Inspection on 04/07/07 for Monica Close (8 and 9)

This is the latest available inspection report for this service, carried out on 4th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Monica Close (8 and 9) 16/11/05

Monica Close (8 and 9) 07/07/05

Monica Close (8 and 9) 24/01/05

Monica Close (8 and 9) 21/06/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Monica Close (8 and 9) 8 and 9 Monica Close Radlett Road Estate Watford Hertfordshire WD24 4GZ Lead Inspector Claire Farrier Key Unannounced Inspection 4th & 10th July 2007 1:00 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 Monica Close (8 and 9) DS0000019471.V344770.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. Monica Close (8 and 9) DS0000019471.V344770.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Monica Close (8 and 9) Address 8 and 9 Monica Close Radlett Road Estate Watford Hertfordshire WD24 4GZ 01923 250561 01923 250561 FP monicaclose@walsingham.com 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) Walsingham Manager post vacant Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Monica Close (8 and 9) DS0000019471.V344770.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd July 2006 Brief Description of the Service: 8 and 9 Monica Close provides support and accommodation for up to 6 people with learning disabilities. The home is owned and managed by Walsingham, which is a voluntary organisation. The houses are neighbouring terraced houses, in a quiet residential neighbourhood in Watford close to the many amenities of the town centre and within easy reach of public transport. Each house has three single bedrooms in domestic style accommodation. The houses and gardens are fully accessible for the current residents. Staffing is provided twenty-four hours per day in 9 Monica Close. They provide support for the people who live at 8 Monica Close, and they are available for them at all times. The Statement of Purpose and Service Users Guide provide information about the home for referring professionals and prospective clients. The current charges were not available at the time of this inspection. Monica Close (8 and 9) DS0000019471.V344770.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We spent one afternoon at Monica Close, and the people who live there and work there did not know that we were coming. The focus of the inspection was to assess all the key standards. Some additional standards were also assessed. We talked to as many of the people who live in the home, as we were able to. We also talked to some of the staff. When we were in the home we looked at the records, care plans and staff files, and we made a tour of the premises. We made a second visit to the home a few days later so that we could talk to the manager about what we had seen during the inspection. What the service does well: What has improved since the last inspection? The manager has made several improvements in the home. She has implemented team-training days to promote good practice in person centred care for the people in the home. The care plans have been updated, with a focus on people setting their own goals. A deputy manager has been appointed since the last inspection. 8 Monica Close has been completely refurbished since the last inspection. There is new furniture in the lounge of 9 Monica Close. Monica Close (8 and 9) DS0000019471.V344770.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. Monica Close (8 and 9) DS0000019471.V344770.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 Monica Close (8 and 9) DS0000019471.V344770.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 and 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has sufficient information on residents’ needs and access to appropriate services to enable their needs to be met but there is no formal assessment format in the home. EVIDENCE: There has been no change in the three people who live at 9 Monica Close since the last inspection. The refurbishment of 8 Monica Close was completed, and two people now live there. One transferred there from another Walsingham home, and one moved in the week before this inspection. The people in 8 Monica Close are semi independent. The staff visit them several times during the day, but there are no staff for most of the day, and no staff during the night. They can call at 9 Monica Close if they need any support at any time. The people in both homes said that the have the support that they need from the staff. The staff said that they have sufficient information and training to enable them to meet the residents’ needs A very detailed social work assessment was seen for the new resident, which provided good information for the staff to be able to provide the support that they need. This person visited the home several times, and had overnight stays of increasing length, before they moved in. There was no assessment in place for the other person in 8 Monica Close. The care plan had been Monica Close (8 and 9) DS0000019471.V344770.R01.S.doc Version 5.2 Page 9 transferred from their previous home, and the manager of Monica Close knew them well because she previously worked at the other home. However there was no assessment in place for either person from Monica Close, and no evidence that a formal assessment had been completed for either person. A formal assessment would provide information for the care plan, and ensure that the home could meet their needs. Monica Close (8 and 9) DS0000019471.V344770.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in the home are fully involved in all decisions about their lives in the home. The care plans are person centred and provide the staff with appropriate information to enable them to meet people’s individual needs. EVIDENCE: We looked at a sample of care plans in each house. The care plans are clearly written, with good details of everyone’s needs and procedures and guidelines for meeting those needs. Each person sets their own personal goals, for example to go to a football match, to cook a meal, to walk to the shops, to go on day trips. The ‘Need to Know’ file, which contains all the information that the staff need on a daily basis, contains copies of the care plans and goals for each person. There is a record of what each person does to achieve his or her goal. The care plans have details of the measures needed to enable each person to take appropriate risks, so that they can lead the life that they want to. Staff spoken to said that the care plans provide them with the information Monica Close (8 and 9) DS0000019471.V344770.R01.S.doc Version 5.2 Page 11 that they need to support the people in the home. The care plan for the person who moved in shortly before this inspection has not yet been completed, but the assessment provided good information for the staff to be able to provide the support that they need. The care plan for the person who moved from another home had not been changed to provide details of the changes needed at Monica Close. Everyone that we spoke to said that they are fully involved in decisions about their lives in the home, and the staff support them to be as independent as possible. One person said that they enjoy taking part in the MenCap selfadvocacy group. Most people have their own bank accounts, and their benefits are paid directly into their accounts. There are good procedures in place for monitoring each person’s money. Monica Close (8 and 9) DS0000019471.V344770.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 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. The people who live in the home are supported to live full and active lifestyles. EVIDENCE: The staff support everyone to take part in their own choice of activities, either individually or in groups. The activities and outings that each person takes part in are recorded in their care plans, and the care plans include each person’s choice of activities. Most of the residents attend a day centre. Daily living activities are written in the care plan as goals. The staff support the people who live in the home to maintain family contacts and enjoy positive relationships with others inside and outside the home. They respect people’s privacy and support the residents to be as independent as possible. The menus are planned in consultation with the people in the home, and a well-balanced, nutritious diet is provided. Monica Close (8 and 9) DS0000019471.V344770.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 people who live in the home are confident that they will receive a good quality of personal care and healthcare. EVIDENCE: The care plans that we saw provide clear details of each person’s personal care and health care needs, and we observed a good relationship between the staff and the people who live in the home. The recording of each person’s health care includes health notes for hospital visits and contact with GPs and other medical professionals. There is good information on specific health problems. One person has mental health problems. Letters in their file from the psychiatrist show that there has been a great improvement, with the result that the person was discharged from the psychiatric service. Monica Close (8 and 9) DS0000019471.V344770.R01.S.doc Version 5.2 Page 14 The staff follows sound medication procedures, using the Boots Monitored Dosage System that features pills supplied by the pharmacist in blister packs. The staff carry out a check of the system at each round. There is a very clear support plan for each medication, with the side effects and contra indications, and how each person likes to have their medication. This system is effective and minimises the risk of mistakes. The new resident has medications that are in the original packaging. It was reported that these would be supplied in blister packs with next month’s prescription. In the meantime the staff have put the medication into a dossette box. This makes it easier for the staff to administer the medication, but may cause some risk, as they are not qualified to dispense the medication in this way. In the future measures must be put in place to make sure that medicines are provided for each person in the most appropriate way for the service. Monica Close (8 and 9) DS0000019471.V344770.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 people who live in the home are confident that their concerns are listened to, and that they are safeguarded from the risks of abuse. EVIDENCE: There is a satisfactory complaint procedure in place that contains the required information on how to complain, this is available to all residents and their relatives. A simplified version has been produced using pictorial symbols designed to be easier for residents to understand. No complaints have been recorded since the last inspection. Up to date policies concerning adult protection are in place that follow the Hertfordshire inter-agency guidelines and a copy of the guidelines is kept in the office. All staff have had training in the prevention of abuse, and the subject is covered in the staff induction programme. Staff spoken with were aware of the general principles involved including the company’s whistleblowing policy. Monica Close (8 and 9) DS0000019471.V344770.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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and well maintained environment which the staff maintain to a good standard of cleanliness for the residents. EVIDENCE: The home consists of two terraced houses in a residential street. Both houses are furnished and decorated in domestic styles that produce a homely, comfortable environment that allows the residents to relax and feel very much at home. The residents all have their own rooms, arranged and decorated to reflect their particular interests and tastes. The lounges, dining rooms and kitchens are domestic in style and are comfortably furnished and well equipped. Each bungalow has a garden with a patio area, lawn and flowerbeds. One of the people in 9 Monica Close showed us around and told us about their life in the home. 8 Monica Close has been completely refurbished since the last inspection. There is new furniture in the lounge of 9 Monica Close. Monica Close (8 and 9) DS0000019471.V344770.R01.S.doc Version 5.2 Page 17 The home appeared to be clean and generally well maintained, and the staff follow appropriate procedures to maintain hygiene and prevent the risk of infection. Monica Close (8 and 9) DS0000019471.V344770.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, 33, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A stable staff team with the experience and training to understand and meet the needs of the people who live in the home is in place. EVIDENCE: The staffing rotas showed that there are two support workers throughout the day, and one sleeps in during the night. Agency staff are used when necessary, usually individuals who know the residents well and understand the way the home works. The support worker who sleeps in at night works a late shift the day before, and an early shift the day after. This means that they work a 20-hour shift in the home. During the week of the inspection one support worker worked 3 20-hour shifts, and another worked 2. These long hours are contrary to the Working Time Directive. The people in the home may be at risk if the support workers are too tired to support them effectively. Walsingham provides comprehensive training for staff that covers all mandatory health and safety training, and training to meet special needs such as epilepsy, and behavioural problems. The staff spoken to said that the Monica Close (8 and 9) DS0000019471.V344770.R01.S.doc Version 5.2 Page 19 training and support provided for them is very good. All the staff has either completed or is currently undertaking NVQ2 or NVQ3 qualifications. The manager confirmed that the recruitment procedures followed by the company are robust and that she sees all the information on each applicant during the recruitment process. The references, CRB (Criminal Record Bureau) disclosures, evidence of identity and full employment history are stored at Walsingham headquarters, and the staff profile in each person’s file confirms that these are satisfactory. Monica Close (8 and 9) DS0000019471.V344770.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 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed for the benefit of the people who live there. EVIDENCE: The home is well run in accordance with the principles set out in the Statement of Purpose. The manager has several years experience of working with people with learning disabilities and managing a residential care service. She was deputy manager at another Walsingham home before being appointed as manager at Monica Close a year ago. She is not yet registered with CSCI, but the application for registration has been completed. She is taking the Registered Manager’s Award course. Monica Close (8 and 9) DS0000019471.V344770.R01.S.doc Version 5.2 Page 21 The manager has made several improvements in the home. She has implemented team-training days to promote good practice in person centred care for the people in the home. The care plans have been updated, with a focus on people setting their own goals (see Individual Needs and Choices). A deputy manager has been appointed since the last inspection. All the staff have training in moving and handling, fire safety, food hygiene and infection control as part of their induction. The home maintains appropriate records for the health and safety of the residents and staff in the home, and staff follow the home’s policies and procedures. There are regular fire drills in the home so that the staff know how to keep the people there safe. However one person consistently refuses to leave her room when the fire alarm sounds, and there is no protocol in place to ensure that the person is safe. Walsingham has a comprehensive system for quality assurance in its homes, which includes annual surveys of residents and their families. However there is no evidence of this at Monica Close. The company carries out regular service audits of the home and monthly Regulation 26 monitoring visits, but there is no formal assessment of the quality of care that includes the views of the people who live there. Monica Close (8 and 9) DS0000019471.V344770.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 2 3 3 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 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 X X 2 X Monica Close (8 and 9) DS0000019471.V344770.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA2 Regulation 14 Requirement Timescale for action 30/09/07 2. YA6 15(2) 3.3. YA20 13(2) 4. YA33 18(1)(a) A comprehensive assessment must be completed before any resident is admitted to the home, that provides appropriate and adequate information to enable the staff to meet all the person’s assessed needs. All people who live in the home 30/09/07 must have a care plan that is up to date. This will ensure that they receive the support that meets their current needs. Measures must be put in place 30/09/07 to make sure that medicines are provided for each person in the most appropriate way for the service. The manager must ensure that 30/09/07 sufficient staff are employed in the home. The people in the home may be at risk if the support workers work excessively long hours. Monica Close (8 and 9) DS0000019471.V344770.R01.S.doc Version 5.2 Page 24 5. YA39 24 6. YA42 A system for monitoring the quality of care must be established, that focuses on the consultation with the service users and other involved people, and provides feedback on the process and the results of the consultation. 23(4)(c)(iii) A protocol must be written to make sure that everyone in the home is safe in case there is a fire. 31/12/07 30/09/07 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 Monica Close (8 and 9) DS0000019471.V344770.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 - 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. 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