Inspection on 15/11/05 for 1 Wharf Close

This inspection was carried out on 15th November 2005.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

1 Wharf Close 23/09/08

1 Wharf Close 04/10/07

1 Wharf Close 24/11/06

1 Wharf Close 02/03/06

1 Wharf Close 16/02/05

1 Wharf Close 25/10/04

1 Wharf Close 26/02/04

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 08/07/2008.

CARE HOME ADULTS 18-65 Wharf Close (1) 1 Wharf Close Goldingham Farm Estate Stanford Le Hope Essex SS17 0EJ Lead Inspector Sarah Buckle Unannounced Inspection 15th November 2005 15.20 Wharf Close (1) DS0000018081.V261769.R01.S.doc Version 5.0 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 Wharf Close (1) DS0000018081.V261769.R01.S.doc Version 5.0 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. Wharf Close (1) DS0000018081.V261769.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Wharf Close (1) Address 1 Wharf Close Goldingham Farm Estate Stanford Le Hope Essex SS17 0EJ 01375 360789 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) Mosaic Essex Manager post vacant Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Wharf Close (1) DS0000018081.V261769.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th February 2005 Brief Description of the Service: Wharf Close provides personal care and accommodation for four adults with a learning disability. The homes’ facilities include one large living/dining area, four single bedrooms and one bathroom. The home is situated in a quiet cul-de-sac in a residential area close to the town centre of Stanford le Hope. There is a pleasant garden to the rear of the property and adequate car parking facilities. Public transport runs close by the home and all amenities are in close proximity. Service users within the home are encouraged to access leisure pursuits and community facilities. The home has its own vehicle available in order to facilitate this. Mosaic (formerly New Essex Housing Association) manages the home. Wharf Close (1) DS0000018081.V261769.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over three and a half hours. Opportunity was taken to examine records, policies and a sample of care plans. During the course of the inspection all of the four service users were observed within the home and spoken with. One staff member was spoken with in depth and another was spoken with briefly. The lounge, kitchen and one service users’ bedroom were also inspected. What the service does well: What has improved since the last inspection? What they could do better: The home does not have clear or comprehensive records regarding staff training. The level of mandatory training completed by the staff group since the last inspection is not adequate. Mandatory training and service user specific training is important to ensure their changing needs are met. Risk assessments and care support plans are not reviewed regularly. Regular reviews are important to ensure that any change of situation or need is Wharf Close (1) DS0000018081.V261769.R01.S.doc Version 5.0 Page 6 recorded and the appropriate support required by the service user is identified and put in place. The premises at Wharf Close should be regularly maintained to ensure they are comfortable, homely and safe for the service users. The acting manager must ensure that all staff members sign medication records to demonstrate that medication has been given to a service user. The acting manager should apply to the Commission for Social Care Inspection for registration. 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. Wharf Close (1) DS0000018081.V261769.R01.S.doc Version 5.0 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 Wharf Close (1) DS0000018081.V261769.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 4 and 5 Wharf Close has a thorough pre-admission assessment procedure. There is a planned transition process for service users prior to their admittance to the home. Written contracts are of a good standard. EVIDENCE: One care plan was looked at in detail and it contained comprehensive preadmission assessment material, which included an ‘Assessment of Needs and Suitability for Residency in Wharf Close’; placing authority letters and ‘Assessment and Review of Needs’ and an ‘Individual Plan of Needs’ for the service user, which was forwarded from their previous home. All of the information recorded was detailed and specific to the individual service user. The home’s pre-admission assessment entitled ‘Assessment of Abilities’ was completed with the inclusion of the service user and written in the first person i.e. “The staff included me and watched me day by day”. Prospective service users have the opportunity to visit the home prior to admittance and there is a three-month trial period in place. One support worker spoken with explained that the newest service user to the home was admitted in 2004 and that the service user had had introductory visits to the home, including visiting for Sunday lunch and staying for a weekend before moving in. She also explained that there is a three-month trial period, which is reviewed before the service user becomes a permanent resident in the home. Wharf Close (1) DS0000018081.V261769.R01.S.doc Version 5.0 Page 9 The service user contract was contained within the care plan. It was positive to note that a Licence Agreement Assessment was also contained alongside the contract stating that the service user was unable to sign or understand the terms of the agreement. Wharf Close (1) DS0000018081.V261769.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Individual care plans were comprehensive and personal to the individual service user, however reviews were not regular. Service users were positively encouraged to make decisions about their lives. Risk assessments were thorough but not reviewed regularly. EVIDENCE: Two care plans were sampled and both of these were thorough and personal to the service user. Both care plans had instructive and detailed support plans, which were written in the first person with service user inclusion i.e. one care plan stated, “I’m currently unable to give an informed consent to support plans, but I am included in writing them as much as possible”. Thorough details of the support needed for each service user were included in a step-bystep fashion. In one care plan, the service users’ key worker reviewed support plans on a monthly basis, whereas in the other, some reviews were outstanding, with the last recorded review date being 03/04/05. Service users are encouraged and supported to make decisions about their lives. It was positive to note a comprehensive list of individual service users Wharf Close (1) DS0000018081.V261769.R01.S.doc Version 5.0 Page 11 likes and dislikes included within each care plan sampled and an assessment of service users abilities regarding choice. In relation to this, one care plan stated, “I like to choose what I do and where I go. I am happy to choose about everything”. In another, where a service user liked to choose but tended to wait to be told what to do, support was identified, as “I need staff to understand that I will let them know what I want by doing things as much as I will let them know what I want by words”. Risk assessments were held separately to care plans. They were informative, stating the potential hazard, control measures needed, risk evaluations and a space for other recommendations or comments. It was positive to note that a sheet was attached to each risk assessment for staff to sign on reading it. The risk assessments were specific to individual service users and covered such aspects as being escorted into the local community, normal daily risks and absconding. All the risk assessments seen were completed on 27/10/03 with a review due date stated as 09/04/04. There were no reviews contained within the risk assessment file since 27/10/03. Wharf Close (1) DS0000018081.V261769.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 and 16 The home supports service users to participate in appropriate activities and to access the local community. Family links are encouraged and service users take some responsibilities in relation to their daily lives. EVIDENCE: The home strives to identify the activities appropriate to each service user and these are recorded within the individual care plans. One service users activities were listed as household tasks, watching TV in her room and trips to the cinema, pub and restaurants. The care plan stated that on average the service user attended approximately six outings each week, both social such as to a restaurant and necessary, such as house shopping. During the week of the inspection, the service user had been shopping and out for lunch, to Southend on the train, had paid her rent, had a hair cut, been to an IPP review and gone home to her parents house. A staff member explained that another service user enjoyed cooking and was encouraged to do this. It was positive to note that in one care plan, the parents of the service user completed a short report regarding how the service user had been while at home and what they had done. Wharf Close (1) DS0000018081.V261769.R01.S.doc Version 5.0 Page 13 One member of staff spoken with explained that the recent closure of formal day centres had had an impact on the service users, and that the staff team were taking service users out themselves to compensate for this i.e. shopping to Lakeside, to Southend for the day and to the cinema. The staff member also explained that all the service users attend a Monday club and on a Tuesday they go to a club where all the local Mosaic homes meet up and go out together. She stated that the home were adjusting to the loss of day services and actively seeking alternatives. It was positive to note that each care plan seen had a specific section in relation to sexual awareness/orientation. In one care plan it stated, “I haven’t shown whether I’d like a boyfriend or a girlfriend. I like talking to men and women the same”. Wharf Close (1) DS0000018081.V261769.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20 and 21 The home is good at identifying the physical and emotional needs of service users. Medication is, in the main part well managed. Last wishes are handled respectfully. EVIDENCE: During the inspection, the service users were observed within the home environment. All service users appeared comfortable and content. Staff were observed to interact with the service users in a respectful and friendly manner. The emotional needs of service users were identified and recorded within their care plans, along with support required i.e. one care plan stated “I like to be spoken to. I often laugh long and loud, particularly at mealtimes. I sometimes become annoyed at other people living in the home and shout at them” and the required support was stated as “I need people to understand why I do things”, and “I need staff to remind me that we are all living in the house together as equals”. One service user with epilepsy has yearly monitoring and any seizures are recorded. The PRN protocol regarding rectal Diazepam was clear and instructive. Evidence was seen of dental check ups for service users, with any required action recorded. Wharf Close (1) DS0000018081.V261769.R01.S.doc Version 5.0 Page 15 The home uses the Boots pharmacy monitored dosage system for administering medication. The medication file contained service user MAR sheets along with the homes’ protocol for changes to repeat prescriptions, protocol for PRN medication and their policy regarding homely remedies. A series of omissions were noted on one service users MAR sheet. Over a period of four days no signature was in place to say that medication had been given. One service users’ last wishes were seen recorded by their mother and contained within their care plan. Wharf Close (1) DS0000018081.V261769.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Service users are in the main part protected within the home, however, both adult protection training and other mandatory training continues to be inadequate. EVIDENCE: The home has clear and detailed policies relating to adult protection. These were viewed in detail during the inspection and were seen to be satisfactory. Guidance was available to staff advising them to report any suspicious observations to the acting manager. There was also a copy of an adult protection referral form within the file. Three members of the staff team were seen to have completed adult protection training during 2005. The last adult protection training recorded was in 2003. It is important for all staff to attend this mandatory training and to update their training on a yearly basis, in order to ensure that the service users are suitably protected from potential harm. One member was spoken with in relation to adult protection issues and she was clearly able to demonstrate that she had the appropriate knowledge i.e. that she would inform her line manager and telephone the homes ‘on-call’ system. Wharf Close (1) DS0000018081.V261769.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 The living room and kitchen within the home were not homely and there were safety issues of concern. EVIDENCE: It was noted that the home is in need of substantial maintenance work. Issues arising at the last inspection were still not attended to. The living room is in need of re-decoration as there are areas where the wallpaper is damaged. The flooring in the living room needs replacing, as it is stained and threadbare in places. There are gaps in its layout, which could cause a trip hazard. The kitchen area is generally outdated and in need of redecoration. The radiators within the home are not covered, and could therefore become hot. They also have sharp corners, which could be dangerous if a service user were to fall. A number of radiators were also noted to be rusting. Wharf Close (1) DS0000018081.V261769.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Mandatory and service user specific training within the home is not adequate. Staff recruitment records were not made available during the inspection. EVIDENCE: Although it was positive to note that some mandatory training had been arranged within the home since the last inspection, this was not sufficient. The acting manager has compiled a training matrix to demonstrate which staff have completed training, however this information was not clearly recorded. It was noted that a number of the staff team had not received mandatory training planned for them owing to sickness. Since the last inspection, three members of the staff team have completed POVA training, one member of staff has completed Manual Handling and one member of staff has completed Basic Food Hygiene. There was no evidence of recent service user specific training, and no evidence of epilepsy training. One support worker spoken with stated that one member of staff has completed NVQ3, another has just started the course and the acting manager has begun the NVQ4. Staff files were not made available during the inspection, as the acting manager who holds the key was not present. Wharf Close (1) DS0000018081.V261769.R01.S.doc Version 5.0 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 The home is run in a safe and effective manner; however mandatory staff training is inadequate. EVIDENCE: Various records were checked and all were seen to be satisfactory. The last recorded incident was on 08/10/05 and this was also recorded in the homes’ accident book. Regular fire drills are held and the name of all staff and service users involved is recorded. All aspects of fire protection is regularly monitored and tested. The temperature of the medication cupboard is monitored and recorded. Generic risk assessments for safe working practices were in place, however these were overdue for the recorded date of their review, which was 14/04/04. Staff training records seen indicated that core training in areas such as moving and handling and first aid is not adequate. Wharf Close (1) DS0000018081.V261769.R01.S.doc Version 5.0 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X 3 3 Standard No 22 23 Score X 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 2 X 1 2 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Wharf Close (1) Score X 3 2 3 Standard No 37 38 39 40 41 42 43 Score X X X X X 2 X DS0000018081.V261769.R01.S.doc Version 5.0 Page 21 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA9 Regulation 2(a)(b) Requirement The acting manager must ensure that staff enable service users to take responsible risks, ensuring they have good information on which to base decisions and risk management strategies are kept under review. This is in relation to risk assessments completed in October 2003 which have not yet been reviewed. The acting manager must ensure that arrangements are made for the safe recording, handling, administration and disposal of medication within the home. This is in relation to a series of four omissions in the recording of medication on one MAR sheet. The acting manager must ensure that arrangements are made for training staff to prevent service users being placed at risk of harm or abuse. Timescale for action 01/02/06 2. YA20 13(2) 01/02/06 3. YA23 13(6) 01/02/06 Wharf Close (1) DS0000018081.V261769.R01.S.doc Version 5.0 Page 22 4. YA24 This is in relation to inadequate levels of mandatory staff training. 23(2)(b)(d) The acting manager must ensure that the premises are kept in good repair internally and externally and that all parts of the home are reasonably decorated. This is in relation to the damage to wallpaper in the lounge, to the soiled threadbare flooring in the lounge, to the kitchen needing modernisation and decoration and to radiators that are rusting and uncovered. The acting manager must ensure that all staff within the home are suitably qualified. This is in relation to inadequate mandatory training. 01/02/06 5. YA32 18(1)(a) 01/02/06 6. YA34 17(3)(b) 31 (3)(b) This is a repeat requirement. The acting manager must 01/02/06 ensure that all records referred to in Sch3 and Sch4 are available for inspection at all times by any person authorised by the Commission. A person authorised by the Commission may inspect and take copies of any documents or records (except medical). This is in relation to the staff files’ being inaccessible during the inspection. The acting manager must 01/02/06 ensure that all staff receive training appropriate to the work they are to perform and suitable assistance to obtain further qualifications. This is in relation to inadequate mandatory training and service 7. YA35 18(1) (c ) (i)(ii) Wharf Close (1) DS0000018081.V261769.R01.S.doc Version 5.0 Page 23 user specific training. 8. YA42 13(6) The acting manager must ensure that arrangements are made for staff training to prevent service users being placed at risk of harm or abuse. This is in relation to inadequate staff training in core areas such as POVA, first aid, manual handling, challenging behaviour, basic food hygiene etc. 01/02/06 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. 2. 3. Refer to Standard YA6 YA34 YA37 Good Practice Recommendations The acting manager must ensure that all service users’ care plans are reviewed on a regular basis to reflect and record their changing needs. The acting manager must ensure that a system is in place for all records to be accessed during an inspection. The acting manager must ensure that an application is made to the Commission for registration as manager. Wharf Close (1) DS0000018081.V261769.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: 0845 015 0120 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 Wharf Close (1) DS0000018081.V261769.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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