Inspection on 23/07/09 for Sampson Avenue

This is the latest available inspection report for this service, carried out on 23rd July 2009.

CQC 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

Sampson Avenue 04/09/06

Sampson Avenue 08/12/05

Sampson Avenue 23/05/05

Sampson Avenue 04/01/05

Sampson Avenue 30/09/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

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Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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: Sampson Avenue 27 Sampson Avenue 27 Barnet Hertfordshire EN5 2RN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Teferi Degeneh     Date: 2 3 0 7 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 26 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 26 Information about the care home Name of care home: Address: Sampson Avenue 27 Sampson Avenue 27 Barnet Hertfordshire EN5 2RN 02084490142 F/P02084490142 jdriscoll@adepta.org.uk www.pentahact.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): PentaHact Limited trading as Adepta care home 6 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category of services only: Care Home only - Code PC to service users of the following gender, Either, whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD Date of last inspection Brief description of the care home 27 Sampson Avenue is a purpose built care home registered for six adults with learning and physical difficulties. The home was opened in 1993 and is run by Adepta, an organisation based in Finchley, North London and specialising in operating care homes and supported living projects for people with learning disabilities. Metropolitan Housing Association own the building and Metropolitan Housing Association and Adepta Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 0 6 6 Brief description of the care home maintain it jointly. The home is a two storey detached property with a kitchen, laundry room, lounge, dining room, office, three bedrooms, one bathroom and one shower room to the ground floor. There are three bedrooms, a staff sleep-in room and one shower room to the first floor. There is a lift with access to both floors. The home is situated on a relatively new housing estate in Barnet. Shops and local amenities are a short walk away. The fees for residents living in the home range from £1,211.54 to £1,463.59 per week depending on their individual needs. The provider must make information available about the service, including inspection reports, to service users and other stakeholders. Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was a surprise inspection which meant that we had not told the home that we were visiting. There were three care staff and the residents when we arrived at the home at 9:00 am. The manager, who came about half an hour of our arrival, was present throughout the inspection. Before our visit to undertake this inspection, we had received a self assessment form known as the annual quality assurance assessment (AQAA) from the home. An AQAA is a form which we request from care homes every year to complete and send back to us. It gives the care homes an opportunity to tell us how they are planning to improve the service. We had a look at the AQAA as part of this inspection. The other activities we carried out on the day of this inspection included a tour of the building, the examination of the residents files including care records, the examination Care Homes for Adults (18-65 years) Page 6 of 26 of health and safety records, the viewing of staff rotas and discussions with and observation of people who use the service, care staff and the homes management. We had an opportunity to talk on the phone to a relative of a resident. We have considered all the other information that we have about the home. 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 26 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 26 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. New residents can be confident that their admission to the home is based on the availability of facilities and services that meet their assessed needs. Evidence: No new service users have been admitted for a long time. The manager said new residents would be assessed if there were a vacancy and they were to be admitted to the home. The AQAA states that the home provides new service users with information about the home and involve professionals such as occupational therapists, speech therapists and advocates to help the residents make informed decisions. The manager confirmed that the home admits new residents only if it believes that it can meet their assessed needs. Care Homes for Adults (18-65 years) Page 10 of 26 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. The care plans and risk assessments are good and the people who use the service can be confident that their needs are identified and met by the home. Evidence: We looked at three residents files. All these files contained detailed care plans and risk assessments. The care plans provide the staff with information such as the likes and dislikes of the residents and how to support them. The manager said each resident has a key worker who regularly updates the care plans. A key worker is a named member of care staff who has a special interest in the care and welfare of a resident. Most of the care plans are written in first person (I) reflecting the residents wishes or how they want to be supported. The other care plans are written in a third person (he or she) for those who have communication difficulties. It was evident from discussions with the manager, and the examination of the files and the AQAA that the home involves other professionals such as social workers in residents assessments and review of care plans. Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: Each resident has a risk assessment which describes the risks and how to manage them. This ensures that the residents are safe at the home. From observations and discussions with the manager we have noticed that the home has taken steps to minimize risks to the residents. For example, a special electrical tool for moving residents with mobility difficulty has been installed in a shower room and some bedrooms. There is also a closed-circuit television (CCTV) installed at the home to help monitor front and back door areas for the safety of those who live and work at the home. Care Homes for Adults (18-65 years) Page 12 of 26 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. The people who use the service have good opportunities to engage themselves and to access leisure activities in the community. The residents can be confident that the food provided at the home can meet their cultural and dietary needs. Evidence: From discussions with the manager and some residents it was clear that the residents have day activities. When we arrived at the home for this inspection some residents were already up and were having their breakfast before going out. We were informed that most of the residents were getting ready to go to the weekly gym which they have been attending supported by the staff. There is a minibus which the residents can use whenever they go out. The manager said there is a range of activities for the people who use the service. This includes Music therapy, massage, horse riding, theatre, concerts, bowling, and going to various places. It was clear from the homes visitors book and the service users files that the residents are visited by their friends Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: and families. The AQAA says that some residents have invited their college friends to the home. It was evident from observations of and conversations with some residents that the home provides food that meet the residents cultural and dietary needs. The residents we spoke to said they liked the meals. The manager confirmed that the residents are involved in menu planning. The manager said pictorial menus are used to help the residents with communication difficulties choose what they want to have for their meals. The staff, who were observed during breakfast time, prompted and encouraged the residents as much as possible to choose and prepare their breakfast. From discussions and the residents files we noticed some residents were supported to go to places of worship. We spoke to one relative who confirmed that they regularly visit a service user. The relative we spoke to said they were happy with the staff and felt welcomed whenever they visited the home. Care Homes for Adults (18-65 years) Page 14 of 26 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. The residents health and personal care needs are met by the homes are good systems and practices. Evidence: A number of the residents who live at this home have a physical disability which means that they need technical aids or equipment to be independent. From the files we noted that many residents need two members of staff for their personal care. Observations of the staff showed that they have skills and experience to provide support in a sensitive manner. The staff we talked to were able to demonstrate their knowledge and skills of ensuring and respecting the residents rights, choice and privacy at all times. We noticed from the files and discussions with the manager that the home has employed a member of staff who speaks a language that one of the service users uses. The residents files showed that they regularly see health professionals such as general practitioners, opticians, dentists and a speech therapist. The residents looked well, presentable and comfortable during this inspection. There were good interaction between the residents and the staff. However, we were concerned about the staffing Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: level especially during the time of supporting the residents with their personal care and other tasks such us helping them with breakfast. We will ask (under staffing below) the manager to look into this and ensure that there are enough staff members to support the residents at all times. We checked the medicines and medication administration record sheets (MARS). We also checked the medication administration policy. The medicines and the MARS we checked were all in order. We were concerned, however, that allergies which were identified in an assessment of one resident were not noted on the MARS. This could be a high risk to the resident. We asked the manager to ensure that allergies are clearly written on the MARS so related incidents can be avoided. Care Homes for Adults (18-65 years) Page 16 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints policy and procedure are good to ensure that the residents concerns are listened to and solved. The homes safeguarding policy, procedure and the experiences of the staff make the residents feel safe in the home. Evidence: The home has a complaints policy which is currently being updated. The people who use the service have been given information on how to complain if they have concerns. A relative of a resident we spoke to said they know who to talk to if they have a concern. There have been no recorded complaints since the last inspection. The home has a safeguarding policy. There is also a copy of the local authoritys adult protection policy and procedure. A member of staff we spoke to was able to explain how they safeguard the people who use the service. The manager confirmed that the staff have attended training on safeguarding. Care Homes for Adults (18-65 years) Page 17 of 26 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. The residents have benefited from the homes good facilities and equipment that meet their needs. Evidence: The home was clean, tidy and bright. The rooms and the corridors were large and most parts of the home were well furnished and decorated to provide a comfortable environment for the residents to live in. During a guided tour of the premises and a conversation with a relative we noted that the lounge could benefit from pictures or plants to give it a homely atmosphere. All parts of the home were free from unpleasant smell. Care Homes for Adults (18-65 years) Page 18 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Despite the good knowledge and skills of the staff, and the good recruitment procedures and practices, the risk to the residents to the health and safety of the residents has not been totally eliminated due to the staffing level at certain peak hours. Evidence: The staff rota showed that there are three care staff on duty during early and late shifts. There is one other member of staff who does a floating shift which means that they come around 10:00am and finish early. The night shift is covered by two waking night staff. We mentioned earlier above that most of the residents at this home need two staff members for their personal care or for moving them to and from their wheelchairs. We noted during breakfast time that a member of staff had to be called on many occasions from supervising a resident to go to assisting another member of staff who was providing personal care to a resident. This has not only inconvenienced both of the residents (one who was about to have breakfast and the other who was receiving personal care) but it also put both of them at risk. We asked the manager to ensure that there are sufficient number of competent staff on shift to support the residents with their needs. We spoke to and observed three members of staff. We also checked five staff files. Our discussions with and observations of the staff indicated that the staff are experienced and know how to support the residents Care Homes for Adults (18-65 years) Page 19 of 26 Evidence: by ensuring their privacy, dignity and choice. The residents and a relative we spoke to told us that they are happy with the staff. The staff files we checked indicated that the staff have attended a range of training programmes related to care. We noted earlier above that the home has employed a care worker who speaks the language of a service user. The AQAA says that all staff undergo induction programme as part of their training. We found out through conversations with the manager that many of the staff are new to the home and are undergoing probationary period. From the staff files, the AQAA and discussion with the manager it was clear that the staff have attended mandatory training programmes including health and safety, medication administration, first aid, basic food hygiene, safeguarding, and moving and handling. The manager said that each staff member has an annual appraisal and training plan. As we said above many of the staff at this home have been recruited recently. We looked at five files and confirmed that two written references have been received for each of them. We also saw evidence of criminal record bureau (CRB) checks, job descriptions and terms and conditions of employment. The manager said that new staff are recruited using the companys recruitment policy. This involves candidates applying for vacancies and going through interview processes. As we said above new staff members have to work for six months probationary (trial) period to be assessed and confirmed permanent. Care Homes for Adults (18-65 years) Page 20 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good management systems to ensure the residents are listened to and their needs are met. Evidence: The manager has a long experience of managing the home. She said she had worked as an assistant manager at another home before coming here. The manager has completed training at higher level of care management. She is supported by senior managers of the Company that owns the home. The staff we spoke to commented positively about the manager. We found the manager to be cooperative and ready to make changes when and as improvements are required. The home has a system of quality assurance. Through this system questionnaires are sent to the residents relatives, professionals and the residents to complete and return to the home. The manager said the companys quality officer manages the system. A copy of the report of the homes last quality assurance exercise was seen. The manager said the feedback received through the exercise were all addressed. She said the home also continuously listens to the residents and relatives and make Care Homes for Adults (18-65 years) Page 21 of 26 Evidence: improvements to the service. We checked the incident and accident records and discovered that there have been nine recorded incidents since April 2009. we confirmed that action has been taken to deal with each of these incidents. From discussions and records we noted that regular maintenance of the facilities and equipment has taken place. The fire alarm tests and fire drills take place regularly. All the portable electrical equipment were tested on 11/08/2008 and the passenger lift was last serviced on 21/07/2009. the gas boilers were serviced on 03/03/2009. The home has a closed-circuit television (CCTV) for the security of the people and the resident. Care Homes for Adults (18-65 years) Page 22 of 26 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 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 Details of any allergies that residents may have must be recorded prominently in their files and medication administration sheets. This is to ensure that staff are fully informed and to ensure the safety of residents concerned. 28/08/2009 2 33 18 There must be sufficient number of staff on duty at the home. This is to ensure that the residents are appropriately supported without risk and inconvenience to them 28/08/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 24 The registered person should provide facilities such as pictures and plants in the lounge to make it attractive and Care Homes for Adults (18-65 years) Page 24 of 26 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 give a homely feeling for the residents. 2 34 The registered person should ensure that there is a low turn over of staff so that the residents are supported by members who they can trust more and who have a long experience of working with them. Care Homes for Adults (18-65 years) Page 25 of 26 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. 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