Inspection on 02/03/06 for 1 Wharf Close

This inspection was carried out on 2nd March 2006.

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 7 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 15/11/05

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 2nd March 2006 11.50 Wharf Close (1) DS0000018081.V266278.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.V266278.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.V266278.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.V266278.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th November 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 for use by the residents. Mosaic Homes (formerly New Essex Housing Association) manages the home. Wharf Close (1) DS0000018081.V266278.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 care plan. During the course of the inspection all of the four residents were observed within the home and spoken with. Two staff members and the responsible person were spoken with. A tour of the building was undertaken. What the service does well: What has improved since the last inspection? What they could do better: Staff files were unavailable for inspection even though this was stated as a requirement at the last inspection. The carpet within the lounge, which is threadbare and stained, has not been replaced, even though this was stated as a requirement at the last inspection, and neither have radiator covers been put in place. Wharf Close (1) DS0000018081.V266278.R01.S.doc Version 5.0 Page 6 The kitchen is in need of modernisation and redecoration, as is the upstairs bathroom. The Medication file is not well organised and has instances of handwritten medication profiles. PRN protocols are not available for all PRN medication. Specialist training in the administration of rectal stestolids has not been undertaken by many of the staff group. Staff training has improved but not all staff members have received sufficient core training. The acting manager has not yet completed all the appropriate actions in relation to being registered by the Commission. 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.V266278.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.V266278.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): Not inspected. EVIDENCE: Not inspected. Wharf Close (1) DS0000018081.V266278.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 Care and support plans were satisfactory. Residents are supported to make decisions and to take part in all aspects of life within the home. Risk assessments were comprehensive. EVIDENCE: One care plan was sampled. This was completed in a clear and informative manner. The needs of the individual were identified and thorough support plans in place, which focussed on maintaining independence i.e. one area of support relating to personal hygiene stated it’s aim as being “To support (the resident) in all daily hygiene needs and to maintain his independence and the skills he has learnt in this area”. One support plan stated “I like to make choices about what I do” and another stated “(The resident) will bring his dirty laundry down and put it in the washing machine.” The support plans were reviewed regularly. It was positive to note that risk assessments had been devised for individual residents and that these were comprehensive and reviewed regularly. Wharf Close (1) DS0000018081.V266278.R01.S.doc Version 5.0 Page 10 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 and 17 Residents’ within the home are encouraged to partake in appropriate activities and to access the community. The menu was balanced and healthy. EVIDENCE: One care plan sampled demonstrated that the resident undertook daily tasks in order to maintain the skills and independence he had learned in these areas. He also had access to an art day, visited the Tate Modern and had been to Watt Tyler Park during the week. The menus within the home were examined. The residents have a varied and balanced diet i.e. each resident had a choice of cereal for breakfast and a cooked breakfast on Saturday and Sunday and a choice of lunch and dinner, including fish and chips and peas; spaghetti Bolognese and pasta; sausage, mash, onions, peas and gravy and roast lamb with all the trimmings. Fresh fruit was available in a bowl in the living room. Wharf Close (1) DS0000018081.V266278.R01.S.doc Version 5.0 Page 11 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): 18 and 20. Residents at Wharf Close adequately receive personal care in the way they prefer. Medication is not well managed. EVIDENCE: The support plans inspected demonstrated that guidance and support are provided where needed regarding personal care and that this is offered in a way that considers the dignity and independence of the resident i.e. one residents’ plan stated that staff were required to wet his hair and to apply shampoo, but that he would rub the shampoo into his hair. The staff members on duty during the inspection were observed interacting with the residents in a familiar and respectful manner. There was a comfortable atmosphere within the home, and the staff enjoyed a good rapport with the residents. The medication file was inspected and it was positive to note that all residents had ‘consent to medication exemplar’, stating that the residents were unable to offer consent or not in relation to administering medication. However, within the file, there were a number of handwritten medication profiles which had no signature or counter signature, no recorded quantity of the drug received or further instruction in relation to this i.e. “3 Diazepam 2 mg tablets P.R.N.”. Wharf Close (1) DS0000018081.V266278.R01.S.doc Version 5.0 Page 12 It was positive to note that five of the six staff training files seen had evidence of Boots MDS medication training, completed in 2004 or 2005. There were some PRN protocols in place. One PRN protocol for Diazepam Stesolid stated that only staff members trained in the administration of stesolids were to administer these. Of the six staff training files seen, only one staff member had evidence of epilepsy and stesolid training, and this was completed on 24/01/03. Wharf Close (1) DS0000018081.V266278.R01.S.doc Version 5.0 Page 13 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): 22 and 23 Resident’s views are listened to. Residents are not adequately protected from the possibility of abuse or harm. EVIDENCE: The complaints procedure was displayed in pictorial form on the wall within the home. Resident’s meetings were held approximately every three months, and there were minutes of weekly meetings to choose the menu, however, these were less regular towards the end of 2005. There had been no complaints made since the last inspection. Six staff training files were examined, and four of these had evidence of POVA training in either 2004 or 2005. Three staff had completed manual handling training in 2004 or 2005 and the other staff members had no evidence of this training. One staff member had completed epilepsy and rectal stesolid training. Wharf Close (1) DS0000018081.V266278.R01.S.doc Version 5.0 Page 14 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 and 30 Wharf Close is, in the main part, a homely environment, however there are outstanding maintenance issues. The home is adequately clean and hygienic. EVIDENCE: It was positive to note that the living room had been redecorated since the last inspection. However, the carpet had not been replaced and was still threadbare and stained. The radiators within the home do not have covers and one staff member spoken with stated that this was an area of concern, as one resident within the home has epilepsy and could fall onto the sharp corners and get hurt. The radiator in the kitchen is rusting in places. The kitchen is worn and outdated. One member of staff stated that a quote has been completed to replace the cupboards and the flooring, however, it was also noted that the cooker has a part missing, and that the wooden windows within the room were rotting. The bathroom was also in need of refurbishment. The floor is worn and the bath panel is broken and loose. The home was clean and well organised. There were no unpleasant odours within the home. Wharf Close (1) DS0000018081.V266278.R01.S.doc Version 5.0 Page 15 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): 31, 34, 35 and 36 The staff files were not available for inspection. This is the second occasion on which they have not been available. Staff training has improved but is not yet satisfactory. EVIDENCE: Staff files were not available for examination on the previous inspection; however, the action plan relating to the requirements of the last inspection did state that a key was available and that the files could be inspected in the acting managers absence. However, this was not the case. A key was brought to the home from head office but proved not to be a key that provided access to the filing cabinet. Six staff members training files were examined and some up to date mandatory training was seen to be in place. One staff member had completed Breakaway training, health and safety awareness, person-centred planning, Boots MDS, POVA and completed NVQ3 all during 2005, whereas another staff member had completed only Boots MDS during 2005 and another had completed POVA, Boots MDS and Breakaway. Only one staff member was seen to have completed epilepsy and stesolid training. Wharf Close (1) DS0000018081.V266278.R01.S.doc Version 5.0 Page 16 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 health and safety of residents is partially protected. EVIDENCE: The manager within the home has held the position of acting manager for a number of years. His application for registration is in the process of being completed at the Commission; however, a reference and a CRB check are still outstanding. Health and safety checks at Wharf Close are undertaken regularly and recorded appropriately. Appropriate mandatory training, is not completed by every member of staff within the home, and this could have an impact on the health and safety of both residents and staff. Wharf Close (1) DS0000018081.V266278.R01.S.doc Version 5.0 Page 17 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 X X X X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 1 1 1 2 1 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Wharf Close (1) Score 3 X 2 X Standard No 37 38 39 40 41 42 43 Score X X X X X 2 X DS0000018081.V266278.R01.S.doc Version 5.0 Page 18 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 YA20 Regulation 13(2) Requirement The registered person must ensure that arrangements are made for the safe recording, handling, administration and disposal of medication within the home. This is in relation to handwritten medication profiles, which are unclear, and PRN protocols not being completed for all medications. The safety of medication practice was a requirement on the last inspection report. The registered person must ensure that arrangements are made for training staff to prevent residents being placed at risk of harm or abuse. This is in relation to inadequate levels of mandatory staff training. This is a repeat requirement with the previous timescale 01/02/06 not met. 23(2)(b)(d) The registered person must DS0000018081.V266278.R01.S.doc Timescale for action 01/05/06 2. YA23 13(6) 01/06/06 3. YA24 01/06/06 Page 19 Wharf Close (1) Version 5.0 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 lounge floor covering being soiled and threadbare, to the kitchen needing modernisation and a new cooker, to radiators that are rusting and uncovered, and to the upstairs bathroom, which has stained and worn flooring and a broken bath panel. This is a repeat requirement. The action plan from the last inspection stated that the new floor would be fitted in the living room by 01/04/06. The registered person must ensure that all staff within the home are suitably qualified. This is in relation to inadequate mandatory training. This is a twice-repeated requirement with the last timescale of 01/02/06 not met. The registered person must ensure that all records referred to in Sch. 3 and Sch. 4 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. 4. YA32 18(1)(a) 01/06/06 5. YA34 17(3)(b) 31(3) (b) 01/02/06 Wharf Close (1) DS0000018081.V266278.R01.S.doc Version 5.0 Page 20 6. YA35 18(1)(c) (i)(ii) This is a repeat requirement with the previous timescale not met. The registered person must 01/06/06 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 specialist training. This is a repeat requirement with the previous timescale of 01/02/06 not met. The registered person 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. This is a repeat requirement with the previous timescale of 01/02/06 not met. 7. YA42 13(6) 01/06/06 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. Refer to Standard YA37 Good Practice Recommendations The registered person should ensure that he orders his CRB check and chases his GP reference in order to progress his application for registration at the Commission. 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