Care Home: Vartry Road, 18

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What the care home does well The service provides good outcomes for the people who currently live at home. The statement of purpose clearly sets out the philosophy and objectives of the home. The home understands the importance of having sufficient information when choosing a care home. Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 6Admissions to the home are made on the basis of a detailed assessment. This ensures the best outcomes for people who live at the home. Care plans provided specific guidance on how people living at the home wished to be supported. The home has involved the residents in the planning of care that affects their lifestyle and quality of life. Risk assessments were found to cover all areas that affected peoples daily life. Risks are managed positively to help people who live at the home to lead the life they want. The menu is prepared weekly with the people who live at the home. A variety of meals are provided that reflect their individual preferences. Care plans outlined the support the people require to maintain their independence when being supported with personal care. Personal support is responsive to the varied individual needs and preferences of people who live at the home. We found that records for the administration of medication were complete. People`s medication is administered in a way that ensures their continued well being. The complaints policy is available in a pictorial and easy read format. The people who live at the home had been supported to share their concerns. The home has an open culture that allows people to express the views and concerns in a safe and understanding environment. Training records confirmed that staff have all the statutory required training. All staff receives relevant training that is focused on delivering improved outcomes for people. The registered manager makes sure that the safety risks to people living at the home and staff is identified. People living at the home are aware of safety arrangements and have confidence in the safe working practices of staff. What has improved since the last inspection? There were seven areas for improvement identified at the last inspection. All of these have been met. The registered manager has made sure that Vartry Road consistently meets the needs of people. The registered manager explained that she had made sure that the relevant representatives or professionals involved in people`s care had read and signed the care plans. Consultation has taken place to make sure that care plans reflect the individual needs of people. Training records and discussions with the registered manager confirms that since the last inspection all staff had received training on adult protection. People living in the home feel safe and well supported by an organisation that has their protection and safety as a priority. Since the last inspection there had been a number of improvements to the home`s environment. Decoration has taken place in a number of areas in the home. The home`s environment meets people`s needs and aspirations. Since the last inspection the registered manager has made sure that staff files contained all the necessary documentation to ensure that staff were safe to work with people. Robust recruitment procedures are followed to ensure the safety and well being of people. Since the last inspection a new manager has been registered with the Commission. Since the last inspection improvements have been made to the system for monitoring the quality of the service provided by the home. There`s a strong emphasis on being open and transparent in all areas of the running of the home. Since the last inspection a certificate for gas safety has been obtained. People have confidence in the safe working practices of the home. What the care home could do better: One area for improvement has been identified at this inspection. On our walk round the home we found that the kitchen had broken cupboards and was inneed of redecoration. The kitchen must be refurbished to provide a safe and homely place where residents can prepare meals. CARE HOME ADULTS 18-65 Vartry Road, 18 18 Vartry Road London N15 6PT Lead Inspector Tony Brennan Unannounced Inspection 11th September 2008 11:00 Vartry Road, 18 DS0000060634.V370481.R02.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 Vartry Road, 18 DS0000060634.V370481.R02.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. Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Vartry Road, 18 Address 18 Vartry Road London N15 6PT 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 8802 8700 020 8299 4818 vartry@choicesupport.org.uk www.choicesupport.org.uk Choice Support Rehma Kizito Care Home 4 Category(ies) of Learning disability (0) registration, with number of places Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th September 2007 Brief Description of the Service: 18 Vartry Road is registered as a care home providing personal care for people between the ages of 18 and 64 who have learning disabilities. Choice Support is the registered provider. The home provides accommodation and support for four people and is situated in a residential area of Haringey close to shops and transport facilities near Seven Sisters’ Road. St. Ann’s Hospital is about a mile away. The stated aim of the home is to ensure for people using the service: presence in mainstream community life, choice, competence, participation, respect, individuality, flexibility, co-ordination with other agencies and racial, cultural and religious sensitivity. The premises consists of a two-storey terrace house with three single bedrooms on the first floor and one single bedroom on the ground floor with en suite facilities, with the remaining being provided with washbasins. The kitchen, laundry area and dining / lounge rooms are all on the ground floor. There is a private back garden, which is partially paved and grassed. The office area situated on the first floor also doubles up as a sleeping in room. A second sleeping in room is on the ground floor. Inspection reports produced by the Commission of Social Care Inspection (CSCI) are available upon request from the registered manager/provider. The cost of placements is £1,133.44 per week. There are additional costs for water cooler, massage therapy and chiropodist. Following Inspecting for Better Lives the provider must make information available about the service, including inspection reports, to service users and other stakeholders. Vartry Road, 18 DS0000060634.V370481.R02.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 star. This means the people who use this service experience good quality outcomes. This unannounced key inspection was undertaken as part of the annual inspection programme. This is the first key inspection since registration of the manager with the Commission. Prior to the inspection the home had completed its annual quality assurance assessment. The annual quality assurance assessment provided us with information about the home and how it was seeking to provide the best outcomes for people. The inspection took place over one day. We were assisted by Rehma Kizito, the registered manager, with the inspection. We spoke with three members of staff. As people who live at the home are not able to express their views of the service we observed care practice and interaction between them and staff. We toured the building and examined a number of records relating to the care, health and safety and management of the home. At the end of the inspection feedback was given to the registered manager. We would like to thank the staff that assisted us by answering questions about the running of the home. We would also like to thank the people who live at the home who discussed their views of the service they receive. What the service does well: The service provides good outcomes for the people who currently live at home. The statement of purpose clearly sets out the philosophy and objectives of the home. The home understands the importance of having sufficient information when choosing a care home. Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 6 Admissions to the home are made on the basis of a detailed assessment. This ensures the best outcomes for people who live at the home. Care plans provided specific guidance on how people living at the home wished to be supported. The home has involved the residents in the planning of care that affects their lifestyle and quality of life. Risk assessments were found to cover all areas that affected peoples daily life. Risks are managed positively to help people who live at the home to lead the life they want. The menu is prepared weekly with the people who live at the home. A variety of meals are provided that reflect their individual preferences. Care plans outlined the support the people require to maintain their independence when being supported with personal care. Personal support is responsive to the varied individual needs and preferences of people who live at the home. We found that records for the administration of medication were complete. People’s medication is administered in a way that ensures their continued well being. The complaints policy is available in a pictorial and easy read format. The people who live at the home had been supported to share their concerns. The home has an open culture that allows people to express the views and concerns in a safe and understanding environment. Training records confirmed that staff have all the statutory required training. All staff receives relevant training that is focused on delivering improved outcomes for people. The registered manager makes sure that the safety risks to people living at the home and staff is identified. People living at the home are aware of safety arrangements and have confidence in the safe working practices of staff. Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: One area for improvement has been identified at this inspection. On our walk round the home we found that the kitchen had broken cupboards and was in Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 8 need of redecoration. The kitchen must be refurbished to provide a safe and homely place where residents can prepare meals. 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. Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 9 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 Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 10 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): 12345 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The statement of purpose is an accurate description of the service provided. People’s needs are assessed prior to admission to the home to ensure they receive the care and support required. People living at the home and their representatives understand how the home will meet their needs. EVIDENCE: The statement of purpose clearly sets out the philosophy and objectives of the home. The statement of purpose has been updated to include the details of the recently registered manager. A copy of the registration certificate was on display and this clearly outlined the registration of the home. The registration conditions of the home had been recently reviewed by the Commission. We checked the insurance certificate and compare this with the company details on the registration certificate. These were found to be identical. The statement of purpose was available in an easy read format. The registered manager explained that it could also be made available to people in a picture format if they needed it. We found that the needs of the people case tracked were within a range of those specified in the statement of purpose. The statement of purpose also identified the skills and staffing resources that are available to meet the needs of people living at the home. The home provides a Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 11 statement of purpose that is specific to the individual service, and the residents who live there. The statement of purpose confirmed that staff would support people to express their religious beliefs. The statement of purpose emphasise peoples right to be involved and active in their communities. We discussed the issue of equalities and diversity with the registered manager. She demonstrated that she would respond positively to people’s diversity. As is outlined in the following outcome areas these resources meet the needs of people living at the home. We found that a detailed service users guide is available for people. It was available in an easy read form that was assessable to all the people living at the home. The registered manager explained that people would receive copies of the service user guide before their admission to the home. The annual quality assurance assessment stated that people were told of their right to receive a service that promoted their equality and diversity. People coming to live at the home and their representatives have sufficient information about the home, so that they can be confident that their individual needs and preferences will be met. All the people currently living at the home have lived there for a number of years. Their records showed that they had had an initial assessment prior to their admission to the home. We found that there were records of more recent reviews with their social workers and other professionals involved in their care. The annual quality assurance assessment highlighted that a full needs assessment would be carried out to establish whether the home can meet the prospective residents needs. The registered manager explained that any initial assessments would be carried out with the involvement of the prospective residents. As part of the ongoing review of peoples needs there were assessments highlighting how their behavioural needs would be supported. Staff were able to describe how they met the needs of the people case tracked. We observed that people were supported by staff that understood their needs. Admissions to the home are made on the basis of a detailed initial assessment that make sure the needs of prospective residents can be met. The annual quality assurance assessment stated that people are encouraged to make daily visits and have overnight stays at the home prior to them coming to live there. The manager explained this would allow staff and people living at the home to develop a relationship with the new resident. We found there were notes of these visits. These visits had been discussed as part of people’s regular care planning meetings. People are supported to make an informed decision about whether the home can meets their needs. Files for the people who live at the home contain a contract. This had been agreed with them or their representatives prior to admission. The contract had been reviewed as part of the ongoing monitoring and assessment of their Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 12 needs. We found that the contracts clearly outlined their rights and responsibilities. People told us staff had discussed the contract with them. The contracts were available in an easy read format. This meant that it was assessable to people who live at the home. As the people living at the home do not always have the capacity to understand their contracts these had been signed by their relatives or professionals involved in their care. People have agreed and understand how the home will meet their needs. Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 13 Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 14 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 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Care plans provide detailed guidance on how the needs of people are to be met. People are consulted about their preferences and how they wished to be supported. People are supported to make decisions about their lives and they know staff will maintain the confidentiality. Risks to people are assessed to ensure their safety and independence. EVIDENCE: The care plans of all the people case tracked were detailed and person centred. This meant that care plans were based on how people wish to be supported by staff. In the annual quality assurance assessment it was stated that care plans are drawn up in partnership with people who live at the home, their families and professionals. The care plans for the people case tracked were Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 15 personalised and detailed how their needs would be met. The registered manager explained that staff were trained in person centred planning. Care plans were found to provide detailed information on the support provided to meet the needs of individuals. The registered manager explained that she had made sure that the relevant representatives or professionals involved in peoples care had read and signed in their care plans. We found that care plans had been signed by peoples representatives or professionals involved in their care. As people who use the service do not always have capacity to fully participate in deciding how their needs will be met this issue had been highlighted in their regular reviews. Consultation has taken place to make sure that care plans reflect the individual needs of people. Care plans were personalised and referred to the cultural needs of people. This included whether or not they wish to take part in religious activities. For example, we found that one of the people living in the home is Muslim. Staff spoken to understood how to support him to express his religious needs. His religious needs were identified in his care plan. The registered manager was also clear that people should be supported to express their sexuality. Staff spoken to were aware of the policy of supporting people to express their sexuality. People live the lives they choose with support for them to express their diversity. We found that care plans had been developed with the involvement of people living at the home. We observed that staff took time to understand people and do things in the way they wanted. The home involves individuals in the planning of care that affects their lifestyle and quality of life. Details of the people’s behaviour that might challenge the service were identified in their risk assessments and care plans. Actions to address and manage these behaviours were outlined in detail. This included giving guidance on how to respond to specific behaviours. One of the people case tracked had been consulted about how he wished to be assisted to manage his behaviour. Staff spoken to understood the specific needs of the person with regards to managing challenging behaviour. Behaviour that may challenge the service is addressed sensitively to support and maintain people’s well-being. Risk assessments were found to cover all areas that affected the people’s daily life. Risk assessments identified the specific risk facing people. Risk assessments were detailed based on the history of previous risk-taking on the part of people living at the home. These are reflected in care plans. Risk assessments had been reviewed. Changes to the level of risk had been addressed. Staff were able to describe how they prevented risks to make sure that people were safe and were supported to exercise control over how they live. Risks Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 16 relating to behavioural issues were identified. We observed that staff engaged with people in an appropriate adult way. Comprehensive risk assessments that are reviewed regularly are in place to ensure the safety and independence of people. There were clear policies on how confidentiality must be maintained. Both observation and discussions with staff showed us that they were sensitive and aware of the importance of maintaining people’s confidentiality. People know that their confidentiality will be maintained at all times. Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 17 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 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are supported to engage in a range of activities that meet their needs. People have community contacts and are supported to maintain personal relationships. People are supported to have a nutritious diet that reflects their personal choice. EVIDENCE: The annual quality assurance assessment explained that people were encouraged to take part in a range of activities. Records showed that people were being supported to find appropriate activities. Three out of four residents currently attend a day centre throughout the week. Records showed that activities were provided in the evening and at weekends. The registered manager explained that she was looking at ways to expand the range of activities being provided the people. People had been supported to make use Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 18 of local facilities such as shops and the park. Staff told us they regularly assist people to plan bus routes and offer to escort them to new activities. People who live at the home are involved in meaningful daytime activities of their own choice, according to their individual interests and capabilities. Daily notes and care plans confirmed that people were regularly involved in activities both in and outside of the home. This included household tasks such as shopping, washing and general cleaning. We saw that people living in the home were involved in preparing the main meal of the day with staff support. People who use the service are involved in the domestic routines of the home to further develop their daily living skills. The annual quality assurance assessment confirmed that people were enabled to develop contacts in the local community. Daily records showed that people were supported to maintain contacts with family and friends. We observed staff reminding one resident that his mother would visit him at the weekend. People who use the service have an opportunity to develop and maintain important personal and family relationships. The menu is prepared at a weekly meeting of people living at the home. We saw minutes of these meetings that confirmed people’s suggestions for meals were recorded. Peoples care plans also outline their preferences regarding the meals the liked to eat. We found that the menu is varied and reflected the cultural and dietary needs of individuals. We observed that there were fresh vegetables and fruit available. We observed that people were able to have a hot drink when they wish. A variety of meals are provided that reflect the individual preferences of people who live at the home. Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 19 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 21 People who use this service experience good outcomes in this area. This judgement has been made using available evidence, including a visit to this service. People are supported with their personal care needs to maintain their independence. People are able to access the medical care they need. People are protected by safe procedures for handling medication. EVIDENCE: Care plans outlined the support the person living at home requires to maintain his independence when being helped with personal care. Staff explained that they provided support and encouragement to help people with personal care. The registered manager explained that male and female carers are in the home to ensure that people have same gender care. Care plans identified if a resident wanted same gender care. Staff were aware of the need to provide the same gender care and to be sensitive to peoples culture when meeting their personal care needs. Care plans outlined the support people require to maintain their independence when being assisted with their personal care. Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 20 Personal support is responsive to the varied individual needs and preferences of people who live at the home Medical needs had been identified as part of the initial assessment and were referred to in care plans and risk assessments. Records show that people living at the home were registered with a local General Practitioner. Daily notes recorded that people had access to the opticians, dentists and chiropodists. People are supported to access the healthcare they need. Peoples health needs are addressed to ensure their well being. We found that records for the administration of medication were complete. Records of medication received and returned were also complete. We checked the records of medication for the people case tracked. They were receiving all the medicines that had been prescribed for them by their doctor. Daily notes showed that health professionals had been consulted to make sure that people were receiving the medicines they needed. As people living at the home may not have capacity to decide who they want to administer their medicines the relevant representatives or professionals had been consulted about this. The home has developed an effective medication policy that ensures records of the administration of medications are maintained to keep people safe. There is clear guidance on the use of medication as part of managing peoples challenging behaviour. This outlined when it was appropriate to use this medication. It clearly stated the types of behaviour that would indicate when it was appropriate to use medication. Medication is only used to manage peoples behaviour when it is clearly required to meet their needs. Training records and discussions with staff confirmed they had training on the safe administration of medicines. This included training on the administration of medication used to manage peoples epileptic seizures. We observed staff administering the medication. This confirmed that they understood and followed the homes procedure. Staff are trained to administer medication safely. Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 21 Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 22 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): 22 23 People who use this service experience good outcomes in this area. This judgement has been made using available evidence, including a visit to this service. People can be confident that their complaints are listened to and acted upon. Adult protection procedures protect people from abuse. EVIDENCE: The complaints policy explained how to make a complaint and how it would be dealt with. The policy is available in both easy read and pictorial formats. This makes it more accessible to people who live at the home. Copies of the complaints policy were available around the home for people to consult. The registered manager explained that as part of the regular house meetings issues are discussed and resolved. Staff explained that people are encouraged to discuss their views of the service. The home maintains a record of any complaints. The home has an open culture that allows residents to express the views and concerns in a safe and understanding environment. We found that there is a detailed policy on safeguarding people from abuse. This was made available in both easy read and pictorial formats. The registered manager has obtained a copy of the host local authority is adult protection procedures. Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 23 Training records and discussions with the registered manager confirms that since the last inspection all staff had received training on adult protection. This training had covered the forms of abuse and staff responsibilities regarding whistleblowing. Staff spoken to were aware of their responsibility to report any bad care practice to the registered manager and the host local authority. The registered manager explained that whistleblowing is also discussed as part of the homes induction of new staff. The registered manager explained that she regularly discusses with staff issues regarding safeguarding in their team meetings and individual supervisions. Records of these meeting showed that safeguarding issues had been discussed. The registered manager said that she uses these meetings to monitor how staff understand safeguarding issues. There have been no adult protection issues since the registration of the home. People living in the home can feel safe and well supported by an organisation that has their protection and safety as a priority. Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 24 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 27 28 29 30 People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who live in the home are mostly provided with a safe and homely environment that is personalised to meet their needs. The home is clean and hygienic. EVIDENCE: The home provides accommodation and support for four people and is situated in a residential area of Haringey close to shops and transport facilities near Seven Sisters’ Road. The premises consists of a two-storey terrace house with three single bedrooms on the first floor and one single bedroom on the ground floor with en suite facilities, with the remaining being provided with washbasins. The kitchen, laundry area and dining / lounge room are all on the ground floor. There is a spacious modern kitchen for the use people living at the home. There is a private back garden, which is partially paved and Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 25 grassed. The homes environment promotes the privacy, dignity and autonomy of people. Since the last inspection there had been a number of improvements to the homes environment. One resident who has mobility needs will be given an en suite shower. A lift is to be installed at the front door to make access easier. Decoration has taken place in a number of areas in the home. The registered manager explained that Haringey (the placing authority for the people who live in the home) had agreed to partially fund this work. The home’s environment meets people’s needs and aspirations. There are two toilets and a bathroom on the first floor. These are suitable for the majority of people living at home. We observed that people were able to access the bathroom and toilets. Checks are in place to make sure that there is a sufficient supply of hot water. The home provides people with the facilities they need to maintain their personal care. On our walk round the home we found that the kitchen had broken cupboards and was in need of redecoration. We discussed this with the registered manager who explained that negotiations were taking place about making sure the kitchen is redecorated and refurbished. There was no evidence available to confirm this. The kitchen must be refurbished to provide a safe and homely place where residents can prepare meals. We observed people enjoying their bedrooms. The care plan showed that they had chosen items of furniture for their rooms. The registered manager explained that she encourages people to personalise their bedrooms. We observed that people’s bedrooms have been decorated and furnished in ways that reflected their personal preferences. Appropriate measures are in place to prevent cross infection. The home has detailed policies on the prevention of cross infection. The annual quality assurance assessment stated that staff had training on infection control. We found that training records confirm this. Staff spoken to understood how to work to minimise the possibility of cross infection. Staff confirmed that they had access to disposable gloves and aprons. Liquid soap and paper towels were available throughout the home. A proactive infection control policy makes sure that the risk of infection for people is minimised. Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 26 Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 27 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): 31 32 33 34 35 36 People who use this service experience good outcomes in this area. This judgement has been made using available evidence, including a visit to this service. Sufficient staff, with the necessary skills and support, are available to meet the needs of people living at the home. People are fully protected by the home’s recruitment procedures. EVIDENCE: We found that the rota showed that a consistent staffing level was maintained. The registered manager explained that three staff are on throughout the day and one staff on waking duty at night with a person sleeping in. The registered manager explained this would be kept under continuous review to make sure that there are always sufficient staff to meet peoples needs. We observed that there was always enough staff available to meet peoples needs. Daily notes showed that staff were on duty to provide escorts to appointments. We observed that support with activities was available. Staff spoken to told us that they felt sufficient staff were available to support Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 28 peoples needs. We saw that sufficient staff are provided at busy times of the day, and to meet the changing needs of people. The service has plentiful staff available at all times to support the needs, activities and aspirations of people living at the home. The registered manager showed us a training plan that she had created for the service. We found that this made sure that staff were provided with a range of skills they would need to meet the needs of residents. New staff are given a full induction. Records were available to confirm that staff had been on the necessary induction training. Staff training records showed that staff had done training in the essential areas, such as food hygiene, health and safety, administration of medication, infection control and first aid. Discussions with staff showed that they had a detailed knowledge of the needs of people who live at the home. Records showed that training had been provided on communication skills, managing behaviour, person centred planning and healthy eating. The training plan detailed how future training needs would be met, so that staff continue to develop their skills. People are supported by staff that have the necessary skills to understand and meet their needs. Training records showed that over 50 of staff has either level 2 or 3 in the National Vocational Qualification in care. We observed that staff understood how to meet peoples needs. Staff have the relevant experience in working with people who have learning disabilities. The home ensures that all staff receive relevant training that is focused on delivery of improved outcomes for people using the service. We looked at two staff files. Since the last inspection the registered manager has made sure that staff files contained all the necessary documentation to ensure that staff were safe to work with people. Their employment records were checked. Two references and a POVAfirst/CRB check had been obtained prior to them starting work at home. This showed that the home followed a clear recruitment procedure that ensures the safety of people. The staff group reflect the cultural backgrounds of people. Robust recruitment procedures are followed to ensure the safety and well being of people. Staff spoken to explained that they had received regular supervision. They told us this helps them to understand and meet the needs of people. We found supervision records showed that staff were supported to understand and improve outcomes for people living in the home. The registered manager explained that appraisals would be carried out to monitor staff and make sure they provide care and support people need. Staff are supported so that they are able to meet the needs of people. Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 29 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): 39 40 41 42 43 People who use this service experience good outcomes in this area. This judgement has been made using available evidence, including a visit to this service. Effective management systems are in place to make sure that people’s well being and safety is promoted. People’s views of the service are sought and used as the basis for improvement. The health and safety of people who live at the home and staff is promoted and safeguarded. EVIDENCE: Since the last inspection a new manager has been registered with the Commission. As part of the registration process, the registered manager’s qualifications had been checked. The registered manager was found to have the necessary skills to manage a service for people with learning disabilities. Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 30 She has experience of working with people with learning disability. She has a number of years experience of this area of work. Training records showed that the registered manager has completed the registered manager award. The registered manager has a clear understanding of the key principles and focus of the service. Staff told us that the registered manager was approachable. Staff meeting minutes showed that she involves staff in the running of the home. We observed that the registered manager works alongside staff to support them in meeting the needs of people living at the home. Staff were clear about their roles and how they contribute to supporting people who live at the home. Effective management systems are in place to provide the best outcomes for people living in the home. The registered manager explained how finances are managed. There are appropriate accounting procedures in place to make sure that the homes resources are used in the best interests of people. The home has the necessary insurance cover. We saw that there were insurance certificates to confirm this. Financial systems make sure that the home’s resources are used in the best interests of people. The annual quality assurance assessment contained clear, relevant information that was supported by a range of evidence. The annual quality assurance assessment told us about the changes that the registered manager plans to make to improve the service. Since the last inspection improvement have been made to the system for monitoring the quality of the service provided by the home. The registered manager explained that she carries out quality monitoring on a regular basis. People are consulted about how the home is run. Minutes were seen of meetings held with residents to discuss the quality of the service provided. Theres a strong emphasis on being open and transparent in all areas of the running of the home. All the procedures and policies were found to be in place. The registered manager explained that policies are regularly reviewed. This was highlighted in the annual quality assurance assessment that showed that policies had been reviewed. The home has the necessary records in place. The registered manager explained that important changes in peoples records were discussed with their representatives. Appropriate procedures and recording systems make sure peoples needs are met. The registered manager ensures that the safety risks to people living at the home and staff are identified. Staff have all the relevant health and safety training to ensure that people are safe. Measures are put in place to provide a safe living and working environment. Records showed that fire equipment was tested regularly and maintained. Fire drills were taking place. The fire risk assessment provides details of potential risks of fire. All health and safety policies were available. Since the last inspection a certificate for gas safety has been obtained. The electrical testing certificate was in date. COSHH guidance is in place and chemicals were stored safely. People living at the Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 31 home are aware of safety arrangements and have confidence in the safe working practices of staff. Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 32 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 3 3 3 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 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 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 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 3 3 3 3 Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 33 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 YA24 Regulation 23 Requirement The registered persons must make sure that the kitchen is refurbished. The kitchen must be refurbished to provide a safe and homely place where residents can prepare meals. Timescale for action 30/12/09 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 Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 34 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Vartry Road, 18 DS0000060634.V370481.R02.S.doc Version 5.2 Page 35 - 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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