Inspection on 28/07/06 for 17 Gordon Road

This inspection was carried out on 28th July 2006.

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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

17 Gordon Road 19/07/07

17 Gordon Road 01/03/06

17 Gordon Road 08/11/05

17 Gordon Road 14/02/05

17 Gordon Road 13/09/04

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 Gordon Road (17) 17 Gordon Road Vange Basildon Essex SS14 1PN Lead Inspector Sarah Buckle Unannounced Inspection 28th July 2006 10:00 Gordon Road (17) DS0000018111.V291969.R01.S.doc Version 5.1 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 Gordon Road (17) DS0000018111.V291969.R01.S.doc Version 5.1 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. Gordon Road (17) DS0000018111.V291969.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Gordon Road (17) Address 17 Gordon Road Vange Basildon Essex SS14 1PN 01268 282777 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 Teresa Elizabeth Rudd Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Gordon Road (17) DS0000018111.V291969.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Up to 3 persons of either sex to be accommodated who have a learning disability. No more than 3 persons to be accommodated at any one time. Date of last inspection 1st March 2006 Brief Description of the Service: 17 Gordon Road provides care and accommodation for three adults with a learning disability. The home’s facilities include a comfortable open plan living room, dining room and kitchen. There is also a shower room, an office and a laundry room on the ground floor. Upstairs there is a bathroom, three bedrooms for residents and a sleeping in room for staff. Gordon Road has a reasonable sized and secluded garden to the rear of the house, which all residents can access. The home is situated within walking distance of local shops. Basildon town centre is a short distance away. There is a good bus service in the area. Residents within the home are encouraged to access leisure pursuits and community facilities supported by experienced staff. The home has its own transport available. The residents within Gordon Road pay weekly rent ranging from £62.35 to £94.45. This information was provided on 31st July 2006. Gordon Road (17) DS0000018111.V291969.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection, which was unannounced. The inspection process included gathering information from various sources, examining relevant documents and records and a visit to 17 Gordon Road. The registered manager was sent a pre inspection questionnaire, which was completed and returned to the Commission. Surveys were sent to the three residents within Gordon Road and two of these were completed and returned. These two residents were offered support by staff in the home to complete the surveys, however, they did not find the format easy to understand and one resident lost interest before the survey was completed. One relative returned a comment card to the Commission and two healthcare professionals also completed comment cards and returned them. These contained positive information regarding the service. During the visit to the home two staff members were spoken with in depth, residents were also spoken with and observed. After the visit to the home, the registered manager forwarded information that was requested during the inspection to the Commission. What the service does well: Gordon Road is a home that is willing to work with the Commission to make any necessary improvements. Over the course of their last three inspections, the manager and the staff team have actively addressed the requirements and recommendations set as a result of the inspection. The residents living within Gordon Road are clearly comfortable and relaxed within their home. They are encouraged to be as independent as possible and are involved in the daily running of their home. The staff team have obvious knowledge and understanding of the needs of the individual residents and offer appropriate support. There is a familiar rapport between the staff and the residents. The home has a committed and consistent staff team who support one another. Gordon Road (17) DS0000018111.V291969.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: The upstairs residents bathroom is tired and worn. The suite is damaged and in need of replacement. A clear procedure needs to be put in place to make sure that all records are available for inspection by the Commission at all times. Protocols regarding ‘as required’ medication do not detail the behaviour strategies to be put in place prior to giving medication for challenging behaviour. Protocols are not in place for all ‘as required’ medication. Handwritten medication profiles were not double signed to prevent errors. One personal staff file seen that was brought to the home from the human resources department of Mosaic did not have evidence of a current CRB check within it. Instead there was a CRB from a previous employer. Care plans were not well organised, however, one staff member did explain that they were in the process of purchasing new folders. Please contact the provider for advice of actions taken in response to this Gordon Road (17) DS0000018111.V291969.R01.S.doc Version 5.1 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Gordon Road (17) DS0000018111.V291969.R01.S.doc Version 5.1 Page 8 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 Gordon Road (17) DS0000018111.V291969.R01.S.doc Version 5.1 Page 9 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The identified needs of the residents are adequately met. EVIDENCE: There have been no new admissions to the home since the last inspection. The residents have all lived at Gordon Road for long periods of time, one resident for almost twenty years. During the visit to the home one care plan was looked at in detail and this demonstrated a clear awareness of the needs of the resident. Gordon Road (17) DS0000018111.V291969.R01.S.doc Version 5.1 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans adequately reflect the identified needs of the residents, however they were disorganised. Residents are actively encouraged to make decisions. Residents are supported to take risks as part of an independent lifestyle. EVIDENCE: One care plan was sampled during the inspection visit and the support plans contained within it were of a good standard. They were detailed, instructive and personal to the individual i.e. a support plan in relation to personal care stated “ I shave each morning and will need staff to check that I have shaved properly. I am most likely to have shaved one side better that the other. I have a tendency to shave the right side of my face really well and the left side not very well”. There was evidence to suggest that the personal, social and healthcare needs of the individuals were met to a good standard. One staff member spoken with explained that the support plans were in the process of being updated. Gordon Road (17) DS0000018111.V291969.R01.S.doc Version 5.1 Page 11 During the course of the inspection visit to the home all of the residents were observed making decisions about what they wanted to do i.e. one resident had decided to change her bed clothes and was in the process of doing so, another resident decided to make tea and biscuits for people within the home. The care plan sampled showed that the resident had an advocate whom he spent time with once each fortnight. There were detailed infringement of rights lists contained within the care plan outlining for example, why the resident did not have a key to his room, and why he handed his lighters over to a staff member at night. Risk assessments were not contained within the care plan sampled and the key worker concerned explained that this was because they were being rewritten on the computer. These risk assessments have since been emailed to the Commission and contain appropriate information. However, there was no risk assessment or risk management plan in place in relation to a resident with challenging behaviour. Gordon Road (17) DS0000018111.V291969.R01.S.doc Version 5.1 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, 15, 16 and 17 Quality in this outcome area is good. This judgement was made using available evidence including a visit to this service. The residents at Gordon Road have adequate opportunities to partake in appropriate activities and to access the local community. Family links are positively encouraged within the home. The rights and responsibilities of residents are adequately recognised. A balanced and varied diet is available for the residents. EVIDENCE: Within the individual care plan sampled during the inspection visit a weekly opportunities record was examined. This detailed the activities and events one resident had been involved in so far this week and included spending the day with his mum, walking along the river, food shopping at Tesco and Asda, working in Brentwood, a trip to Leigh-on-Sea with his advocate, going to Basildon and to Billericay, going for a ride to Pitsea and relaxing at home watching the TV. A member of staff spoken with stated that the individual also attends college but that this has broken up for the holidays. Gordon Road (17) DS0000018111.V291969.R01.S.doc Version 5.1 Page 13 During the inspection visit the residents were observed selecting and making their lunch in the kitchen and sitting down together to eat at the dining room table. Menus were examined and these demonstrated that a varied and balanced diet was available for the residents. Gordon Road (17) DS0000018111.V291969.R01.S.doc Version 5.1 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): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personal support needs of residents are met in the manner they prefer. Gordon Road adequately meets the physical, emotional and health needs of the residents. Medication is in the main part well managed. EVIDENCE: During the inspection visit residents were observed interacting with the staff members in a relaxed and comfortable manner. Staff members spoken with had a clear understanding of the needs of the residents. Independence is encouraged and support offered where needed. All of the residents were treated with respect for their privacy and their dignity. Each resident was asked whether before anyone entered their bedroom and each bedroom was personalised in the manner preferred by the resident. There is a key worker system in place within Gordon Road. Records clearly outline the personal support needs of residents. Within the care plan sampled there was evidence of regular health care appointments and medication reviews. The resident had had appointments with the dentist, doctor and optician and these were recorded along with the outcome. Gordon Road (17) DS0000018111.V291969.R01.S.doc Version 5.1 Page 15 The medication folder was examined. There were no omissions on the medication charts. Two protocols for ‘as required’ medication had been developed and one of these was thorough and knowledgeable in relation to the behaviours expressed by the resident prior to them becoming ‘challenging’. It did not however outline strategies to put in place before making the decision to administer the medication. The other had clear information recorded upon it in relation to the medication to be administered, the dose, the reason for use, however, the criteria prior to the administration of medication could have included behavioural strategies. There were also other ‘as required’ medications i.e. for hay fever, which did not have a protocol. On one medication chart, newly prescribed medication had been administered during the month and this had been handwritten onto the MAR sheet. This information did include the medication profile, quantity and date received, however, there was only one signatory. In accordance with the Royal Pharmaceutical Society’s guidelines, handwritten medication profiles must be double signed. Gordon Road (17) DS0000018111.V291969.R01.S.doc Version 5.1 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): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The views of the residents are adequately sought and acted upon. The residents are protected from harm. EVIDENCE: There have been no complaints, no POVA referrals and no notifications since the last inspection. Six members of staff are booked on to POVA training this year, and this is for either initial or updates to training. One staff member was spoken with regarding POVA and they were aware of both the procedure for reporting suspected abuse and of what constitutes abuse. Gordon Road (17) DS0000018111.V291969.R01.S.doc Version 5.1 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 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 part well maintained, however the resident’s bathroom is shabby and worn. The home is clean and hygienic. EVIDENCE: The environment within Gordon Road is comfortable and homely. There has been redecoration of communal areas and individual bedrooms and these are maintained to a good standard. However, the carpet in the hallway and up the stairs is stained and tired looking. A staff member explained that this was in the process of being replaced. The residents’ bathroom was in need of modernisation. Although the ceiling and gloss work have been recently repainted, the bathroom suite is old fashioned and damaged. The enamel has worn out at the bottom of the bath leaving the area rough to touch, the taps are rusted and the plugholes are rusted and look dirty. The bath panel is torn and tired looking. The hand basin and the toilet are equally outdated and worn. Gordon Road (17) DS0000018111.V291969.R01.S.doc Version 5.1 Page 18 Two of the resident’s bedrooms, which were situated on the first floor of the home, did not have window restrictors in place. The windows could therefore be opened to a position wide enough for a person to fall out of. The home was clean and hygienic. On the day of the inspection visit the covers to the living room sofas and chairs had been washed to freshen them and were drying on the line in the garden. Gordon Road (17) DS0000018111.V291969.R01.S.doc Version 5.1 Page 19 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, 35 and 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A competent staff team supports residents’ within the home. The Mosaic recruitment procedure is not robust and there is no formal procedure in place to ensure all records are available for inspection. Mandatory and specialist training has improved and staff are adequately supervised. EVIDENCE: Two members of staff were spoken with during the course of the visit to the home. Both staff members were approachable and comfortable with the residents. They were seen communicating with residents in an interested and motivated manner. One staff member is currently completing her NVQ 3 and the newest employee is due to be registered to begin the training in 2007. During the visit to the home, the registered manager was not available. At the last inspection a requirement was made that a procedure be put in place to ensure that the Commission can access all records during an inspection. The staff members on duty were not aware of the procedure. The responsible individual was contacted and asked to deliver a key to enable access to staff files. However, a key was not brought to the home, instead various staff records were made available from Mosaic human resources department. These did not contain the specific information required for inspection. The registered manager was contacted and she brought the key to the home. Gordon Road (17) DS0000018111.V291969.R01.S.doc Version 5.1 Page 20 The staff files from Mosaic human resources were examined and a gap in the corporate recruitment process was identified. There was evidence that one staff member has been employed on a CRB check from a previous employer. This CRB check was a photocopy and was dated 2002. There was no evidence of a CRB being obtained by Mosaic. Staff training within Gordon Road has improved and is well organised. A matrix was received prior to the inspection visit, which detailed training that had been undertaken and training that was booked. One member of staff was spoken with and they stated that they had received training in an introduction to learning disabilities, manual handling, breakaway techniques and care of medicines. They also had POVA, first aid and professional boundaries and ethics training booked during 2006. One staff member’s supervision file was examined and this demonstrated a good standard of support. Supervision was regular, recorded and formal. Gordon Road (17) DS0000018111.V291969.R01.S.doc Version 5.1 Page 21 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): 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. Gordon Road is a well run home. Residents’ views underpin the running of the home. Health and safety is well managed. EVIDENCE: Gordon Road is a well run home. The manager is now registered with the Commission and has almost completed the NVQ4. Quality assurance is addressed by Mosaic rather then by individual homes; however, there was evidence of a residents meeting in January 2006. There was also information in a relatives meeting regarding questionnaires that Mosaic had sent out to family members and to service users. One staff member spoken with during the inspection stated that the residents are spoken with on a daily basis in an informal manner and their views are sought in this way. Gordon Road (17) DS0000018111.V291969.R01.S.doc Version 5.1 Page 22 The pre inspection information received by the Commission listed all of the dates that health and safety tests and checks had been completed. During the inspection the fire extinguishers were checked and had been serviced in November 2005. Water temperature records were also checked, as were fire drills. Gordon Road (17) DS0000018111.V291969.R01.S.doc Version 5.1 Page 23 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 2 35 3 36 4 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 3 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Gordon Road (17) DS0000018111.V291969.R01.S.doc Version 5.1 Page 24 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 YA24 Regulation Requirement Timescale for action 01/10/06 23(2)(b)(c) The registered person must ensure that the care home is kept in a good state of repair and that equipment provided by the care home is maintained in good working order. This is in relation to an outdated and worn bathroom suite, which has a rough bottomed bath, rusty taps and plug holes and a torn bath panel. 2. YA34 17(3)(b) 31(3)(b) The acting manager must 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 there being no clear procedure in place for obtaining a key during an inspection to ensure that all records are available to the Commission. 28/07/06 Gordon Road (17) DS0000018111.V291969.R01.S.doc Version 5.1 Page 25 3. YA34 19(1)(b) Sch.2 This is a repeat requirement. The corporate recruitment procedure must ensure that persons are not employed to work within care homes unless all the information specified within Schedule 2 has been obtained. This is in relation to one Mosaic staff file having no evidence of a current CRB check for an employee, and to the CRB check in evidence being a photocopy from a previous employer dated 2003. 01/09/06 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 YA20 Good Practice Recommendations This is in relation to the medication file not containing all the appropriate PRN protocols. It is also in relation to protocols that have been completed requiring additional information regarding behaviour strategies to put in place prior to the administration of medication and to handwritten profiles needing double signatories. This is in relation to upstairs windows that do not have window restrictors or risk assessments to state that these are not necessary and why. 2. YA24 Gordon Road (17) DS0000018111.V291969.R01.S.doc Version 5.1 Page 26 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. 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