Inspection on 04/10/07 for 1 Wharf Close

This inspection was carried out on 4th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 4 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 24/11/06

1 Wharf Close 02/03/06

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 1 Wharf Close 1 Wharf Close Goldingham Farm Estate Stanford Le Hope Essex SS17 0EJ Lead Inspector Helen Laker Unannounced Inspection 4th October 2007 10:00 1 Wharf Close DS0000018081.V349848.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 1 Wharf Close DS0000018081.V349848.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. 1 Wharf Close DS0000018081.V349848.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 1 Wharf Close 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) www.familymosaic.co.uk Family Mosaic Mrs Diane Hull Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 1 Wharf Close DS0000018081.V349848.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th November 2006 Brief Description of the Service: Wharf Close provides personal care and accommodation for four adults with a learning disability. The home’s 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. Family Mosaic (formerly New Essex Housing Association and Mosaic Homes) manages the home. The Service User Guide and Statement of Purpose are available and are updated as required. The residents and their representatives are provided with this information and it is displayed for reference along with current Commission for Social Care Inspection reports. At the time of this report the homes fees for current service users were not ascertained. The current scale of weekly charges at the home’s last inspection for residents is between £1050.00 and £1116.10. Additional charges are made for aromatherapy, chiropody, hairdressing, toiletries, personal clothing, activities and for the lease vehicle. 1 Wharf Close DS0000018081.V349848.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine key unannounced key inspection. Information was provided by the home in the form of an AQAA pre-inspection questionnaire. Surveys were sent to the residents and relatives and one of these was completed and returned. A tour of the premises was carried out; two staff members were spoken with and the manager, on this occasion, was not on duty. Residents were observed within the home, a mealtime was also observed and relevant records and certificates were examined. What the service does well: What has improved since the last inspection? What they could do better: Medication has improved but there are still some minor omissions and anomalies. Staff members would benefit from foundation and advanced level training. Window restrictors require fixation to all of the upstairs windows for health and safety reasons. 1 Wharf Close DS0000018081.V349848.R01.S.doc Version 5.2 Page 6 The recruitment process within the home is not clear or robust and records should be accessible at all times for inspection purposes. Mandatory training has been undertaken, but updated training in moving and handling, fire and POVA needs to be completed. 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. 1 Wharf Close DS0000018081.V349848.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 1 Wharf Close DS0000018081.V349848.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. Prospective residents have the information they need to make an informed choice about where to live. Service users have contracts directly with the home if privately placed EVIDENCE: No residents have been admitted to the home since the last inspection. Documentation reviewed for the last admission was seen to be appropriate. Transition plans were seen Service users are offered the choice of home after a full needs assessment has been undertaken by the home’s referral and admission process and through partnership working with service user, family, care manager/social worker and or advocate where appropriate. This is characterised by visits to the home and agreement by all concerned, then followed by a transition plan/ trial plan. 1 Wharf Close DS0000018081.V349848.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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each service user has an individual plan and service users are supported to take risks as part of an independent lifestyle via a process of assessment. The health needs of service users are well met and due to service users learning disabilities they are only able to make limited decisions but staff facilitate this as much as possible. EVIDENCE: Care plans were seen to be generally comprehensive and person centred. Reviews on a regular basis were not all evident and attention is required to ensuring signatures and dates are fully documented. Care plans included detailed assessments but evidence of involvement of service users and their families/representatives needs more prominence. A support plan in relation to challenging behaviour demonstrated clear awareness of triggers and interventions to be used. 1 Wharf Close DS0000018081.V349848.R01.S.doc Version 5.2 Page 10 Within the occupations and leisure section of the plan there were areas that needed to be expanded. However, it was positive to note that health care needs were clearly documented and there was evidence of the resident’s involvement in tasks around the home. Residents within Wharf Close are encouraged to make decisions about their lives. Resident’s meetings are held on a regular basis and record decisions about choice of menus. One resident has images and makaton symbols on a board in his bedroom to facilitate communication. These included images of place they liked to visit and encouraged choices. Risk assessments were contained within the care plan sampled and in the main part these were thorough and detailed. However, one resident at the last inspection did not have window restrictors on an upstairs window. A staff member spoken with stated that this was because they like to have the window open wide and look out of it. There was no risk assessment in place in relation to the risk impact on the other residents within the home. At this inspection it was noted that all the upstairs windows apart from one, were like this and this must be addressed for the same reasons and risk assessed accordingly. 1 Wharf Close DS0000018081.V349848.R01.S.doc Version 5.2 Page 11 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 and 17 Quality in this outcome area was good. This judgement has been made using available evidence including a visit to this service. Residents within Wharf Close are able to take part in appropriate activities. Residents are able to access the local community, however, this is somewhat reliant on there being enough staff on duty to enable this. Family links are encouraged at Wharf Close. The rights and responsibilities of residents are adequately recognised and the menu offers a balanced diet. EVIDENCE: At the last inspection it was noted that residents at Wharf Close are no longer able to access day care facilities as they had all recently been closed. The manager within the home stated previously that all of the college courses that she looked at for the residents were full up, however, she did state that she would be trying to find people places on appropriate courses in the future. 1 Wharf Close DS0000018081.V349848.R01.S.doc Version 5.2 Page 12 Although residents do not undertake courses they do attend the Eversley activity centre. The residents within the home do have the opportunity to take part in activities within the home, these include house keeping tasks, weekly food shopping, putting away their laundry etc. Staff within the home do undertake activities with the residents such as painting, drawing and keep fit. The residents are able to access the local community. On the day of inspection one service user was out with a member of staff shopping to buy shoes in Lakeside. Residents visit the cinema, go to Southend by train, visit the library and go shopping for clothes. Community access was documented within the care plans examined during the inspection. Residents at Wharf Close are encouraged to have close family links and friendships. One resident was goes to her family home regularly for weekends. All of the residents go to a Monday Club each week where they meet up with residents from other homes. Menus were examined during the inspection and one meal was observed. The residents were able to make choices about what to have for their lunch. The menus demonstrated that the diet was both balanced and varied. 1 Wharf Close DS0000018081.V349848.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents receive personal care in the way they prefer. The physical and emotional health care needs of residents are adequately met. Medication is in the main part well managed, however some areas require improvement. EVIDENCE: The care plans sampled demonstrated that residents received support in their preferred manner. There was evidence of comprehensive procedures in place to assess and address the physical and emotional healthcare needs of residents. A GP monitoring form was examined for one resident and this documented all GP visits and the reasons for the visits. There were monthly weight checks in place and records of other professional input, such as opticians and continence advisors. These had outcomes recorded. An antecedent behaviour chart is also contained within the care plan, which detailed incidents of challenging behaviour, including what happened directly 1 Wharf Close DS0000018081.V349848.R01.S.doc Version 5.2 Page 14 before the incident, what the behaviours were and what the consequence of this was. Medication was examined as part of the inspection. Handwritten medication profiles were not countersigned and the information provided on them was not always clear i.e. a homely remedy of evening primrose oil was duplicated three times on the same sheet. 1 Wharf Close DS0000018081.V349848.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s views are adequately listened to and acted upon. protected from potential harm and abuse. EVIDENCE: There have been no major complaints since the last inspection. One minor complaint was noted to have been dealt with appropriately. There were minutes available of regular resident’s meetings. Two staff members spoken with had good understanding of the procedure to be implemented if they suspected an incident of adult abuse. The accident and incident book was recorded appropriately and these were cross-referenced to the care plan for further information. The training file was examined and updated training in POVA was noted to be required for some staff, the last course was noted to have been held on 19th March 2007. Residents are 1 Wharf Close DS0000018081.V349848.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The environment is in the main, safe and comfortable for the residents, however, there are some maintenance issues. The home is, in the main, clean and hygienic. EVIDENCE: A tour of the premises was undertaken and it was again positive to note that there had been improvements within the home. Two new sofas, a coffee table, a glass fronted cabinet and a nest of tables have been purchased. A new carpet had been laid in the living room previously. All of the resident’s bedrooms were observed and these were personalised, with residents choosing their colour scheme and bedding. All of the rooms had previously been redecorated and had new carpets. 1 Wharf Close DS0000018081.V349848.R01.S.doc Version 5.2 Page 17 However, there were still some outstanding maintenance issues within the home. The kitchen although new and modernised had no room for the dishwasher, which the inspector was told was to be located in the laundry room. This is not seen as an adequate placement of the same and some reconsideration should be given to this. The boiler has also been identified as useable but for replacement but this has not yet happened. The bathroom was which was previously identified as uninviting had a new floor in place but this was inadequately fitted in areas creating trip hazards and odours were present. A new blind had also been purchased. The staff sleep-in room does not have adequate facilities for washing. There is a sink basin within the room; however, there is nowhere for the staff on duty to shower. There is no lock on the resident’s bathroom door also. Double glazed windows with sliding perspex inner walls were noted to have panes missing so only half the window had the effect of being double glazed. In addition to this adequate window restrictors should be fitted to all the upstairs windows for health and safety reasons as all windows apart from one were noted to open up widely. The inspector was informed that one service user’s sink was not useable due to it being used as a urinal and appropriate measures were discussed with options to address and prevent this issue occurring whilst still maintaining a useable washing area. The home was generally clean and tidy on the day of the site visit and the garden was welcoming and improvements such as the purchase of furniture and wood chips being laid there were also identified. 1 Wharf Close DS0000018081.V349848.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. It was not possible to confirm that adequate recruitment policies and practices were in place on this occasion due to the inaccessibility of records. The home has an effective and competent staff team who receive training to the required standard and some updates are required. EVIDENCE: There are currently six staff members within the home including the manager. Staff recruitment files were examined at the homes previous inspection. These were disorganised and there was no clear procedure in place for recording information. Two staff files contained most of the required information. However, neither contained proof of identity, a start date, a current photograph or a date for their CRB disclosure. Staff files could not be accessed at this inspection and staff did not have a key to open the filing cabinet as the manager keeps this. 1 Wharf Close DS0000018081.V349848.R01.S.doc Version 5.2 Page 19 Family Mosaic have an agreement with the Commission that they will keep CRB Disclosures, records of disciplinary action and references at their central HR office. Each employee will have a pro forma in their staff file at the home, completed by HR detailing all of this information along with all other records. Pro forma’s previously examined had not been completed appropriately. The person concerned had completed the employee information, but HR had completed none of the other information. Previously some staff files contained most of the required information and some contained no information at all. There was no recruitment information available at all for the most recently appointed employee. The proprietors are advised that any records required for inspection must be easily accessible within the home at all times. Training records indicated that most staff have attended a wide range of training. Proprietors provide a list of training courses available for staff to attend. The inspector was also unable to access supervision records and appraisals. The inspector was informed that the manager carries out staff formal supervision on a monthly basis. In addition staff would undertake an annual appraisal, which is reviewed on a quarterly basis. None of this information could be evidenced on the day of inspection due to the inaccessibility of records. 1 Wharf Close DS0000018081.V349848.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is guidance and direction to staff and the home has in place practices that will promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: A new manager has recently been appointed at Wharf Close and is now registered with the CSCI. She stated at the homes last inspection, as she was not present for this one, that she has registered to undertake the NVQ 4, which should have started in January 2007. Family Mosaic manages quality assurance within the home. This is completed at a corporate level annually and copies of summary sent to the CSCI. 1 Wharf Close DS0000018081.V349848.R01.S.doc Version 5.2 Page 21 Health and safety is generally well managed within the home. Staff do receive mandatory training, however, this does need to be updated regularly. A number of records and training certificates were examined during the inspection and these demonstrated that water temperatures are tested on a weekly basis, there are weekly fire drills, and the emergency lighting is tested, as are the means of escape. The gas safety certificate was seen, as was the Legionella risk assessment and liability insurance. These were all in date. 1 Wharf Close DS0000018081.V349848.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 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 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 1 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 3 X X X 1 Wharf Close DS0000018081.V349848.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES 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 provide conflicting and unclear information and in relation to omissions of signatures on MAR sheets. The safety of medication practice was a requirement on the last two inspection reports. 2. YA24 23(2)(b)(d) The registered person must ensure that the premises are kept in good repair internally and externally and that all parts of the home are reasonably decorated. This with particular reference to window restrictors being fitted to all windows without them on the first floor of the 1 Wharf Close DS0000018081.V349848.R01.S.doc Version 5.2 Page 24 Timescale for action 11/01/08 11/01/08 house. This is a repeat requirement, which has been partially met since the last inspection. The outstanding issues must be addressed as a matter of urgency. 3. YA34 19(1)(b) Sch 2 Recruitment records required by regulation for the protection of service users and for the effective and efficient running of the business must be maintained, up-to-date and accurate and be easily available and accessible for inspection at all times. This is in relation to the staff recruitment files within the home previously not demonstrating a robust procedure. One staff member had no documentation available, others had some but not all, and pro-forma’s, which should have been completed by HR, had not been. 4. YA35 18(1)(c)(i)(ii) The registered person must 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 mandatory training needing to be updated and to specialist training not being adequately provided. 11/01/08 11/01/08 1 Wharf Close DS0000018081.V349848.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 1 Wharf Close DS0000018081.V349848.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 1 Wharf Close DS0000018081.V349848.R01.S.doc Version 5.2 Page 27 - 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. 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