Inspection on 29/10/08 for Cascade Care Ltd (Cascade III)

This is the latest available inspection report for this service, carried out on 29th October 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cascade Care Ltd (Cascade III) 30/07/06

Similar services:

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Extracts from inspection reports are licensed from CQC, this page was updated on 29/01/2009.

CARE HOME ADULTS 18-65 Cascade Care Ltd (Cascade III) Cascade III 74 Linthorpe Road London N16 5RF Lead Inspector Robert Sobotka Key Unannounced Inspection 29th October 2008 10:00 Cascade Care Ltd (Cascade III) DS0000067296.V368266.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 Cascade Care Ltd (Cascade III) DS0000067296.V368266.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. Cascade Care Ltd (Cascade III) DS0000067296.V368266.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cascade Care Ltd (Cascade III) Address Cascade III 74 Linthorpe Road London N16 5RF 020 8800 8530 020 8221 7981 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) Cascade Care Ltd Manager post vacant Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5) of places Cascade Care Ltd (Cascade III) DS0000067296.V368266.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 - Code PC to service users of the following gender: Male whose primary care needs on admission to the home are within the following categories: 2. Mental Disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 5 22nd November 2007 Date of last inspection Brief Description of the Service: Cascade III is a registered care home, which provides care, support and accommodation for a maximum of five male service users within a community setting, who have mental health needs. The premises are situated in Linthorpe Road, which is situated in Stamford Hill, N16, within a walking distance from Stamford Hill Train Station. Access to buses and underground trains (Victoria Line) from Seven Sisters and Piccadilly Line from Manor House Station are approximately 10 minutes away from the home and the 235 bus stop is two minutes away. Further buses with routes to Tottenham, London Bridge, Aldgate and Euston are also within walking distance. The property is a large Victorian terraced house, which consists of five single bedrooms, a large communal lounge with cable TV and a music centre, separate laundry facilities with a dryer, bathroom and WC, separate WC, large dining room, fully equipped kitchen and a large garden at the rear of the house. The premises are not suitable for those with complex mobility needs and are not wheelchair accessible. Cascade Care Ltd (Cascade III) DS0000067296.V368266.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 unannounced. As part of this visit, the inspector spoke to four of the service users living in the home, as well as one member of the care staff and the new home manager who had transferred from another home run by Cascade Care Ltd approximately two weeks prior to this inspection. The home’s previous manager was also present during a part of this unannounced visit. The inspector undertook a tour of the premises and view various documents kept in the home. In addition, the inspector spoke with the social worker of one of the people who was using the service, to obtain her views about the home and the way it is managed. Prior to this inspection visit, the home manager was asked to complete an Annual Quality Assurance Assessment. This document was completed by the previous home manager and comments from it have been included in this report. The aim of this unannounced inspection was to check the home’s compliance with the National Minimum Standards for Care Homes for Adults (18-65) and The Care Homes Regulations 2001. The inspector would like to thank service users and staff who co-operated and contributed to the inspection. What the service does well: What has improved since the last inspection? Improvements have been noted to the home’s medication systems, as previously required. Cascade Care Ltd (Cascade III) DS0000067296.V368266.R01.S.doc Version 5.2 Page 6 The responsible person has ensured that the joint account between one of the service users and his keyworker had been closed, in order to protect service users from financial abuse. At the last inspection, a requirement was made that a completed Annual Quality Assurance Assessment is returned to the Commission without delay. This requirement has been met. What they could do better: 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. Cascade Care Ltd (Cascade III) DS0000067296.V368266.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 Cascade Care Ltd (Cascade III) DS0000067296.V368266.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be confident that they are admitted to the home once a thorough assessment has been carried out to establish they their needs can be met. The home was meeting the needs of those accommodated there. Prospective service users have an opportunity to “test drive” the home, prior to moving in. EVIDENCE: As part of this visit, the inspector checked four service users care plans. All documents viewed contained appropriate pre-admission assessments, which was carried out by the Cascade Care Ltd managers. There was also evidence that all necessary information was obtained from each person’s placing authority as well as copies of minutes from each person’s CPA (Care Planning Approach) meetings. Following a discussion with the service users, staff working in the home, one social worker responsible for one of the service users, as well as review of the documentation, the inspector was satisfied that the home was meeting the needs of the current service user group. Cascade Care Ltd (Cascade III) DS0000067296.V368266.R01.S.doc Version 5.2 Page 9 There was evidence on each person’s file that service users are offered to visit the home and have overnight stays in the home, before they make a decision to move to the home on a full time basis. Cascade Care Ltd (Cascade III) DS0000067296.V368266.R01.S.doc Version 5.2 Page 10 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, 9, 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate care planning and risk management systems were in place and those using the service are encouraged to take part in decision-making about the care they needed. Confidentiality is maintained. EVIDENCE: As part of this visit, the inspector checked care plans of four service users. Since the last inspection visit, the organisation has changed its care planning format. Documents viewed during this inspection visit were appropriately maintained and were reviewed on a regular basis. Minutes from the Care Planning Approach meetings were also in place. There was evidence that service users are encouraged to participate in their care planning process and their views were taken into account. Since the last inspection service users’ care plans have been reviewed on a monthly basis to reflect any changes of service users’ needs. The home operates a keyworking system. Each person had a designated keyworker and this person was responsible for coordinating care of their keyCascade Care Ltd (Cascade III) DS0000067296.V368266.R01.S.doc Version 5.2 Page 11 client. Keyworking sessions were also organised, during which any individual goals, progress and areas that needed further support were discussed. Regular service users’ meetings are held, during which service users can make any comments and suggestions as to how the home should be run. Appropriate risk assessments were in place and there was evidence that service users were encouraged to take responsible risks as part of an independent lifestyle in line with their individual risk assessments. Confidentiality was being maintained. All confidential information was kept in the office, which was locked when not in use. Staff working in the home shared information about the service users with the inspector on a need-to-know basis. Service users were aware that they had access to their files should they wish to view them. Cascade Care Ltd (Cascade III) DS0000067296.V368266.R01.S.doc Version 5.2 Page 12 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): 12, 13, 15, 16, 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Those who live in the home were encouraged to lead active lifestyles within the local community and develop and maintain friendships and family links. Service users enjoyed food offered in the home, however improvements are required in relation to food storage. EVIDENCE: Documentation checked during this inspection visit, such as individual care plans, keyworking sessions minutes and daily logs confirmed that staff working in the home encourage and support service users to become a part of the local community and to attend local college courses and day centres. They are also offered assistance in seeking paid and/or voluntary employment. People who use the service are allowed to receive visitors in the home. They are also encouraged to maintain family contact and to have appropriate relationships. Cascade Care Ltd (Cascade III) DS0000067296.V368266.R01.S.doc Version 5.2 Page 13 Care plans of the service users evidenced that those who live in the home are encouraged and supported to maintain appropriate family contacts and develop appropriate friendships. Those who spoke with the inspector confirmed this. There were appropriate food supplies in the home. Some of the meals offered to the people who used the service were prepared some staff and also prepared by the service users themselves. Fridge freezer temperatures were taken and recorded daily. Records of food offered by the home was appropriately maintained. Storage of food required improvement, as at the time of this inspection visit, meat products were being kept in the home’s freezer on top of other food products thus increasing the risk of crosscontamination. In addition, there was a tomato soup left in the fridge in an opened can. The responsible person must ensure that food products are appropriately stored to prevent cross-contamination and food poisoning. Cascade Care Ltd (Cascade III) DS0000067296.V368266.R01.S.doc Version 5.2 Page 14 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. The home was appropriately meeting the physical and emotional needs of the service users. Appropriate medication systems were in place and where possible, the home encouraged service users to be in charge of their medication. EVIDENCE: At the time of this inspection, none of the service users required support with personal care. There was evidence in the care plans viewed that verbal prompts to service users were sometimes required. Issues of personal hygiene were also discussed during keyworking sessions, where necessary. Care plans checked showed that people who use the service received appropriate care from the healthcare professionals. Those who use the service received regular psychiatric reviews. Each person was registered with the General Practitioner and any other healthcare professional who would be beneficial to meeting their needs. Improvements have been noted to the home’s medication systems. As part of this visit, the inspector checked the home’s medication stocks and records and Cascade Care Ltd (Cascade III) DS0000067296.V368266.R01.S.doc Version 5.2 Page 15 these were found to be correct. At the time of this visit one of the people who used the service was in charge of his medication. Appropriate risk assessment to that effect was in place. All medication was being appropriately stored. Cascade Care Ltd (Cascade III) DS0000067296.V368266.R01.S.doc Version 5.2 Page 16 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had a appropriate complaints system in place and any concerns are dealt with without delay. Satisfactory systems were in place to protect those living in the home from abuse, neglect and self-harm. EVIDENCE: The inspector viewed the complaints record. There have been four complaints since the last inspection. There was evidence that they were appropriately investigated and dealt with and resolved within reasonable timescale. Those who lived in the home were also given opportunities to raise their concerns about the way the home is run, during resident’s meetings and their keyworking sessions. People who spoke to the inspector said that they felt comfortable raising any concerns with the manager or a member of staff. There have been 4 complaints since the last inspection, all of which were upheld. Records of accidents/incidents were also reviewed during this visit. These showed that appropriate action is taken following any incident/accident to prevent further incidents from reoccurring. There has been one adult safeguarding referral made by the home since the last inspection and the inspector was satisfied that the home took appropriate action to protect the service user from harm/abuse. Cascade Care Ltd (Cascade III) DS0000067296.V368266.R01.S.doc Version 5.2 Page 17 The responsible person has ensured that the joint account between one of the service users and his keyworker had been closed, in order to protect service users from financial abuse. Service user are mainly responsible for dealing with their own finances, however the home may offer support in budgeting, where it has been identified that this may be for the benefit to service user. Cascade Care Ltd (Cascade III) DS0000067296.V368266.R01.S.doc Version 5.2 Page 18 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, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Those who use the service benefit from a homely, comfortable and safe environment. EVIDENCE: The premises are situated in Linthorpe Road, which is situated in Stamford Hill, N16, within a walking distance from Stamford Hill Train Station. Access to buses and underground trains (Victoria Line) from Seven Sisters and Piccadilly Line from Manor House Station are approximately 10 minutes away from the home and the 235 bus stop is two minutes away. Further buses with routes to Tottenham, London Bridge, Aldgate and Euston are also within walking distance. The property is a large Victorian terraced house, which consists of five single bedrooms, a large communal lounge with cable TV and a music centre, separate laundry facilities with a dryer, bathroom and WC, separate WC, large dining room, fully equipped kitchen and a large garden at the rear of the house. The premises are not suitable for those with complex mobility needs and are not wheelchair accessible. At the time of this inspection, the premises were well maintained. Cascade Care Ltd (Cascade III) DS0000067296.V368266.R01.S.doc Version 5.2 Page 19 Service users who spoke with the inspector said that they were generally happy with the home’s communal areas and their bedrooms. During the tour of the premises, the inspector noted that one of the service users’ bedrooms was very cold. To remedy this situation, the staff working in the home called the heating engineer and as a temporary measure provided the service user with an electric heater. The inspector was informed by the home manager that since the last inspection a new kitchen has been installed and service users’ bedrooms have been repainted. The premises were found to be clean and hygienic at the time of the inspection. Appropriate laundry facilities were in place. Staff working in the home have attended infection control training. Cascade Care Ltd (Cascade III) DS0000067296.V368266.R01.S.doc Version 5.2 Page 20 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 good. This judgement has been made using available evidence including a visit to this service. People who use the service are supported by staff who are committed to providing good quality of care and are appropriately trained. EVIDENCE: The inspector viewed duty rosters, which showed that there were sufficient numbers of staff on duty. There are two members on each shift, including nights. Night staff remain awake throughout the night. Staff who spoke with the inspector stated that they felt that staffing levels were sufficient to meet the assessed needs of the current serviced users group. The majority of staff working in the home either have obtained the NVQ qualification or were in the process of obtaining one. Staff working in the home receive mandatory training, as well as other training beneficial to supporting people with mental health issues. As part of this visit, the inspector checked three randomly selected staff personnel files and he was satisfied that appropriate pre-employment checks have been undertaken before employing any member of staff in the home. Cascade Care Ltd (Cascade III) DS0000067296.V368266.R01.S.doc Version 5.2 Page 21 There was also evidence that each member of staff received induction. It was noted however that some Criminal Records Bureau disclosures were more than three years old and did not contain checks against the Protection of Vulnerable Adults (POVA) register. It is recommended that Criminal Records Bureau checks be carried out on a three yearly basis. Staff supervision and appraisal sessions were not checked during this inspection visit. Cascade Care Ltd (Cascade III) DS0000067296.V368266.R01.S.doc Version 5.2 Page 22 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, 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was appropriately managed, however the organisation must submit an application to the Commission for the manager to be formally registered as fit to manage the home. EVIDENCE: As previously mentioned the current home manager commenced work in the home on 6th October 2008. He previously worked in a sister home as a deputy manager. The new manager has recently obtained his social work and management qualifications. The standard that relates to the manager’s competencies and management style was not fully assessed on this occasion, as the manager has only just started working in the home. It was noted however that positive comments were made by the people who use the service and a member of staff working in the home about the new manager. The home has been operating without a registered manager for a considerable length of Cascade Care Ltd (Cascade III) DS0000067296.V368266.R01.S.doc Version 5.2 Page 23 time and it therefore vital that an application is submitted to the Commission for the manager to be formally registered as fit to manage the home. Appropriate quality assurance systems were in place. Regular visits from the registered provider (Regulation 26 visits) were taking place and reports from these were being forwarded to the Commission. Appropriate health and safety checks were in place. The home was adequately insured for its purpose. Cascade Care Ltd (Cascade III) DS0000067296.V368266.R01.S.doc Version 5.2 Page 24 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 X 2 3 3 3 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 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 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 3 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X X X 3 X X 3 X Cascade Care Ltd (Cascade III) DS0000067296.V368266.R01.S.doc Version 5.2 Page 25 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 YA17 Regulation 16(2)(g) Requirement The responsible person must ensure that food products are appropriately stored to prevent cross-contamination and food poisoning. Timescale for action 01/12/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA34 Good Practice Recommendations It is recommended that Criminal Records Bureau checks be carried out on a three yearly basis. Cascade Care Ltd (Cascade III) DS0000067296.V368266.R01.S.doc Version 5.2 Page 26 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 Cascade Care Ltd (Cascade III) DS0000067296.V368266.R01.S.doc Version 5.2 Page 27 - 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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