Inspection on 04/12/05 for 30 to 31 Pickwick Close

This inspection was carried out on 4th December 2005.

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

Other inspections for this house

30 to 31 Pickwick Close 30/09/09

30 to 31 Pickwick Close 21/06/07

30 to 31 Pickwick Close 01/08/05

30 to 31 Pickwick Close 16/02/05

30 to 31 Pickwick Close 07/09/04

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 Pickwick Close (30/31) 30/31 Pickwick Close Laindon Basildon Essex SS15 5SW Lead Inspector Mrs Bernadette Little Unannounced Inspection 4th December 2005 15.20a Pickwick Close (30/31) DS0000018073.V269630.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 Pickwick Close (30/31) DS0000018073.V269630.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. Pickwick Close (30/31) DS0000018073.V269630.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Pickwick Close (30/31) Address 30/31 Pickwick Close Laindon Basildon Essex SS15 5SW 01268 410634 01268 410634 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) Estuary Housing Association Limited Mr George Lai-Chun Care Home 8 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (2), Learning disability (8), Learning disability of places over 65 years of age (8) Pickwick Close (30/31) DS0000018073.V269630.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Accommodation and personal care to be provided for three service users who have Dementia and whose names are know to the Commission. No more than a total of eight service users to be accommodated at any one time. 01/08/05 Date of last inspection Brief Description of the Service: Pickwick Close is situated relatively close to Basildon, Laindon and Wickford town centres. There are a good bus and train links to the area. The home provides 24 hour residential care for up to eight adults who have a learning disability. The homes registration has been varied to allow care to be offered to up to three residents will also have dementia. 30/31Pickwick Close comprises of two interconnecting bungalows. Each bundle offers four single bedrooms, a large lounge, at dining room, kitchen, bathroom, shower room, sluice facility and separate toilet. There is also a separate office and a sensory room. Each bungalow has its own garden/patio area to the rear of the property. Parking is available to the front of the bungalows. The home has its own transport facilities for residents. Pickwick Close (30/31) DS0000018073.V269630.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The was the homes second routine unannounced inspection of the year. It took place on a Sunday evening and lasted approximately 4 hours. Standards not covered at this inspection were assessed at the last inspection and that report should also be read. Time was spent with all of the seven residents currently living at home as well as with the four staff that were on duty. Two visitors were also spoken with. All parts of the home were looked at, as were records, policies and procedures. The assistance of the staff and the residents was greatly appreciated and in particular the member of staff who stayed on working an extra hour to ensure the safety of the residents through appropriate supervision, while the person in charge worked with the inspector. What the service does well: What has improved since the last inspection? What they could do better: The people who own the home must put more staff on duty at some times to make sure residents needs are met, including at mealtimes. They must also make sure that records about all staff are available in the home for inspection. Pickwick Close (30/31) DS0000018073.V269630.R01.S.doc Version 5.0 Page 6 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. Pickwick Close (30/31) DS0000018073.V269630.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 Pickwick Close (30/31) DS0000018073.V269630.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): 1,3, 5 Pickwick Close had a good range of information available for those thinking about using the service. EVIDENCE: The service user guide had been amended as recommended following the last inspection. Both this and the statement of purpose were displayed in the home. The service user guide confirmed who was responsible for paying the fees for the residents placed at Pickwick Lodge. The permanent staff records confirmed that they had had appropriate training to meet the needs, including the specialist needs, of the residents at Pickwick Close. This included training on Parkinsons disease, dementia, and communicating with people who have a learning disability. The contracts in the residents’ files were in a pictorial format to be easier to understand. They were supported by a license agreement. Pickwick Close (30/31) DS0000018073.V269630.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, 9 Care plan folders were in place for all residents, which contained good information for the staff to help them to care for the residents. EVIDENCE: As identified at the last inspection, care plans sampled identified clear aims and care instructions to support consistency of care. They were supported by risk assessments. These demonstrated the inclusion of appropriate professionals where required, for example occupational therapist or speech and language therapist. It was disappointing to note that a resident’s care plan required them to be bathed twice a week, but that this was not taking place because that bungalow did not have assisted bathing facility appropriate to meet the resident’s needs. The resident had prescribed bath oil to be used on these occasions to support good skincare management. Staff said that they try to put it on the resident’s skin when they shower them each day. Pickwick Close (30/31) DS0000018073.V269630.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): 11, 13, 14, 17 Residents take part in limited opportunities in the community. A varied menu was provided but the timing of meals was not always in the residents best interests. EVIDENCE: Weekly activities charts were not up to date. They showed some variety of activities at home. Activities in the community were mainly limited to shopping and car rides. Staff and records confirm that for example the residents rarely eat out or go to the pub. A resident who had regularly attended church services at their previous home, continued not to have opportunity to do that at Pickwick Close. This resident’s recent review by the funding authority identified the resident’s need as also including opportunities to go to clubs etc. The planned menu showed variety including a cooked breakfast at weekends. The meal observed was well presented. Two residents required feeding and one needed to be supervised because of a risk of choking. Staff provided sensitive support. The evening meal, a roast dinner, was served to residents in this bungalow at 4pm. This had been moved to an earlier time to ensure adequate staff supervision before staffing levels were reduced at 4.30pm. This was the residents’ last meal of the day. Pickwick Close (30/31) DS0000018073.V269630.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): 20, 21 The home’s medication practices protected residents. EVIDENCE: Medication Administration records were well maintained including those for controlled drugs. Protocols were in place for PRN (as required) medication. Patient information leaflets were available as was a record of drugs returned. Storage was appropriate and staff confirmed that only those appropriately trained are involved in medication practices. The sample record of staff signatures could be updated. The file sampled did not indicate that the home had endeavoured to ascertain the resident or relatives’ current wishes for end of life practices. The family spoken to confirmed they felt comfortable to discuss this with staff. Pickwick Close (30/31) DS0000018073.V269630.R01.S.doc Version 5.0 Page 12 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 Staff had appropriate training and knowledge to protect residents. EVIDENCE: The training files for permanent staff confirmed that they had had training on the protection of vulnerable adults. An agency staff member also had confirmation of attending training. Staff were aware of the whistleblowing policy and appropriate action to take to protect residents. Evidence was also available that staff had attended the second part of the positive responses training identified at the last inspection. Pickwick Close (30/31) DS0000018073.V269630.R01.S.doc Version 5.0 Page 13 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, 25, 27, 30 Pickwick Close generally provided a safe and comfortable environment. Bathing facilities did not provide adequate equipment to best meet resident need. EVIDENCE: A carpet cleaner had been provided and carpets were notably cleaner. One residents bedroom continued to be without a carpet without adequate reason. It was noted positively that a vision panel had been fitted in the interconnecting door. The sensory room continued to be used for the storage of furniture although this facility was stated to have been used on a daily basis to provide activities for residents. As noted earlier in the report, one residents identified care needs were not being met, as there was no suitably equipped assisted bath in the bungalow they were resident in. The home was seen to be clean and appropriate infection control measures in place. Pickwick Close (30/31) DS0000018073.V269630.R01.S.doc Version 5.0 Page 14 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, 33, 34, 35 Staffing levels continue to be considered inadequate at times to ensure quality care for residents. EVIDENCE: It was advised that two staff had very recently completed NVQ level 3 training. The home operates with three staff on duty between 7am and 9.30pm. There is an additional staff member between 9am and 4.30pm. Allowing that there is one resident vacancy, this is still considered inadequate based on the resident’s personal care and supervision needs in the morning. As noted earlier some residents are being fed their last meal of the day at 4pm due to reduced staffing levels after that time. The last inspection report identified the inadequacy of the staffing levels at those times. The home report continued difficulty in recruiting permanent staff. The roster indicated that regular agency staff were used to ensure consistency of care for residents. This was confirmed by the three agency staff on duty. Occasions were again noted on the roster when only agency staff were on duty in the home. Induction records were not available for permanent staff. Pickwick Close (30/31) DS0000018073.V269630.R01.S.doc Version 5.0 Page 15 Photographs were available of all permanent staff as required. They were not available for all agency staff although some of those on duty had worked at the home for 18 months. Records required by regulation in relation to the identity of agency staff and evidence of appropriate references and checks were again not available. Training files were available for all permanent staff. Those sampled confirmed that staff received mandatory training and updates. Evidence was also available of additional training. Training records were not available for agency staff. One of the agency staff on duty later in the evening provided evidence of training stamped by the agency. All four staff demonstrated an awareness of residents’ needs and personalities, and how to interpret their communications. Pickwick Close (30/31) DS0000018073.V269630.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): 38, 39, 40, 41, 43 Pickwick Close presented as well organised. The management of some care outcomes in relation to staffing levels and the facilities were not seen to be in the residents’ best interests. EVIDENCE: Staff and visitors confirmed that the manager was approachable and they could raise any concerns and offer ideas. Minutes were available of regular residents meetings. Records were also seen where staff had spoken with residents individually in an effort to ascertain their views and wishes. Estuary have undertaken regular regulation 26 visits and provided reports to the commission. Policies and procedures are corporate and were readily available. The missing resident procedure could include reference to informing the commission. Accident records, nutrition records, visitors record and roster were sampled and met requirements. The current certificate of employers liability insurance was displayed. There was no evidence to suggest that the home is anything but financially viable. Pickwick Close (30/31) DS0000018073.V269630.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 3 X 3 X 3 Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 2 X 2 X x 3 LIFESTYLES Standard No Score 11 3 12 3 13 1 14 2 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 2 2 2 2 x CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Pickwick Close (30/31) Score X X 3 2 Standard No 37 38 39 40 41 42 43 Score X 2 3 3 3 3 3 DS0000018073.V269630.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 YA6 Regulation 15(1) Requirement A care plan to be in place for each resident that shows accurately how all aspects of the persons of their health and welfare is to be met . The registered person must ensure that a range of leisure and recreational activities are provided for all residents. This includes evenings and weekends.(Previous timescales from 17/03/03 not met) Meals must be provided at reasonable times and to meet residents needs. The person registered must provide adequate storage. This refers to the use of the sensory room for storing furniture. Bathing facilities must be provided to meet residents assessed needs. The person registered must ensure that there are adequate staffing levels on duty in the home at all times to meet the needs of residents in all aspects of their health and welfare. (Previous timescale of 01/09/05 not met.) DS0000018073.V269630.R01.S.doc Timescale for action 20/12/05 2 YA13YA14 16(2) 01/01/06 3 4 YA17 YA24 16(2)(i) 23(2)(l) 05/12/05 01/01/06 5 6 YA27 YA33YA38 23(2) (j) & (n) 18(1) 01/01/06 20/12/05 Pickwick Close (30/31) Version 5.0 Page 19 7 YA34 8 YA35 9 YA35 Evidence must be available of the persons identity and their references and checks for all staff employed at the home, this includes agency staff. 18(1)(c) Evidence must be available of the training of all staff, including agency staff, which was not available in the home for inspection. (Previous timescales from 01/01/04 not met). 18(1)(c) & The person registered must Sch 2 ensure that staff are provided with induction training. Evidence of this was not available on request (Previous timescale of 01/09/05 not met). 19 & Sch 2 20/12/05 20/12/05 20/12/06 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 YA24 YA32 YA42 Good Practice Recommendations The flooring in a residents bedroom should be assessed for their individual needs and be more homely in character unless their assessment clearly indicates otherwise. 50 of care staff should achieve NVQ training The safety of the filing cabinet in the office should be assessed and actioned. This is outstanding from the last inspection and not assessed on this occasion. Pickwick Close (30/31) DS0000018073.V269630.R01.S.doc Version 5.0 Page 20 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 Pickwick Close (30/31) DS0000018073.V269630.R01.S.doc Version 5.0 Page 21 - 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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