Inspection on 27/05/09 for Maplestead Road

This is the latest available inspection report for this service, carried out on 27th May 2009.

CQC found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Maplestead Road 20/02/07

Maplestead Road 13/12/05

Maplestead Road 01/07/05

Maplestead Road 03/03/05

Maplestead Road 02/09/04

Maplestead Road 29/03/04

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Maplestead Road 36 Maplestead Road Dagenham Essex RM9 4XR     The quality rating for this care home is:   three star excellent 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: Julie Legg     Date: 2 7 0 5 2 0 0 9 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 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (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 27 Information about the care home Name of care home: Address: Maplestead Road 36 Maplestead Road Dagenham Essex RM9 4XR 02085957645 02085957645 jade@outlookcare.org.uk 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) : Outlook Care care home 6 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: 6 The maximum number of service users who can be accommodated is: 6 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: Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home Maplestead Road is a large house that provides residential accommodation for up to six adults with mental health needs, and at the time of this inspection four people were living at the home. It is the aim of the home to promote independence, and to work with people who use the service to improve their daily living skills. The service is provided by Outlook care who lease the property from the local authority. The home is well equipped, homely and comfortable. There is a large well-maintained garden at the rear of the home, complete with built in barbeque. The house comprises of six bedrooms and two bathrooms arranged over the ground and first floors, a communal lounge, a kitchen diner, WC and office. The home is situated in a residential area and Care Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home is in walking distance of local shops and has easy access to local bus routes. There is unrestricted parking outside of the home. Care Homes for Adults (18-65 years) Page 5 of 27 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: three star excellent 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 was an unannounced inspection undertaken on the 27th May 2009, commencing at 10.00 hours and finishing at 16.00 hours on the same day. Evidence was taken from the returned Annual Quality Assurance Assessment (AQAA), Annual Service Review, discussions with service users, the manager and staff, viewing records and other documentation including case tracking. A tour of the home was also undertaken. We would like to thank the service users and staff for their input and assistance during the inspection. Care Homes for Adults (18-65 years) Page 6 of 27 Care Homes for Adults (18-65 years) Page 7 of 27 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 –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 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 9 of 27 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. Service users can be confident that the home is right for them ad that the staff are able to meet their individual needs. Evidence: Three service users files were examined and there was evidence that comprehensive pre- admission assessment had been undertaken prior to a service users admission to the service. Information was gathered from care and health professionals as well as families and the service user themselves. The manager was able to describe the admission process for the most recent service user and the importance of up to date relevant information and the knowledge that the staff have the appropriate skills, training and qualifications to meet those needs. Prospective service users are encouraged to visit the service prior to their admission and spend time talking to staff and the other service users. There is comprehensive Service User Guide which is comprehensive and all of the Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: service users have been given a copy of this document and each service user has a service agreement which states the rights and responsibilities of the service user and the provider. these service agreements have been signed by both parties and copies were seen on service users files. Care Homes for Adults (18-65 years) Page 11 of 27 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. people who the service are involved in developing their individual; care plans and the future development of the service. Evidence: The service involves individual service users in the planning of their care which has an impact on their lifestyle and quality of life. Staff understand the importance of service users being supported to take control over their lives. Service users are encouraged to make their own decisions and choices. On the day of the inspection it was the birthday of one of the service user sand she made decisions regarding the celebrations. Care plans are comprehensive and person centred and cover all areas of personal, health and social care needs. Plans that were seen were completed with the involvement of the service users and also included information on their life history. Equality and diversity issues are also addressed in the care plans and in discussion with the staff they demonstrated a good understanding of equality and diversity Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: issues. The service has a key worker system and this allows staff to work on a one-to-one basis and contribute to the care plan for the individual service user. The care plan is a working document and there was evidence that these are being reviewed regularly, with the involvement of the individual service user. Reviews focus on the outcomes for the service user and what future actions are required. Each care plan includes a comprehensive risk assessment. The management of risk is positive in addressing safety issues while aiming for improved outcomes for people. Where there are limitations, the decisions have been made with the agreement of the service user and are accurately recorded. Service users are consulted regularly through house meetings and surveys to ensure their satisfaction with the service and with the future development of the service. Care Homes for Adults (18-65 years) Page 13 of 27 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. Service users have opportunities for their own personal development and to participate in activities of their choice. Evidence: During the inspection it was evident that the service respects the human rights of the service users with fairness, equality, dignity, respect and autonomy underpinning the care and support being provided. Service users are involved in meaningful day time activities of their own choice and according to their individual interests, needs and capabilities. Some of the service users lack motivation to try different activities and staff continually try to encourage and support them to broaden their horizons. Service users are encouraged and do use community facilities such as local colleges, pubs, restaurants, cinema and shops. One Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: of the service users was attending a local college but this has now stopped, other service users enjoy shopping at the local shops, as well as visiting a shopping mall (Lakeside). Most enjoy eating at restaurants, pubs and local fast food chains. Some of the service users are able to access some of the activities independently and others require the support of a member of staff. Service users are able to access all areas of the home independently and were seen to be doing this during the inspection. Service users are encourage to keep their own bedrooms clean and tidy; some with support and to participate in household chores within the home again with support if required. Service users are involved in menu planning and shopping for groceries. One of the service users supported by a member of staff went shopping during the inspection. Fresh fruit and vegetables are always available and theese were seen during the inspection. If necessary meals are in accordance with an individuals religious and/or cultural needs. Service users have their main meal in the evening, as this is their choice. throughout the inspection service users were seen to help themselves to drinks and snacks during the inspection. Service users are encouraged to develop and maintain important personal and family relationships. The staff practices promote individual rights and choice but also consider the protection of individuals in supporting them to make informed choices. All of the service users have contact with their families, some more frequent than others. Some families visit the service and some of the service users visit their families in their own homes. Service users are involved in family celebrations and one service user goes on holiday with their relative. Care Homes for Adults (18-65 years) Page 15 of 27 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. People who use the service are supported and encouraged to be as independent as possible with regard to their personal and health care needs. Medication policies and procedures are robust which safeguard the service users. Evidence: Care plans that were examined showed clearly the level of support that each service user requires with their personal care tasks. Service users told us that they receive assistance with their personal care tasks in a way that respected their dignity and privacy and that they felt respected by staff. Care plans and daily records showed that staff are responsive to changing needs and choices and that personal care is person centered and delivered in a flexible and consistent manner. Health care plans showed that service users are accessing community health services including; optician, GP, dentist, chiropodist as well as breast and cervical screening. referrals are also being made to specialist health professionals. records detailed the appointments attended, the outcome and any follow up actions. Service users are encouraged to make and keep their own appointments however staff do support when Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: required. Staff work to clear and robust practices when working with the service users. Care plans are person centred and contain clear information about individuals wishes, choices and decisions if their mental health deteriorates and staff work consistently to a high standard to ensure that the service users receive the care and support they require to enable them to live as independently as possible. The manager advised us that none of the service users are self medicating or taking controlled drugs. The service is managed by Outlook care and there is a corporate document that includes guidance on storage, administration, recording and disposal of medicines. All staff that are involved in the administration have received appropriate training. we sampled the Medication Administration Records (MAR) and actual medication for two service users. The MAR sheets were found to be in good order and the medications seen corresponded with the MAR sheets. Service users wishes regarding their end of life are being discussed with them and their relatives and recorded in their care plans where appropriate. Care Homes for Adults (18-65 years) Page 17 of 27 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. Service users can be confident that their concerns and complaints are taken seriously and acted upon. Evidence: The home has an open culture that allows service users to express their views and concerns in a safe and understanding environment. Service users say that they are happy with the service being provided, feel safe and well supported by an organisation that has their protection and safety as a priority. The service has a corporate Outlook Care complaints procedure, this includes the process and timescales within which the home aims to deal with complaints. These are available to all of the service users in a format which they can understand. Service users told us that they knew how to complain and that they would either speak to the manager, their key worker or a relative. We also looked at the complaints record and there has been two complaints in the past twelve months. One of these complaints led to a safeguarding investigation, which has been dealt with appropriately. The complainants was satisfied with how the complaints were dealt with. There is a clear system for staff to report concerns about colleagues and managers. Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: Staff that were spoken to were aware of the organisations whistleblowing policy and had been supported by the service when this had been instigated. Staff files showed that training in safeguarding and abuse awareness have taken place and this was confirmed by staff. they also demonstrated actions they would take if they had concerns about the welfare and safety of any of the service users. Staff that were spoken to understood what restraint is and alternatives to use would always be looked for. Staff training files confirmed that staff have received appropriate training in this area. Care Homes for Adults (18-65 years) Page 19 of 27 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. Service users live in a home that meets their needs, is clean, well maintained and odour free. Evidence: A tour of the home was undertaken and found that all parts of the home were well maintained. clean and odour free. The service employs a housekeeper on two days a week for undertaking the heavier cleaning tasks. On the ground floor there is a communal lounge with a range of comfortable seating, a TV and stereo unit. The communal kitchen/diner is bright and airy with a fitted kitchen and a large dining table and chairs. the refrigerator, freezer and pantry cupboard were all well stocked. Also on the ground floor is one of the service users bedroom and a large bathroom which contains a bath, a walk in shower, WC and a wash hand basin. the first floor is accessed via a staircase. A further five service users bedrooms, a seperate WC and a further bathroom are located on this floor. Bedrooms are furnished and decorated to suit the needs and preferences of each service user. Care Homes for Adults (18-65 years) Page 20 of 27 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. Service users are supported by staff who have the appropriate skills and knowledge to meet their needs. Evidence: Outlook Care has a centralised Human Resources Department that manages the recruitment process. records relating to staff recruitment were available and we sampled two personnel files. these showed that the staff recruitment process is robust; there was evidence that an application form had been completed, two satisfactory references had been obtained, proof of identity and an enhanced Criminal Records Bureau (CRB) checks undertaken. The service has a small but stable workforce and staff commented that they very much work together as a team. There has been an addition to the staff team and the service now has a deputy manager. Most of the staff have attained their NVQ 3 and the manager has her NVQ 4 and the registered managers Award (RMA). Training is given a high priority and all of the staff have undertaken training in mental health and in the Mental capacity Act 2005. Training records show that staff have attended training in all mandatory areas. All of Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: the staff have in place a training and development plan and this is discussed during staff supervision. Personnel files showed that staff they are receiving regular supervision, attending monthly staff meetings and have also had a yearly appraisal. staff that we spoke to during the inspection confirmed that these were taking place. In discussions with staff they demonstrated a very good understanding and awareness of equality and diversity issues and it was apparent from observations that this is being put into practice within the service. Service users have confidence in the staff who care for them. Rotas show that the service is staffed efficiently and that they cover both day and night shifts. this enables staff to have more of a holistic view of the service users needs. Service users told us that the staff team are approachable and that they can talk to them easily and that they felt their needs were being met. Care Homes for Adults (18-65 years) Page 22 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager has the required experience and qualifications to ensure that the service is run in the best interests of the service users. Evidence: The registered manager has been at the home for a number of years. She has a qualification in Advanced Management in Care, NVQ 4 and the Registered Managers Award (RMA). She is a highly competent person and is able to manage the home and meet the organisations stated aims and objectives. She was also able to demonstrate a sound knowledge of the organisations strategic and financial planning systems and how the business plan for the home links into these. The manager has a clear understanding of the key principles and focus of the service, which she is continually working to improve. There is a strong focus on equality and diversity issues, promoting human rights and person centred thinking and she and her staff team strive to provide best practice in these areas. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: The manager has an open door policy for both service users and staff and their views are listened to and acted upon. Service users spoke highly of her and said that they felt she was there for them. From discussions with staff and our observations it was evident that the manager is an excellent role model for the staff. The manager leads and supports a strong staff team who have undergone a robust recruitment and selection procedure as well as receiving appropriate training. Staff follow the organisations policies and procedures this was evidenced through staff files and speaking to staff and the manager. Staff demonstrated an awareness of these during the inspection. there was also evidence that staff practice and performance were discussed during supervision, staff training and team meetings. The manager and a service manager undertake spot checks and monthly quality monitoring, this provides evidence that the practice of the service reflects the organisations policies and procedures. The service has efficient systems to ensure effective safeguarding and management of service users money and valuables. Service users are supported to manage their own money where possible however there is support from staff if required. There were written record of all safety checks and maintenance records that were seen were in good order. The home pro actively monitors its health and safety performance and consults with outside specialist agencies about health and safety as and when required. The manager and the staff team have a good understanding of the risk assessment processes which is underpinned by promoting Independence, choice and autonomy. these principles are taken into account in all aspects of the running of the service. this was evidenced through risk assessments seen during the inspection and discussions with the manager and staff. The Annual Quality Assurance Assessment (AQAA) contains excellent information that is fully supported by appropriate evidence. The home demonstrates a high level of self-awareness and recognises the areas that it still needs to improve. The monthly visits required under Regulation 26 of the Care Home Regulations are being regularly undertaken and we were able to see copies of these reports during the inspection. The manager notifies us of any incident/issues as required under Regulation 37 of the Care Home Regulations. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 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 Care Homes for Adults (18-65 years) Page 26 of 27 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 27 of 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. 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!