Inspection on 19/04/05 for Adeyfield Road (39)

This inspection was carried out on 19th April 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Adeyfield Road (39) 05/09/07

Adeyfield Road (39) 28/09/06

Adeyfield Road (39) 02/11/05

Adeyfield Road (39) 26/08/04

Adeyfield Road (39) 10/05/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Adeyfield Road 39 Adeyfield Road Hemel Hempstead Herts HP2 5DP Lead Inspector Jeffrey Orange Unannounced 19 April 2005 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 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 Stationary 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. Adeyfield Road Version 1.10 Page 3 SERVICE INFORMATION Name of service Adeyfield Road Address 39 Adeyfield Road Hemel Hempstead Herts HP2 5DP 01442 251840 01442 251840 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Walsingham Mrs Christine Hewitt Care Home 6 Category(ies) of LD 6 registration, with number LD(E) 5 of places PD 5 Adeyfield Road Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: This home may accommodate 5 older people with physical disability (only when associated with learning disability) This home may accommodate up to 5 older people (only when service users have had residency at the home prior to that age) Date of last inspection 26 August 2004 Brief Description of the Service: 39 Adeyfield Road is a care home registered to provide care and accommodation for up to six people with learning disabilities. (And see above additional conditions). 39 Adeyfield Road is currently home to six adults with a learning disability, five of whom came into the home together as part of the resettlement from Cell Barnes. The home is run and maintained by Walsingham, of 1331-1337 High Road Whetstone, London N20 9HR and consists of a large, detached, chalet style bungalow, with additional facilities on the first floor. The home stands in its own grounds with a parking area, detached office and garden with seating area to the front and a rear garden, including a greenhouse enjoying views over parkland. Local shops ar close by and the home is not far from the Jarman centre, which has leisure facilities, a supermarket complex and a day centre which the residents attend. The home has the use of its own minibus. Adeyfield Road Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. As the manager, assistant manager and senior support worker were not on duty on the day of this inspection, the home was being managed by a care worker with the assistance of two agency workers. In view of the absence of members of the home’s management team, the inspection was restricted in terms of what records could reasonably be discussed, it was however a good opportunity to see how the routine of the home was maintained for the benefit of its residents. The care outcomes seen appeared good. Staff were obviously stretched at the “peak” period when they were assisting the residents to get ready for day care, however they coped well. There are a few environmental issues that are mentioned in this report, but overall the standard of accommodation is satisfactory. Care plans are still under a process of review and can sometimes appear disjointed, with historical and current information kept together, however again the overall standard of records is satisfactory. Although some minor gaps were found in the medication records, the standard was generally acceptable. Most importantly the residents were firmly at the centre of the home and its’ activity and the focus of staff was quite properly on the care and wellbeing of residents. What the service does well: Person Centred Planning is made a reality in the way this home is run and it benefits from a genuine commitment to the involvement of its’ residents in the way that services are provided. Adeyfield Road Version 1.10 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Adeyfield Road Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Adeyfield Road Version 1.10 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 standard(s) 1,2,3,4,5 Anyone considering moving to the home has the information they require, in a format they can understand to help them make an informed judgement about the home and what it can offer them in order to meet their needs. EVIDENCE: There have not been any recent changes in residents. It has previously been found that the assessment process and the information provided to prospective residents are satisfactory. Individual contracts are provided in an accessible, appropriate format and have been seen along with Service User’s Guides and assessment details. There is an impressive commitment on the part of Walsingham to develop and refine the format of all documentation to make it readily accessible to their residents, without becoming patronising. Adeyfield Road Version 1.10 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 standard(s) 6,7,9 Residents are involved in the review process and in the setting of personal goals and choices. EVIDENCE: Staff were seen to actively involve residents in the morning routine of the home, in their personal care, their choice of breakfast and residents were assisted to take part in these processes wherever possible, rather than having things done for them in all cases. This provides residents with real opportunity to determine how they live their lives and how any care they require is given to them. The care plan documentation is being changed and will be improved once this process is completed. The Person centred approach of the home is reflected in the care plan documentation files provide good documentary evidence of resident participation in the care planning process. Adeyfield Road Version 1.10 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 standard(s) 12,13,15,16. Residents are encouraged to maintain social contact with family and friends. Each has access to appropriate leisure and day activities. EVIDENCE: All residents attend day centre during the week and on the days they do not are assisted to access local leisure facilities. Five residents were taken to day centre on the morning of the inspection, the remaining resident was enjoying a day off and went, with a member of staff, to do some shopping and have lunch out. Family contacts and involvements in community activities are recorded in the care plan documentation. Adeyfield Road Version 1.10 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 standard(s) 18,19,20 Residents are firmly at the centre of the home and staff ensure that appropriate support is provided to meet individual personal and healthcare needs. Medication procedures are under review and whilst some gaps in administration records were found, the general standard was acceptable. EVIDENCE: The Person Centred planning approach of the home was evident both in the records seen and more importantly in the way that the staff were seen to approach, talk with and provide help to residents. Residents were being treated with respect and offered help in a way which recognised their right to choose and determine how care is provided. Medication records were checked and although improved, some gaps were found in the administration charts. The home’s incident forms include several recent medication errors. A new monitoring procedure is under consideration. Details of residents’ physical and emotional needs are well recorded and reviewed in the care plan documentation, including the involvement of GPs and other health professionals. Adeyfield Road Version 1.10 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 standard(s) 22,23 The Person Centred approach to residents is obvious from the way, for example, they are involved in meetings at local and regional/national level and have a role in the appointment of staff including the new Chief Executive of Walsingham. The home’s policies and procedure on the protection of vulnerable adults from abuse are robust and training for staff is included in induction training and on an ongoing basis. EVIDENCE: All documentation used by residents is produced in an appropriate format , without being patronising or condescending. For example the “Our News” magazine included an annual plan and five year plan and details of the process for selecting a new chief executive with service user participation. In the absence of the manager and senior staff it was not appropriate on this occasion to look at residents’ financial records. However the system used has previously been found to be robust and well documented. Adeyfield Road Version 1.10 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 standard(s) 24,25,28,30 The “feel” of the home is essentially domestic and homely and certainly not institutional. Residents’ bedrooms are very individual to them and have individually chosen furnishings. The corridors and kitchen, require some attention to maintain and improve their decorative condition. EVIDENCE: Resident’s rooms were seen to be decorated in a range of styles and colours schemes with different furnishings. Care plan documentation included evidence that residents had been involved in the decoration of their rooms and had sometimes, with appropriate consultation, chosen to spend their own money providing additional items. The curtain in the lounge was loose, one toilet seat was loose, some corridor walls now need attention in places and the kitchen floor and units are in need of replacing/refurbishment, although it is understood that this is in hand. Externally, the dormer cladding needs repainting and the tidiness of some areas is poor, with old milk containers etc not disposed of or stored inconspicuously. Adeyfield Road Version 1.10 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35 With three care staff on duty the minimum staffing level was met, however there was little spare capacity in the event that, for example, a resident required the attention of two staff in a crisis situation. EVIDENCE: The absence of the manager and assistant manager meant that the care staff on duty, including two agency staff, were stretched at times during the busy period in the morning as they were getting residents up and ready to leave for day care. Agency staff are provided with the information they need to know and have to sign to indicate they have read it. Those members of agency staff on duty had been to the home before and appeared to be familiar with its routines and the needs of the residents. There were no staff on duty who could drive the home’s mini-bus and so taxis had to be provided to take residents to the day centre. Adeyfield Road Version 1.10 Page 15 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39,41,42 The Person centred Approach followed by the home ensures that residents are involved in decisions about their lives, and can express choice and opinion in a meaningful way. Policies and procedures are in place to promote and protect residents and staff training, including induction, reinforces this. EVIDENCE: In the absence of any member of the management team for the home it was not possible to look at all these standards in detail. There is a robust system of risk assessment in place and care plans include evidence that these are reviewed periodically. The employers’ liability certificate on display had expired in March 2005. Food in the refrigerator had all been dated on opening and was within date, the daily instructions included the need to test hot water, and temperature records Adeyfield Road Version 1.10 Page 16 for the freezer and fridges were seen. Fire extinguishers had been tested within the past year. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 x x 3 x 3 Standard No Standard No 31 32 Score x x Page 17 Adeyfield Road Version 1.10 11 12 13 14 15 16 17 x 3 3 x 3 3 x 33 34 35 36 2 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 3 x 3 3 x Adeyfield Road Version 1.10 Page 18 NO 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 23 (2) (b) Requirement The Registered Provider must review the maintenance schedule of the home to take account of the areas of concern identifid in this report. Timescale for action By 31.7.05 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 33 Good Practice Recommendations The manager should review the staffing of the home to ensure it is satisfactory in respect of any identified need for mangement or senior care worker presence, and should assess the adequacy of the number of qualified drivers for the homes own transport that are available. Adeyfield Road Version 1.10 Page 19 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City Herts AL7 3BQ 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 Adeyfield Road Version 1.10 Page 20 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!