Inspection on 28/01/08 for Wray Court (3)

This is the latest available inspection report for this service, carried out on 28th January 2008.

CSCI found this care home to be providing an Good 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

Wray Court (3) 05/12/05

Wray Court (3) 15/08/05

Wray Court (3) 18/01/05

Wray Court (3) 27/07/04

Wray Court (3) 09/03/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

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 09/07/2008.

CARE HOME ADULTS 18-65 Wray Court (3) 3 Wray Court London N4 3QS Lead Inspector Caroline Mitchell Unannounced Inspection 28th January 2008 11:00 Wray Court (3) DS0000031155.V361025.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 Wray Court (3) DS0000031155.V361025.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. Wray Court (3) DS0000031155.V361025.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wray Court (3) Address 3 Wray Court London N4 3QS 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) 020 7281 4464 020 7272 4768 andy.washington@islington.gov.uk Islington Social Services Chris John O’Donnell Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places Wray Court (3) DS0000031155.V361025.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st October 2006 Brief Description of the Service: The service moved from Wray Court to 28 King Henry’s Walk, N1 where it has operated for around 18 months. This was a temporary move, whilst the Wray Court building was upgraded. However, plans have changed and a recent decision was made that the service will remain at King Henry’s Walk, after some modifications to the building. The service is co-located with another Islington learning disability home, Orchard Close. A minor variation had been agreed for King Henry’s Walk to accommodate, on a temporary basis, Wray Court and Orchard Close. The registered manager of that home is responsible for both services whilst they are in their temporary accommodation. 2 assistant managers have specific responsibility for the Wray Court service. The service offers 6 places. It is a building based, respite (planned short stays) and emergency service for adults with learning and/or physical disabilities. The London Borough of Islington operates the service and access is always via an assessment by Islington Learning Disability Partnership. Prospective service users are the financial responsibility of the borough, and assessed as eligible for community care services. The home currently provides respite services to approximately 25 people. Stays are planned so as to enable people to continue living with their families. Personal care is provided on a 24hour basis, with staffing levels being based on the assessed needs and numbers of people using the service in on any particular day or night. King Henry’s Walk has full disabled access, and each person has a single room. Lounges, a small kitchen/dinner, bathrooms and toilets are shared. Charges are £50.40 per day for people aged under 25 and 62.35 per day for those over age 25. Following Inspecting for Better Lives the provider must make information available about the service, including inspection reports, to residents and other stakeholders. Wray Court (3) DS0000031155.V361025.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 star. This means the people who use this service experience good quality outcomes. This inspection was done on an unannounced basis, so the service did not know the inspector was coming. The inspection took half a day to complete. The inspector spoke to the assistant manager and members of the staff team. 1 person who uses the service was in the home and talked to the inspector. The inspector looked at the files that the home keeps about 2 people who use the service, which included their multi disciplinary reviews, care plans and risk assessments. The inspector also looked at 3 other people’s care plans. The inspector saw the training record for all of the staff. Other things that the inspector looked at were the daily records, the complaints book, the medication, health and safety, handover information and looked around the home. After the visit to the service the inspector also spoke to the registered manager on the telephone and he sent some information to the inspector about how he makes sure the quality of the service is good (quality monitoring). What the service does well: What has improved since the last inspection? What they could do better: The plan for the service to return to the Wray Court building has been changed. The respite service is now going to stay at King Henry’s Walk. The Wray Court (3) DS0000031155.V361025.R01.S.doc Version 5.2 Page 6 service will move to another building for a while so that changes can be made to building at King Henry’s Walk. Despite having to move again, this will make the King Henry’s Walk building better for people to stay in when it is finished. Although the care plans are good, they could be made easier for people to understand and be involved in by using pictures and large print. Although the home has got better at making sure that the information about people’s needs is kept up to date, there is still room for improvement. The managers need to make sure that staff get support to help them because of all of the changes in the service. 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. Wray Court (3) DS0000031155.V361025.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 Wray Court (3) DS0000031155.V361025.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. The service offered supports both the people who use the service and their carers. Planned, admissions are not made to the home until a full needs assessment has been undertaken by Islington Learning Disability Partnership and the assessment is copied to the service. Where emergency admissions are made further information is gathered, as soon as possible following admission. Risk assessments are carried out prior to such admissions. EVIDENCE: This is a respite service and takes people for short breaks that are planned. People also come at short notice if there is an emergency. When someone needs the service members of Islington Learning Disability Partnership carry out the assessment. The eligibility panel then looks at a report. If the panel think the person should have respite in the home a copy of their assessment is then given to the home. Each person is allocated a set number of respite days depending on their individual needs. The inspector saw 1 person’s assessment on their file, and their needs were clearly stated. The inspector saw the file of 1 person who had come into the home in an emergency and as much information as possible was gathered, as soon as possible following their admission and a risk assessment had been done. Wray Court (3) DS0000031155.V361025.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, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff understand the importance of people being supported to make their own decisions and choices. The service knows and records the preferred communication style of each person, and enable the person to lead a full life that promotes independence and choice. Care plans are person centred and are written in plain language, are easy to understand and look at all areas of the individual’s life. They include reference to equality and diversity and address any needs identified in a person centred way. A key worker system allows staff to work on a 1-1 basis and contribute to the care plan for the person. The plan includes a range of information about their goals and aspirations, how they communicate, their skills and abilities and how they make choices in their life. It also includes information about their health. It is kept up to date. Reviews focus on asking what has worked for the individual, where there is progress, achievements, concerns and identifies action points. Each care plan includes a comprehensive risk assessment, which is reviewed regularly. 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 person or their representative and are accurately recorded. Wray Court (3) DS0000031155.V361025.R01.S.doc Version 5.2 Page 10 EVIDENCE: The inspector looked at the files for 2 people who use the service and the care plans for 2 others. At the time of this inspection one person had been placed in the home on an emergency basis for a number of weeks. This person had plan of care on file. This person was in the home during the inspection and spoke to the inspector, they said that they didn’t want to stay for much longer as it was temporary, but that they were comfortable and liked the staff. Due to limitations in some people’s ability to communicate verbally, the home makes sure that staff get to know the ways in which each person communicates their wishes and choices. The ways in which people communicate are described in people’s plans. There was evidence that peoples’ informal carers are consulted to provide the staff team with as much information as possible to help them understand peoples’ needs and preferences and can help them be as independent as possible. The care plans showed that there is a person centred approach. The quality of the care plans is good. They set out people’s needs and preferences very clearly. However, they could be further improved by being presented in a way that is more accessible and meaningful for the residents. This could be done by using pictures and a larger print. A recommendation is made about this. At the previous inspection a requirement was made for the care plans to be regularly reviewed, so that they reflect actual practice, and preferences. The inspector found that there is evidence that work has been done to improve in this area. The key workers write a summary of people’s stays and progress on a 3 monthly basis. This includes changes in their needs. The inspector also saw evidence of where someone’s needs had changed and this had been recorded at the time. However, this is an area where there is still need for improvement as the inspector saw 1 person’s file that didn’t include a recent 3 monthly summary. In acknowledgement of the progress made this requirement is not restated. A recommendation is made for the registered manager to continue to address this issue, and it is intended that progress be monitored at the next inspection. The other care records that the inspector looked showed clear evidence of regular multi-disciplinary reviews of the people using the service. Staff support the people using the service to make decisions. There is a key worker system in place. The inspector spoke to 1 key worker who was able to demonstrate that they knew their key people well, and was familiar with the way in which they make choices and indicate what they like and don’t like. During the inspection the inspector observed staff offering support and guidance to the person who was in the home in a respectful way Wray Court (3) DS0000031155.V361025.R01.S.doc Version 5.2 Page 11 The staff keeps daily records about each person using the service. In these the staff write about how people are and what they have been doing when they stay. The risk management system supports people to be as independent as possible within their capabilities. There were very good risk assessments in people’s files that had been regularly reviewed. The risk assessments give guidance about each of the risks that are relevant to each person. They include information about specific strategies and interventions by staff. As part of the quality audit the registered manager has identified that the manual handling risk assessments for the people who use the service need updating and when talking to the registered manager he explained the action that has been taken to address this. Wray Court (3) DS0000031155.V361025.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, 15, 16 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who use the service are encouraged to continue their day-to-day activities whilst they are receiving respite care. The service respects the human rights of people using the service with fairness, equality, dignity, respect and autonomy underpinning the care and support being provided. EVIDENCE: There was evidence that people are supported by staff to maintain their usual lifestyles whilst staying at King Henry’s Walk. Many of the people who use the service are supported by external agencies and this continues during heir respite stays, attending day centres, collages, and clubs. Both of the care plans that the inspector looked at included details of people’s usual lifestyle. There was lots of evidence in people’s files that the staff work closely with families to make sure that they were up to date with people’s needs and preferences. Wray Court (3) DS0000031155.V361025.R01.S.doc Version 5.2 Page 13 The person who was staying at the home as an emergency placement told the inspector that they liked art and that they had been able to go out since they’d been at King Henry’s Walk. The daily records that the inspector saw showed that people do go out, such as visiting local pubs, shops and out for walks while they were staying in the home. Wray Court (3) DS0000031155.V361025.R01.S.doc Version 5.2 Page 14 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, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive personal and healthcare support using a person centred approach with support provided based upon the rights of dignity, equality, fairness, autonomy and respect. Personal healthcare needs including specialist health, nursing and dietary requirements are clearly recorded in each person’s plan. They give a comprehensive overview of their health needs and act as an indicator of change in health requirements. Personal support is responsive to the varied and individual needs and preferences. The delivery of personal care is individual and is flexible, consistent, reliable, and person centred. Staff respect privacy and dignity and are sensitive to changing needs. People are supported and helped to be independent and take as much responsibility for their personal care as possible. People have access to healthcare services and have the aids and equipment they need to support them and staff in daily living. The home has an efficient medication policy supported by procedures and practice guidance, which staff understand and follow. Regular management checks are recorded to monitor compliance. Where there have been omissions in the administration of medication the registered manager has responded appropriately. Wray Court (3) DS0000031155.V361025.R01.S.doc Version 5.2 Page 15 EVIDENCE: The care plans that the inspector looked at had good information about people’s personal care needs and what people can do for themselves. They included information about what people’s routines are like when they are at home, so that staff can try to help people to keep the same routines where possible. In 1 person’s file there was a very good explanation of the person’s medical condition and the effects this has on their daily life. There were also detailed risk assessments about the person’s medical condition. The inspector looked at the arrangements that are in place to make sure that people have the correct medication when they are staying in the home. There are good facilities to store medication. As part of the monthly quality audit the registered manager had identified 2 recent errors in the administration of medication. Single doses had been missed for 2 people. The inspector also noted that most staff had not had external training in medication. The registered manager provided evidence that action has been taken to address this and the staff team have been referred for training. The registered manager told the inspector that this would be completed by the end of March 2008. At the last inspection the registered person was required to ensure that daily records accurately reflect the service provided, and how this has impacted upon the person. The registered person was also required to review the recording system for changes in personal and healthcare support. This particularly related to medication changes and the requirement stated that there must be a comprehensive daily record of persons’ stay. At this inspection the daily records of the 2 people that the inspector looked at did provide a good record of people’s stays. At the last inspection the registered person was required to ensure that the correct procedure is always followed in relation to MAR charts and the requirement stated that labels must not be stuck over previous prescriptions. At this inspection the inspector was able to confirm that these issues had been addressed. The inspector was shown 1 person’s records, which had been updated when their parents had sent instruction about a new medication that they had been prescribed. The inspector saw the medication records for 2 people and these had been properly completed. They showed the medication that had been brought into the home, staff had signed when medication had been administered and had also indicated when the people who use the service had administered their medication themselves. The staff member who was on duty also gave the inspector a copy of a medication reminder chart, which has been introduced as an extra safeguard to make sure that staff are clear about what time medication should be given when people are staying. Wray Court (3) DS0000031155.V361025.R01.S.doc Version 5.2 Page 16 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, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has a complaints procedure that is clearly written and easy to understand. It is available on request in a number of formats (including other languages, large print) to help anyone living at, or involved with, the service to complain or make suggestions for improvement. The home keeps a full record of complaints and this includes details of the investigation and any actions taken. Staff working at the service know when incidents need external input and who to refer the incident to. There is a clear system for staff to report concerns about colleagues and managers. Staff that ‘blow the whistle’ on bad practice are supported by the service. Training of staff in safeguarding is regularly arranged by the home. People are involved in the decision making process about any limitations to their choice in this area. Individual assessments are completed which involve the individual where possible, their representatives and any other professionals such as the care manager or GP. EVIDENCE: Wray Court (3) DS0000031155.V361025.R01.S.doc Version 5.2 Page 17 At the last inspection the registered person was required to keep a record of all complaints/concerns, including where there is speedy local resolution. The inspector saw the records that the home keeps about concerns or complaints and these indicated that any concerns and complaints are taken seriously, looked into in an open and balanced way and responded to. The registered manager told the inspector that the home has recently started a new complaints tracking system. At the last inspection the registered person was required ensure that all reported marks, such as scratches and bruises, are followed up. Also that reported health problems that could be abuse related are followed up. The requirement stated that the adult protection procedure must be complied with. As part of this inspection the inspector talked to 2 staff members and the assistant manager about the process that the staff go through when they notice such marks. They were all clear about the process and explained what action had been taken regarding incidents since the last inspection. The registered manager also provided the inspector with evidence of a recent example of an incident that led to temporary guidelines being put in place about working with 1 person and changes made in that person’s plan. The inspector saw evidence that all but the newest staff member had received training in safeguarding people and the registered manager gave the inspector evidence that updated training had been arrange for all staff for the week after the inspection. Wray Court (3) DS0000031155.V361025.R01.S.doc Version 5.2 Page 18 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, 27, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. It is acknowledged that there is room for improvement in this area and it is planned for the building to be refurbished to make it more suitable for long-term use. In the short term the home provides a physical environment that adequately meets the specific needs of the people who use the respite service and provides specialist aids and equipment to meet their needs. Bathrooms, showers and toilets are accessible to all people using the service, are appropriately located and are in sufficient numbers. The home is clean and tidy and there is an infection control policy. EVIDENCE: The service moved from Wray Court to 28 King Henry’s Walk, N1 where it has operated since mid October 2006. This was originally a temporary move, whilst the Wray Court building was upgraded. However, a recent decision was made that the service will now remain at King Henry’s Walk, after some modifications to the building. This means that the service will soon move again, to another temporary location, for the time it takes to upgrade King Henry’s Walk to make it more suitable for long term use. The senior managers Wray Court (3) DS0000031155.V361025.R01.S.doc Version 5.2 Page 19 of the service have discussed the details of the planned temporary move and registration requirements with the Commission. The assistant manager showed the inspector around the home. There are single bedrooms and sufficient adapted toilets, showers and bathrooms to meet people’s needs. All areas have been designed with space in mind for people with physical disabilities. All areas were clean, tidy, and hygienic. However, there is a “temporary” feeling in a lot of areas, particularly the bedrooms. These are sparsely furnished and there are areas where the lighting is more suited to an office environment. This gives the home an institutional feel. There are also ongoing issues with the boiler not working properly. This is housed in the day centre that is next door, so there are times when there is no access when problems occur. The inspector was shown the plans for the upgrade of the building. Staff told the inspector that the senior managers of the service have consulted people about the refurbishment. No requirements are made about the building at this inspection, as it is expected that these matters will be addressed as part of the refurbishment. Wray Court (3) DS0000031155.V361025.R01.S.doc Version 5.2 Page 20 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, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Rotas show well thought out and creative ways of making sure that the home is staffed efficiently, with particular attention given to busy times of the day and needs of the people who use the service. There are consistently enough staff available to meet the needs of the people using the service, with more staff being available at peak times of activity. All staff receive relevant training that is focussed on delivering improved outcomes for residents. The service puts a high level of importance on training and staff report that they are supported through training to meet the individual needs of people in a person centred way. EVIDENCE: On the day of the inspection there were enough staff on duty in relation to the numbers of people using the service. The assistant manager gave the inspector a copy of the training plan. This shows the training that members of the staff team have had and the training that is planned. The plan prioritises the core training necessary to safeguard the safety and wellbeing of people using the service such as health and safety, manual handling, first aid, fire prevention, medication and adult protection. It included details of the other training that individual staff had attended recently and this included Wray Court (3) DS0000031155.V361025.R01.S.doc Version 5.2 Page 21 understanding and supporting people with mental health issues and learning disabilities, hearing and eyesight, autistic spectrum disorder and deaf awareness training. The plan indicates that staff have had good access to training. Additionally, as part of the quality audit the registered manager has identified particular training needs, and the manager was clear about the action that has been taken to address them. It is evident that the staff team have completed or are completing NVQ training at level 2 and above. 1 of the staff members who spoke to the inspector was proud to have recently completed their NVQ training and an NVQ assessor was visiting another staff member at the time of the inspection. Wray Court (3) DS0000031155.V361025.R01.S.doc Version 5.2 Page 22 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, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service focuses on the individual, takes account of equality and diversity issues, and generally works well in partnership with families and professionals. The management team is improving and developing systems that monitor practice and compliance with the plans, policies and procedures of the home. The management team is aware of the need to promote safeguarding and has developed a health and safety policy that meets health and safety requirements and legislation. The registered manager has highlighted areas where they need to make improvements and has an action plan for undertaking the work. The service has been through a period of uncertainty and change but despite this continue to work together to provide a good service. EVIDENCE: The day-to-day management of the service is responsive and person centred. The members of the management team that the inspector had contact with as Wray Court (3) DS0000031155.V361025.R01.S.doc Version 5.2 Page 23 part of the inspection were helpful, open, knowledgeable and professional in their approach. The short break service in Islington is being reorganised overall, and this includes services moving, new staffing structures and management arrangements. This has had an impact on the staff team at King Henry’s Walk. Although staff are continuing to provide a good service, morale seems low and when talking to staff it was apparent that they have been through a lot of changes and uncertainty over the past 2 years, and there are further changes to come, with another temporary move imminent. This uncertainty seems to have weighed heavily on the team. However, there is now more clarity about where the service will be located, there was evidence that proper consultation is being undertaken about the staffing strategy and there are no planned job losses. It is recommended that the managers of the service seek ways in which staff moral might be further supported and improved throughout this period of disruption and change. At the last inspection the registered person was required to ensure that there is an effective quality assurance system in place and that this includes seeking the views of the people who use the service, their families, and other stakeholders. The registered manager provided the inspector with evidence that people’s views had been sought about the service and about it’s future a number of times in the past year. The registered manager gave the inspector a copy of the questionnaire that people had been asked to fill in last January. The questionnaire was in an easy read format and had pictures to help people with learning disabilities to understand it, and be involved in filling it in. It asked people questions about what they liked and didn’t like about the service. In October 2007 as part of the respite review, the home asked the people who used the service which building they prefer for respite. They used a questionnaire with photographs and large poster in the corridor. The quality assurance system also includes an audit that the registered manager does monthly. The registered manager gave the inspector a copy of the most recent audit that had been done. The things that the management team looked at for the audit included making sure that health and safety and equipment checks have been done, that the fire safety arrangements are sound, and risk assessments are up to date, that medication records are up to date and completed properly. The audit also includes monitoring the records of any incidents that have happened and complaints that have been made, along with staff training and supervision. It showed areas that needed improvement the action that was being taken to address them. As there is an active quality assurance process this helps to identify areas for improvement and actively addresses them. The registered manager provided evidence that a number of policies had recently been updated. These included guidelines about PCP (person centred planning) medication, cash handling, people’s money and valuables, and holidays. The service has also produced it Wray Court (3) DS0000031155.V361025.R01.S.doc Version 5.2 Page 24 own internal guidelines on infection control, although the inspector did not review these at the time of the inspection. Wray Court (3) DS0000031155.V361025.R01.S.doc Version 5.2 Page 25 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 2 25 X 26 X 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 3 X Wray Court (3) DS0000031155.V361025.R01.S.doc Version 5.2 Page 26 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations It is recommended that the format that the care plans are presented in be reviewed to make them more accessible for the people who use the service. It is recommended that the progress made by the registered manager in addressing the issue of the regular review of care plans so that they reflect actual practice, and preferences. It is recommended that the managers of the service seek ways in which staff moral might be further supported and improved throughout this period of disruption and change. 2. YA6 3. YA37 Wray Court (3) DS0000031155.V361025.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU 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 Wray Court (3) DS0000031155.V361025.R01.S.doc Version 5.2 Page 28 - 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!