens, 11 DS0000022770.V375129.R01.S.doc Version 5.2 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. People using the 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 people who live at the home feel that if they had to make a complaint their views would be listened to and acted on. The safeguarding procedure helps to protect the service users. EVIDENCE: The home has a complaints procedure which meets the legal requirements and is included in the statement of purpose and service user guide. An ‘easy-read’ version of the procedure is available for service users. Each of the service users with whom we had contact could name someone to whom they would speak if they were unhappy or wanted to make a complaint. The records of complaints showed that the Registered Manager take appropriate action in response to, referring on to other agencies as necessary and providing acknowledgement and reassurance to the complainant. The records of complaints are kept confidentially. Staff showed understanding of the complaints procedure and of whistle-blowing. Staff have received training in safe-guarding issues, and this is included in induction as well as on an on-going basis. A copy of the local authority safeguarding procedure is available in the home for reference. In order to safeguard service users’ financial interests there are checks of valuables held on their behalf at each shift change. Tooting Bec Gardens, 11 DS0000022770.V375129.R01.S.doc Version 5.2 Page 16 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 28, 29, 30. People using the 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 people who live at the home benefit from an environment which is homely, clean, safe and meets their needs. EVIDENCE: The building is a large detached property on a one way system in Streatham, close to local amenities. Some limited parking is available to the side of the home. A garden is to the rear and there is a small front garden. Part of the back garden has decking on the floor and this allows easy access. The building has a comfortable and homely atmosphere, it is well decorated and maintained and meets the needs of the people who live there. Each service user has a single bedroom, we saw a selection of rooms. They were all clean, airy, well decorated and personalised. Bedrooms are available Tooting Bec Gardens, 11 DS0000022770.V375129.R01.S.doc Version 5.2 Page 17 on all floors of the home , this means that service users whose mobility may limit their ability to use stairs can have a ground floor room. All of the service users who showed us their rooms said that they liked them and had helped to decorate them with their personal items such as photographs and pictures. There is ample communal space consisting of a kitchen and dining room, living room and a large conservatory which is used for activities, and leads to the garden. Arrangements were being made for further decoration to take place. Throughout the building are handrails which assist service users and visitors whose mobility may be limited. During the inspection arrangements were being made for a handrails to the conservatory to be changed so that it is strong and attractive. This suggests a proactive approach to ensuring the accessibility of the building and an understanding of mobility needs. The home was very clean and attractive at the time of the inspection. the laundry area is suitable for the needs of the home. There were no unpleasant odours and there are suitable facilities for infection control. Tooting Bec Gardens, 11 DS0000022770.V375129.R01.S.doc Version 5.2 Page 18 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough well trained staff to meet the needs of the people who live at the home. Recruitment of new staff is thorough and contributes to the protection of the people who live at the home. EVIDENCE: The staff team consists of, in addition to the Registered Manager, a Senior care Worker, six care workers (three of whom work part time) and four bank care staff. There are also a Finance Officer, a Domestic and a Maintenance person. The staff team is described on the AQAA as ‘multi-cultural’ and reflects the service user group. There are at least two members of staff on duty between 8am and 9.15pm, frequently with additional staffing available to ensure that service users are supported with activities when necessary. At night time one member of staff sleeps in the building with additional support available from senior staff through the ‘on-call’ system. A pictorial rota allows people who live at the home to be clear about which staff members are due to work at the home and Tooting Bec Gardens, 11 DS0000022770.V375129.R01.S.doc Version 5.2 Page 19 when they are expected. We heard from staff that the communication systems work well in the home. We observed a ‘handover’ meeting and noted that the staff coming on duty were given full information about each of the people who live at the home and there was useful discussion about their needs. The staff team is well qualified. The Senior Care Worker has achieved NVQ3; of the permanent Care Workers, five have achieved NVQ 2 or 3 and one has only recently joined the care staff team. A comment received about the staff team described it as ‘a skilled caring team’. Other training that the staff have received over the last year includes working with challenging behaviour; person centred planning; the Mental Capacity Act; safeguarding adults and first aid. It is planned that over the next year training will be provided in nutrition and dementia. Staff confirmed that the training that they receive is relevant and assists them to do their work well. One person said that the ‘training is on-going and thorough’. The induction programme for new staff was reported to be thorough, useful and include essential information such as health and safety issues, safeguarding and moving and handling. We checked three staff recruitment files; we found that each included the appropriate range of checks and references specified by regulation. In accordance with good practice service users are involved in recruitment of new staff. Tooting Bec Gardens, 11 DS0000022770.V375129.R01.S.doc Version 5.2 Page 20 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 42. People using the 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 well managed in a manner that promotes openness and a sense of direction. Service users’ views are included as part of the quality assurance systems. Regular checks of health and safety systems ensure that service users, staff and visitors are safe. EVIDENCE: The Manager of the home has been registered under the Care Standards Act since 2004. She is well qualified and appropriately experienced for the role, she is currently undertaking additional management training. We had feedback about the management style in the home from a range of sources – comments included ‘good management’; ‘very good….[the Tooting Bec Gardens, 11 DS0000022770.V375129.R01.S.doc Version 5.2 Page 21 management] has direction’; ‘the Registered Manager appears open and very experienced’. There is a range of ways the organisation uses to assess the quality of the service provided in the home. These include service user satisfaction surveys, an annual quality assurance report, and annual business plan. Monthly visits to the home are made by senior managers. Reports of the visits are available in the home. They showed that the visits include discussion with residents and staff. Health and safety records were in good order. The fire risk assessment had been reviewed in May 2008. Regular fire drills had been conducted in the home and the fire alarms’ operation is tested weekly. The fire extinguishers were serviced in July 2008. Electrical appliances, the gas appliances and the electrical system are tested at appropriate intervals. Staff have received training in health and safety matters such as infection control and food hygiene and moving and handling . Tooting Bec Gardens, 11 DS0000022770.V375129.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 4 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 3 26 3 27 X 28 3 29 3 30 4 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 4 3 3 LIFESTYLES Standard No Score 11 X 12 4 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 2 X 4 4 3 X X 3 X Version 5.2 Page 23 Tooting Bec Gardens, 11 DS0000022770.V375129.R01.S.doc 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 YA20 Regulation 13(2) Timescale for action The Registered Person must 15/05/09 make improvements to the management of medication by ensuring that: • all medication administration records include details of service users’ allergies; • the list of ‘homely remedies’ is approved by the GP annually. This will ensure that the service users’ individual needs are taken into account when medication is given. Requirement RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Tooting Bec Gardens, 11 DS0000022770.V375129.R01.S.doc Version 5.2 Page 24 Care Quality Commission London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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