Inspecting for better lives Random inspection report
Care homes for adults (18-65 years)
Name: Address: Granville Road 75-77 Granville Road 75-77 Wood Green London N22 5LP one star adequate service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Susan Shamash Date: 2 6 0 2 2 0 0 9 Information about the care home
Name of care home: Address: Granville Road 75-77 Granville Road 75-77 Wood Green London N22 5LP 02088884189 F/P02088884189 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : HAIL (Haringey Association for Independent Living Limited) care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: Date of last inspection Brief description of the care home 6 75 - 77 Granville Road is a registered care home providing personal care for six younger adults with learning disabilities. Circle 33 Housing Association owns the property and the care and support are provided by Haringey Association for Independent Living (HAIL), an independent sector provider offering a range of accommodation for people with a learning disability in the London Borough of Haringey. The home is a large converted domestic building with three floors. The ground floor comprises the main communal areas and one resident bedroom. The second and third floors contain the remaining resident bedrooms with an additional activity/therapy room recently created on the second floor. There are adequate bath and toilet facilities in close proximity to the residents bedrooms. The home is situated in a quiet residential road within easy reach of Wood Green shopping centre and a range of multicultural resources in the vicinity. The stated aim of the home is to Care Homes for Adults (18-65 years)
Page 2 of 12 Brief description of the care home provide twenty-four hour support and care for six people with a learning disability to live as independently as possible within the community of Wood Green. Care Homes for Adults (18-65 years) Page 3 of 12 What we found:
This unannounced random inspection visit took place over approximately four and a half hours, in order to check on compliance with the requirements made at the last key inspection visit. Two residents were present when I arrived in the home, alongside the homes manager and another staff member. The other residents arrived back home from day activities later in the afternoon, and had the opportunity to spend time with all of them. The majority of people living at the home are non-verbal. I had the opportunity to speak to one resident and two staff members during the visit in addition to observing the general routines within the home. A tour of the building was also conducted, and two residents gave permission for me to see their bedrooms. Two resident files and three staff files were inspected alongside other records regarding the general running of the home including residents financial records and health and safety documentation. Two care plans were inspected including Person Centred Plans recorded in accessible pictorial formats. Risk assessments and care plans were in place but some of these had not been reviewed within the last six months. There were monthly key working summaries in place for both residents. I observed staff supporting residents appropriately, and discussion with staff indicated that they were very well aquainted with the needs of people living at the home. The upstairs office which included many archived files with information about service users was unlocked during my visit, which potentially compromised the confidentiality of people living at the home. Staff advised that more activities were being undertaken, although the evidence of this was less clear from records examined. Activities recorded for one person in daily records and monthly summaries included walks, trips to local parks, pubs, eating out in Caribbean restaurants, a photograph of the person in their cultural dress, contact with relatives, day centre attendance including participation in sports. For the other service user activities included trips to the cinema, a Kurdish community centre, bowling, swimming, horse riding, a theatre trip, pub trips, travel training, cycling, yoga, an art project, gardening training, cites of interest around london, Turkish cafes and shopping trips. Daily records showed that some evening activities are occuring particularly attending a disco club, and occasional weekend activities, but there remains some room for continued improvement in this area. Improved records were available regarding peoples diets within the home, and menus provided. Although a pictorial chart is available to record the days menu, it is recommended that more pictorial symbols be made available to increase the choice and variety of foods, vegetables and fruits available to people. Health care plans were detailed and generally up to date, including important Care Homes for Adults (18-65 years) Page 4 of 12 information about health conditions and staff care and professional support needed. Both residents whose files were inspected have regular appointments with their GPs, dentists, chiropodists and opticians. A communication passport was being put together for one resident with regular psychiatric reviews to address behavioural issues. Each service user had been reviewed by a social worker within the last year. Medication storage was appropriate with current and complete administration records in place. Medication records included signing in of medicines received within the home, however those being carried forward from previous months were not clearly indicated on the records. One medicine for an individual, recorded on records as to be administered at night time, was being administered earlier (at tea time). It is advisable that when medicines are given at a different time to that recorded on the MAR sheet, to suit the persons preferences, this should be adjusted on the charts. The home has a history of addressing safeguarding issues appropriately. Clear policies are in place regarding complaints and safeguarding issues. No complaints had been received since the previous inspection. Inspection of the building indicated that it is generally in a good state of repair and decorated and furnished comfortably. A new flat screen television was provided in the lounge. Two residents showed me their bedrooms, indicating that they were happy with facilities provided. The kitchen was clean and generally in working order, however one oven and grill remain in need of repair (staff advised that they are managing adequately with the other oven and grill available). The manager advised that the provider organisation is in the process of arranging for these facilities to be repaired. The standard of cleanliness was generally good, with significant improvements made to the upkeep of the multi-sensory room as required. Staff advised that there continue to be problems with the hot water supply to the home, although there were no specific issues on the day of the inspection. The maintenance book confirmed regular call outs to the housing provider to deal with faliures of the hot water. However the manager advised that recently repairmen had demonstrated a quick fix to get the hot water running again when next there is a problem. Apparently the issues are due to air getting into the system. In addition when hot water is available, the records showed occasional hot water temperatures from bath and shower outlets above 43 degrees Celsius, which may present service users with a risk of scalding. The highest recorded temperatures were 61 (for a shower) and 50 degrees Celsius (for a bath). It remains recommended that a water feature be considered for the rear garden with the preferences of a particular service user in mind. I had the opportunity to speak to two staff members during the visit, and both were generally positive about the home although one staff member was concerned at the amount of time it was taking for a residents passport application to be sent off, so that they might have a holiday abroad. Three staff files were inspected. The file for the newest staff member and a member of bank staff did not include recruitment documentation so this area was not inspected on this occasion. Supervision records indicated that more regular supervision sessions are now being held and each staff member had had an annual appraisal. Care Homes for Adults (18-65 years)
Page 5 of 12 Each file contained a selection of training certificates, and staff spoken to confirmed that they had undertaken a range of training, although the most recently recruited staff member confirmed that she still needed to undertake training in Safeguarding Adults and First Aid training. As required at the previous inspection relevant staff had undertaken updated trained in food hygiene and fire safety. Records indicated that reports of some regulation 26 visits are being sent to the home. However I was concerned that the home did not appear to be receiving these promptly (in particular the last two months inspection reports were missing). Records indicated that staff meetings are not being held very frequently and it is recommended that more frequent meetings be arranged to aid communication within the staff team. Inspection of financial records for two residents indicated that these are being maintained accurately as appropriate, with improved procedures in place to protect residents from financial abuse. However it remains required that an identified resident be reimbursed for money that was unaccounted for previously. The manager advised that he is applying to the tenants fund to recoup this money on behalf of the relevant person. As required at the previous inspection, there was an improvement in the recording of food served at the home, with current records available and few gaps in the recording. However there were a substantial number of gaps in the fridge/freezer temperature records, indicating that these were not checked on a daily basis. I was also concerned to note that there were gaps in the records of weekly fire alarm tests, indicating that these were not always tested on a weekly basis. There had also not been a fire drill held at the home for several months. What the care home does well:
The home continues to be well run, with a committed staff team and there are trusting and supportive relationships between staff and people living at the home. The staff team undertake effective work with people living at the home and relatives with support from the senior staff and the home continues to provide a wide range of activities for residents both inside and outside of the home. There is a high level of satisfaction with the food served in the home, and people are encouraged to be as independent as possible taking part in household chores with support from staff as appropriate. Residents are also supported to make their own choices, and their preferences are respected. All people living at the home have person centred care plans and they are reviewed regularly and are consulted about these as far as possible. The staff team are generally well trained and experienced, and offer consistent support Care Homes for Adults (18-65 years) Page 6 of 12 to people living at the home. A massage therapist attends people living at the home according to their choices and staff are creative in arranging a wide range of activities for people living at the home according to their wishes. Residents usually have an annual holiday away from the home. The home is decorated with photographs of residents holidays and parties, and the use of pictorial formats to communicate menus and staff members on duty, are very successful. 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 set out on page 2. Care Homes for Adults (18-65 years) Page 7 of 12 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 8 of 12 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 6 15 The registered persons must 29/05/2009 ensure that care plans and risk assessments for people living at the home are reviewed at least every six months and that this is recorded, to ensure that peoples needs are reviewed regularly. . 2 10 12 The registered persons must 10/04/2009 ensure that the upstairs office is kept locked when not in use to protect the confidentiality of people living at the home. . 3 24 23 The registered persons must 29/05/2009 ensure that the identified oven and grill are repaired for the comfort of people living and working at the home. . 4 30 23 The registered persons must 24/04/2009 ensure that a permanent
Page 9 of 12 Care Homes for Adults (18-65 years) Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action solution is found to problems of intermitent hot water in the home, for the comfort of staff and residents. . 5 35 18 The registered persons must 29/05/2009 ensure that all staff have current safeguarding adults and first aid training for the protection of people living at the home from harm. . 6 41 26 The registered persons must 30/04/2009 ensure that reports of visits by the responsible individual on behalf of the provider organisation must be sent to the home without delay on a monthly basis, so that issues identified can be addressed promptly. . 7 42 13 The registered persons must 10/04/2009 ensure that there are no gaps in the recording of fridge/freezer temperatures, fire drills and fire alarm call point tests, and that action is taken to address hot water temperature from bath and shower outlets that exceeds 43 degrees Celsius, to ensure the safety of people living and working at the home. . Care Homes for Adults (18-65 years) Page 10 of 12 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 14 It is recommended that there be further development of activities for residents in the evenings and at weekends, according to their choices. It is recommended that more pictorial symbols be made available for foods to ensure more choice for residents regarding the menus. It is recommended that medicines carried forward from previous months should be recorded on administration records, so that there is an accurate record of all stock within the home, and that the time of administration should be altered on MAR sheets if this differs significantly from the printed instructions. It is recommended that serious consideration be given to installing a water feature in the rear garden, in the interests of an identified person living at the home. It is recommended that there be more frequent staff meetings to ensure better communication within the team. It is recommended that the debt owed to a particular service user should be recorded on the homes current financial record to ensure that this is not overlooked. 2 17 3 20 4 24 5 6 39 41 Care Homes for Adults (18-65 years) Page 11 of 12 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 12 of 12 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
