Inspection on 08/12/08 for Huddleston Close, 36

This is the latest available inspection report for this service, carried out on 8th December 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

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Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Huddleston Close, 36 36 Huddleston Close Parmiter Street London E2 9NR     The quality rating for this care home is:   two star good service 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. Lead inspector: Sarah Greaves     Date: 1 6 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 03000 616161 (telephone order line) 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. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 24 Information about the care home Name of care home: Address: Huddleston Close, 36 36 Huddleston Close Parmiter Street London E2 9NR 02089833515 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) : h3m055sewell@mencap.org.uk Royal Mencap Society care home 3 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 3 The maximum number of service users who can be accommodated is: 3 The registered person may provide the following category of service only: - Care home only - Code PC to service users of the following gender Either whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD Date of last inspection Brief description of the care home 36 Huddleston Close is a three bedroomed care home for people with learning disabilities; the three residents are young men. The service is located in Bethnal Green in an ordinary domestic property in a residential street, close to the shops and amenities available on the nearby high street. The service is close to underground and overground rail services, and regular bus services. The care home is managed by Mencap and the property is owned by a local housing association. Care Homes for Adults (18-65 years) Page 4 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was conducted over two days, hence the first day was unannounced. We gathered information through speaking to and observing the residents, reading care plans and discussions with members of staff. We checked the care homes management of medications, toured the premises and looked at staff files (to check upon recruitment, training and supervision). We joined a resident for lunch, and observed staff suporting residents with activities selected by the residents. The service satisfactorily completed an Annual Quality Assurance Assessment (AQAA) earlier this year, which we used to gain further information. Care Homes for Adults (18-65 years) Page 5 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –03000 616161. Care Homes for Adults (18-65 years) Page 6 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 7 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents are assured that their admission will be carefully arranged, including the provision of information, visits and holistic assessments. Evidence: We were informed that a resident had been admitted to the care home since the last inspection visit. It was noted that the residents needs and aspirations had been comprehensively assessed prior to admission, and opportunuities for visits to 36 Huddleston Close had been provided prior to moving in for a trial period. We looked at the care plans for two of the three residents at the care home. Each care plan contained a pictorially presented contract and other information (such as a pictorial complaints procedure) to enable residents (and their supporters) to gain relevant information about the care home. Care Homes for Adults (18-65 years) Page 8 of 24 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are provided with individualised support, which recognises their entitlement to make choices and engage in activities that could present risks. Evidence: We read two care plans during the course of this inspection. These documents were well-written and individualised, and the staff on duty were able to discuss all aspects of the personal, health and social care. We noted that one of the care plans addressed the challenging behaviour of a resident. There were written records to demonstrate that staff closely monitored and recorded any significant information in the day-to-day life of this resident, to enable the care home team and external professionals to identify and respond to events that might initiate episodes of challenging behaviour. We observed interactions between residents and staff over two separate days. It was noted that staff presented very detailed information of the preferences and dislikes of individual residents, including people that were unable to verbally express their views. For example, we observed one of the residents listening to music in the lounge and Care Homes for Adults (18-65 years) Page 9 of 24 Evidence: appearing to enjoy this activity; staff were able to identify exactly what kind of music the resident responded well to. Residents were supported to access external advocates, in addition to the support provided by families. Each care plan viewed at this inspection contained up-to-date risk assessments that were individualised to the specific identified needs of the residents. Care Homes for Adults (18-65 years) Page 10 of 24 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported to pursue fulfilling interests, and exercise choices regarding their daily activities and routines. The food service demonstrated that residents are consulted. Evidence: We noted from the care plans and observations that residents were offered a broad range of activities at the care home and in the community. We were provided with pictorial evidence of a holiday that a resident had taken in Paris; other holiday destinations included Cornwall and Morrocco. Staff reported that they had learnt more about the interests of the residents during time away from the care home; for example, one resident demonstrated an interest in art installations. During the course of the inspection we observed staff supporting residents with home-based activities, such as watching videos and getting involved in food preparations. We observed that a Care Homes for Adults (18-65 years) Page 11 of 24 Evidence: resident had been involved in making Christmas decorations (picture of a Christmas tree). Residents attended externally organised projects in the community and visited amenties such as cafes, parks, shops and places of interest. Arrangements had been made for one of the residents to have their own transport, and this was planned for another resident. Via discussions with the staff and through reading two of the care plans, we noted that residents maintained regular contact with family members. The importance of these relationships was fully understood by the service and demonstrated through supportive actions undertaken by staff. We observed that residents were able to choose their own routine; for example, one of the residents had chosen to spend the day at home rather than attend activities at a community resource. Residents also chose when to retire to their own rooms or sit in a communal area. We joined a resident for lunch on the first day of the inspection, which was a homemade vegetable soup. The menu plans indicated that the known preferences of the residents was incorporated, including food that reflected individual cultural heritage. It was noted on the first day of this inspection that there was no fresh fruit available, although the shopping was due to be done that day. However, there was fresh vegetables, juices, snacks, yoghurts and choices of cereals. Care Homes for Adults (18-65 years) Page 12 of 24 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are provided with effective support to meet their personal care and health care needs, although a medication issue needs to be addressed. Evidence: We found that the care plans provided clear information regarding how the service supported people to meet their personal care and health care needs. Via discussions with staff we were provided with information regarding how the service supported residents with their health needs, including any conditions that would require dietary changes. We checked the services management of medications. It was noted that one of the medication charts had not been properly completed with the correct code to indicate that a resident had refused their medication, although other documentation appeared satisfactory. We were informed that one of the residents was prescribed a supplement drink but appeared not to like it; we suggested that the service could try chilling the product, which was permitted by the manufacturer. It was noted that the medication administration records stated if a resident was known to have relevant allergies but did not state No Known Allergies. This action has been Care Homes for Adults (18-65 years) Page 13 of 24 Evidence: recommended as it would clarify that the blank space next to the allegies section has not been mistakenly left blank. It is advised that this issue should initially be discussed with the services pharmacy provider. Care Homes for Adults (18-65 years) Page 14 of 24 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service demonstrated that systems were in place to listen to and protect residents. Evidence: We looked at the services complaints procedures (pictorial and written versions); these documents were presented in a straight-forward and informative manner. It was observed that there have been two complaints received since the last inspection, which were satisfactorily managed. These compaints were from neighbours. The service demonstrated that it was equipped with both the Mencap and the Tower Hamlets social services Adult Protection procedures. Staff were aware of how to whistle-blow within the organisation and externally. The Commision has been kept informed of any issues regarding the protection of residents, and staff were in receipt of appropriate training. Care Homes for Adults (18-65 years) Page 15 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are provided with a comfortable and homely environment. Evidence: The service occupied a three bedroomed house with a rear garden; there was also a communal lounge and kitchen/diner. We were permitted by one of the residents to view their bedroom; it was noted that the room had been decorated and individualised in accordance to personal preferences. We observed that there was equipment of interest to the residents; for example, a trampoline in the rear garden. It was noted that the service liased with the housing association in order to achieve improvements to the house, which was an on-going process. The premises were found to be satisfactorily maintained, clean and free from any offensive odours. Care Homes for Adults (18-65 years) Page 16 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents were supported by staff with suitable training and supervision; an improvement has been recommended to the documentation for recruitment. Evidence: We checked two staff files, which evidenced that staff received appropriate training for their roles and responsibilties. It was noted that several of the staff have been appointed since the last inspection, hence their training and development needs were being met by induction training and probabationary period reviews. Staff accessed mandatory and specialist training; the Annual Quality Assurance Assessment (AQAA) commented upon the specific training and support delivered, to enable staff to meet the needs of residents with challenging behaviours. It was also noted from the AQAA that new staff were enrolled upon National Vocational Qualifications in Care, following completion of introductory level training. The recruitment of staff was generally satisfactory, but it was noted that there was no record to demonstrate that referees were contacted by telephone in order to verify the authenticity of their written references. We were informed that this occured; however, it was not evidenced. The supervision records viewed at this inspection evidenced that staff received detailed and relevant supervision. Staff were also appraised annually. Care Homes for Adults (18-65 years) Page 17 of 24 Care Homes for Adults (18-65 years) Page 18 of 24 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are assured that their service is effectively managed and monitored; however, staff need to be more vigilant regarding the identification of expired food items. Evidence: We visited the service on two days. It was noted that the registered manager was on holiday; however, a deputy manager was present on both days. The registered manager had worked at the Huddleston Close service for several years and achieved a suitable qualification (Registered Managers Award). We noted that the service had improved since the last inspection, indicating that the registration of no.36 as a separate 3 bedded care home has had a positive impact. We observed staff managing very well with difficult experiences during the inspection visits, such as the temporary loss of electricity on one day and challenging behaviour by a resident on the second day. We read a selection of the Regulation 26 visits (monthly unannounced monitoring visits by the area manager); we were satisfied that these reports provided staff with a Care Homes for Adults (18-65 years) Page 19 of 24 Evidence: realistic account of how the service was performing and contained guidance for improvement. We also noted that as well as consultation with residents and advocates, staff responded to the views of relatives. The service was supporting a resident to regularly visit their family home in the local community. The following health and safety practices were checked and found to be satisfactory; (1) weekly fire alarm testing (2) weekly fire extinguisher check (3) monthly first aid equipment check (4) weekly piper alarm testing (5) weekly electrical equipment tests (6) checking of cold and hot water temperatures and (7) shower head cleaning and descaling records. We found one box of expired cereal and an out-of -date yoghurt. It was also found that staff did not put labels on food that needed to be used up by a certain date (for example, a jar of jam that needed to be eaten within six weeks of opening). Requirements have been issued. Care Homes for Adults (18-65 years) Page 20 of 24 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 21 of 24 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, Care Homes 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 42 13 The registered manager must ensure that safe measures are undertaken in order to correctly label opened refrigerated food items. So that residents are not placed at risk from expired food. 31/03/2009 2 42 13 The registered manager must ensure that there is a system in place to check upon expiry dates for nonrefrigerated food items. So that residents are not placed at risk from expired food. 31/03/2009 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 20 The service should implement a system for medication administration charts, in order to categorically evidence Page 22 of 24 Care Homes for Adults (18-65 years) whether a resident has an allergy or not 2 34 The service needs to visibly demonstrate that it is contacting referrees by telephone following the receipt of a written reference. Care Homes for Adults (18-65 years) Page 23 of 24 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 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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