Inspection on 01/07/08 for Market Street (152)

This is the latest available inspection report for this service, carried out on 1st July 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.

Other inspections for this house

Market Street (152) 12/05/06

Market Street (152) 20/10/05

Market Street (152) 18/04/05

Market Street (152) 27/09/04

Market Street (152) 19/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

CARE HOME ADULTS 18-65 Market Street (152) 152 Market Street East Ham London E6 2PU Lead Inspector Sarah Greaves Unannounced Inspection 1st July 2008 13:00p Market Street (152) DS0000022884.V368757.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 Market Street (152) DS0000022884.V368757.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. Market Street (152) DS0000022884.V368757.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Market Street (152) Address 152 Market Street East Ham London E6 2PU 020 8470 2535 0208472 3717 queendollydot@hotmail.co.uk 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) Mrs Grace Antwi-Nyame Ms Dorothy Mensah Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Market Street (152) DS0000022884.V368757.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st January 2008 Brief Description of the Service: 152 Market Street is a residential home for people with mental health problems and is registered for up to three service users. The home is privately owned and the proprietor works at the establishment. The home is situated in Newham, close to the shopping facilities, amenities and transport links available at High Street North. The home comprises of a single bedroom and a communal lounge on the ground floor, and two bedrooms on the first floor. The home occupies an ordinary domestic property in a residential street. Market Street (152) DS0000022884.V368757.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 that people who use the service experience good quality outcomes. This unannounced key inspection was conducted in one day. We gathered information through speaking to the registered manager and the one resident present in the premises at the time of this visit. We read two care plans and looked at other documents including the staff files for recruitment, training and supervision. We toured the premises and looked at the storage and recording for medications. The service was sent an Annual Quality Assurance Assessment (AQAA), which is a self-audit tool; information from the AQAA is used as part of the inspection process. What the service does well: What has improved since the last inspection? Two requirements and two recommendations were issued in the previous inspection report, which were satisfactorily addressed. The service demonstrated that all documents for safe recruitment were obtained and appropriate equipment had been acquired for the secure storage of refrigerated medications. Market Street (152) DS0000022884.V368757.R01.S.doc Version 5.2 Page 6 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. Market Street (152) DS0000022884.V368757.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 Market Street (152) DS0000022884.V368757.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are assured that their needs and wishes will be ascertained before admission. EVIDENCE: We found that there were no new residents since the last inspection visit. We have previously found that the service has assessed the needs of prospective residents, as well as obtaining an assessment from the placing authority. Prospective residents (and their representatives) have been offered opportunities to visit the service before moving in for a trial period; the only exception to this practice would be an admission arranged in emergency circumstances. Market Street (152) DS0000022884.V368757.R01.S.doc Version 5.2 Page 9 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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by effective care planning, although it would be beneficial if their involvement in the planning of risks could be consistently demonstrated. EVIDENCE: We read two care plans, which were up-to-date and reflective of the identified needs of individuals as recorded in their Care Planning Approach (CPA) meetings. We spoke to the one resident that was present during the inspection and we felt that the care plan was an accurate reflection of the needs and wishes of this person. Residents were encouraged to participate in the development and monitoring of their care plans. Market Street (152) DS0000022884.V368757.R01.S.doc Version 5.2 Page 10 We observed that residents made their own decisions. One of the residents had attended a hospital appointment with a member of staff on the day of this inspection; the registered manager received a call during the inspection from the care worker to state that the resident had decided to visit a street market in a neighbouring town immediately after the appointment. We noted that the service encouraged people to make their own decisions but would offer guidance if a resident wished to make a choice that would negatively impact upon their safety and welfare. The risk assessments were up-to-date in both care plans; however, we noticed that one of the residents had signed their risk assessment analysis but the other resident had not. We felt that this opportunity should be offered to the second resident and staff could document if the resident did not want to sign their risk agreement. We were informed of a recent development regarding one of the resident’s that might need to be subject to a risk assessment if the service establishes that the person is at risk. Market Street (152) DS0000022884.V368757.R01.S.doc Version 5.2 Page 11 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 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were supported to make choices about their lives, and to maintain links with their families and the local community. EVIDENCE: At the time of this inspection one of the residents had gone out on their own and another resident was attending a hospital appointment with a member of staff, which was followed by a visit to a street market. The third resident was at home during the inspection. Through speaking to one resident, reading two care plans and discussions with the registered manager, we found that residents were supported to take part in meaningful activities. One of the residents stated that they were paid a therapeutic allowance by the care home for tending the garden; the resident Market Street (152) DS0000022884.V368757.R01.S.doc Version 5.2 Page 12 showed us the work that they had done. We were aware that the staff have supported the resident to attend local projects for people with mental health problems (such as a group for people from the African-Caribbean community) and there was also a recreational plan drawn up between the resident and an occupational therapist; however the resident declined to attend groups or participate in the recreational plan. The staff were supporting this person to become more involved in household chores, which was an agreed objective from their Care Planning Approach meeting. Another resident enjoyed going out shopping and making visits to their family. All of the residents had contact with relatives and friends. It was noted that individuals might not wish to lead an active lifestyle due to factors not linked to their mental health needs (for example, physical health problems that impact upon activity levels). Through discussion with the registered manager, we were notified of important decisions that residents were making about their own lives. We have not recorded this information in this report in order to maintain the anonymity of people living at the care home. We found that the menu plans provided sufficient information to demonstrate that residents were actively involved in planning a balanced and healthy diet. The menu plans indicated individual choices by the residents, which demonstrated personal and cultural preferences. We found that there was a choice of fresh fruits and vegetables within the kitchen, as well as a choice of snacks and beverages. Market Street (152) DS0000022884.V368757.R01.S.doc Version 5.2 Page 13 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 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service demonstrated that residents were competently supported with their personal and health care needs, inclusive of their medication needs. EVIDENCE: Through reading two care plans and speaking to one of the residents we found that the service supported people with their personal care needs, in accordance to their assessed needs and own wishes. Residents were able to pursue their own routine (for example, when they wished to have a wash, shower or bath); the only restriction to this flexibility would be due to a resident needing to be ready at a certain time in the morning in order to attend an appointment. No issues of concern were identified with the service’s support to assist residents with their health care needs. On the day of this inspection one of the residents had attended a hospital appointment with a member of staff. We found that the health care needs of individuals was discussed as part of their Market Street (152) DS0000022884.V368757.R01.S.doc Version 5.2 Page 14 Care Planning Approach (CPA) meetings. It was noted that the service was supporting a resident with a chronic health care condition; the care plan clearly stated that the resident was receiving medical and nursing monitoring. We checked the service’s storage and recording for the medication that it administers to residents (the care home also stored medication that was administered by a visiting community psychiatric nurse). There were no issues of concern regarding the management of the medication although we advised the registered manager to bring back a copy of a current British National Formulary medication book, which was off the premises at the time of this inspection. A requirement was issued in the previous inspection report for the service to provide secure storage equipment for any medications that need to be refrigerated; this requirement was met. Market Street (152) DS0000022884.V368757.R01.S.doc Version 5.2 Page 15 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service evidenced good approaches to listening to and protecting the residents. EVIDENCE: The service produced a satisfactorily written complaints procedure, which was provided to residents (and their representatives) as part of the Service Users Guide. Residents were provided with information regarding how to access independent advocacy services. The service had not received any complaints and no complaints have been separately forwarded to the Commission. We observed at this inspection and at previous inspections that residents were able to express any concerns or anxieties to the registered manager. We felt that this informal communication meant that residents (and their representatives) were less likely to consider it necessary to make formal complaints. The Adult Protection policy was accurately presented. Staff received annual refresher training regarding the protection of vulnerable adults. There have been no safeguarding vulnerable adults issues. Market Street (152) DS0000022884.V368757.R01.S.doc Version 5.2 Page 16 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): 24,26 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were provided with a clean and comfortable environment; however, some improvements could be promoted in one of the bedrooms. EVIDENCE: The care home occupies an ordinary two-storey domestic property in a residential street. Two of the bedrooms are located on the first floor and one bedroom is on the ground floor. There is a communal lounge and kitchen on the ground floor. We noted that one of the bedrooms was well maintained and was very homely. There were some areas for improvement in the other bedroom, which were discussed with the registered manager. We have acknowledged that specific Market Street (152) DS0000022884.V368757.R01.S.doc Version 5.2 Page 17 difficulties arise if residents engage in destructive behaviour towards their physical environment due to their mental health problems. The premises were hygienic and free from any offensive odours. Market Street (152) DS0000022884.V368757.R01.S.doc Version 5.2 Page 18 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 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefited from appropriately trained, safely recruited and satisfactorily supervised staff. EVIDENCE: At the time of this inspection the care home staff comprised six people, including the registered manager. One care worker had completed a National Vocational Qualification (NVQ) in Care at level 3 and two care workers had attained NVQ level 2. One member of staff had achieved the Registered Managers Award and a diploma in community mental heath (this was the proprietor, who undertook shifts at the care home). Another care worker had been accepted to commence NVQ level 2 this year. Therefore, significantly more than 50 of the staff had achieved a minimum of NVQ level 2, as stipulated by the National Minimum Standards for Care Homes for Younger Adults. Market Street (152) DS0000022884.V368757.R01.S.doc Version 5.2 Page 19 The service evidenced that there was an on-going training programme for mandatory and relevant training. Some training was accessed from the Newham Social Services, as well as via independent trainers and video training. We were informed that the registered manager and one member of staff attended a national conference for care homes in March 2008. It was noted that the service had not arranged any specialist training in mental health issues since the last inspection; the registered manager confirmed that this would be addressed. One of the residents chose to participate in the fire training session. We noted at the last inspection that one of the staff files did not contain satisfactory evidence to demonstrate that the employee was legally permitted to be working in the UK. The registered manager had stated that she had seen the necessary document but did not make a copy of the original. We looked at this file during this inspection and found that all aspects of this recruitment were satisfactory. There have been no new staff appointed since the last inspection; we looked at the recruitment process for only one employee, taking into account that this is a small care home and all other recruitment files have been looked at during previous inspections. We looked at the supervision records for two members of staff. It was noted that supervision took place once every two months and appeared to be suitably detailed. Market Street (152) DS0000022884.V368757.R01.S.doc Version 5.2 Page 20 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): 37,39,41 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents received a well- managed service that listened to their views, and promoted safety and welfare. EVIDENCE: The registered manager of the care home has attained the Registered Managers Award and a diploma in community mental health. It was noted that the two requirements from the previous inspection report had been achieved in a timely manner. No concerns regarding the management of the service were detected during this inspection and there have been no issues reported to the Commission from health and social care professionals, and other stakeholders. Market Street (152) DS0000022884.V368757.R01.S.doc Version 5.2 Page 21 The views of the residents regarding the service were sought through documented one-to-one monthly meetings. The registered manager had attempted to conduct group meetings but residents did not want to participate in this type of forum. We looked at the financial records for one of the three residents, which was appropriately maintained. We checked a sample of the health and safety records (refrigerator and freezer temperatures, hot water temperatures, fire alarm testing, labelling of opened food items); all were satisfactory. Market Street (152) DS0000022884.V368757.R01.S.doc Version 5.2 Page 22 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 X 4 X 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 2 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X 3 3 X Market Street (152) DS0000022884.V368757.R01.S.doc Version 5.2 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA9 Regulation 15 Requirement The Registered Manager must ensure that all residents have the opportunity to demonstrate their involvement in the development and monitoring of their risk assessments. The Registered Manager must ensure the improvement of the standard of the bedroom referred to within this report. Timescale for action 30/11/08 2. YA26 23(2)(b) 30/11/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Market Street (152) DS0000022884.V368757.R01.S.doc Version 5.2 Page 24 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 Market Street (152) DS0000022884.V368757.R01.S.doc Version 5.2 Page 25 - 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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