Inspection on 02/11/05 for Adeyfield Road (39)

This inspection was carried out on 2nd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Adeyfield Road (39) 05/09/07

Adeyfield Road (39) 28/09/06

Adeyfield Road (39) 19/04/05

Adeyfield Road (39) 26/08/04

Adeyfield Road (39) 10/05/04

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Coopers Mill Ltd

Sun Court Nursing Home

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Paradise Lodge

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Upaya Ananda

15 Bramble Close

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

CARE HOME ADULTS 18-65 Adeyfield Road (39) 39 Adeyfield Road Hemel Hempstead Hertfordshire HP2 5DP Lead Inspector Jeffrey Orange Unannounced Inspection 2nd November 2005 08.45 Adeyfield Road (39) DS0000019260.V262540.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 Adeyfield Road (39) DS0000019260.V262540.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. Adeyfield Road (39) DS0000019260.V262540.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Adeyfield Road (39) Address 39 Adeyfield Road Hemel Hempstead Hertfordshire HP2 5DP 01442 251840 01442 251840 adeyfieldrfpwalsingham.com 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) Walsingham Mrs Christine Hewitt Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (5), Physical disability (5) of places Adeyfield Road (39) DS0000019260.V262540.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. This home may accommodate 5 older people with physical disability (only when associated with a 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). 19th April 2005 Date of last inspection 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 are 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 (39) DS0000019260.V262540.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place during the early morning, as staff were assisting residents to prepare for the days activities which included four residents going to the day centre, one visiting the GP with her father and another going out to the hairdresser’s and then to lunch. The Standard of care observed remains good with the staff and residents having a very good working relationship that promotes choice and maximises independence in an appropriate and respectful way. Those medication records and procedures assessed were satisfactory and accurate, care plans are still in the process of being updated and improved. Environmental issues raised in previous reports are being addressed, including the installation of a new kitchen, which is in the process of being completed. Where key standards were assessed during the inspection of the 19th April 2005 these have not all been assessed again on this occasion and reference should be made to the report of that inspection for details. What the service does well: What has improved since the last inspection? The improvement in medication practice appears to have been maintained and there have been significant improvements in the environment, principally with the kitchen. Adeyfield Road (39) DS0000019260.V262540.R01.S.doc Version 5.0 Page 6 What they could do better: 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. Adeyfield Road (39) DS0000019260.V262540.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 Adeyfield Road (39) DS0000019260.V262540.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): This set of standards were fully assessed during the inspection of the 19th April 2005, please refer to the report of that inspection for details. EVIDENCE: Adeyfield Road (39) DS0000019260.V262540.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): 8.10. Consultation and participation by residents is encouraged and facilitated and forms a core part of the philosophy of care for this service. Confidentiality is promoted and safeguarded by the homes’ policies and procedures. EVIDENCE: Staff were again 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. Alternative tile and wall colour samples were on display, with resident’s assisted if required to nominate their choice for the decoration of the kitchen. The Person Centred Planning files provide good documentary evidence of resident participation in the care planning process. Walsinghams’ policies and procedures in respect of confidentiality and data protection have been seen to be satisfactory. Adeyfield Road (39) DS0000019260.V262540.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): 11,14,17. The social, educational and physical needs of residents are addressed within the Person Centred Planning ethos of the home. (“Person Centred” means listening and learning about what people want from their lives, helping them to think about what they want now and in the future and working together, with them, to make this happen.) EVIDENCE: Four residents were taken to day centre on the morning of the inspection, one resident was enjoying a day off and went, with a member of staff, to have her hair done and then for lunch, the remaining resident went with her father and a member of staff to visit her G.P and was then going horse-riding. The lounge now has a computer station for the use of residents. Family contacts and involvements in community activities are recorded in the care plan documentation. Details were seen of a range of holidays, including for one resident an activity break on Exmoor. Adeyfield Road (39) DS0000019260.V262540.R01.S.doc Version 5.0 Page 11 Care plans contain evidence of the involvement of dieticians with residents as required, meal times are social occasions and offer residents a choice of alternative options. During this inspection each resident going to day centre was encouraged to choose what they wanted to take with them for lunch. Adeyfield Road (39) DS0000019260.V262540.R01.S.doc Version 5.0 Page 12 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 The medication policy and procedures in place provide satisfactory safeguards for the home’s residents and were seen to be being followed in the case of those records checked. When and if medication is provided for residents attending day centre, the home has a duty of care to take reasonable and proportionate steps to ensure that it can demonstrate that this has been administered as required. Recommendations are made in respect of the storage of medication requiring refrigeration, the recording of medication leaving the home and storage temperatures for medication. EVIDENCE: Medication records seen were accurate, fully completed and reconciled with medication currently held. Medication storage temperatures are recorded and sometimes exceed recommended levels. This has been discussed with the home’s pharmacist and whilst a fan has been provided, it is recommended that, subject to the advice of the pharmacist, consideration be given to the installation of an appropriate air-conditioning unit to keep temperatures within recommended levels. Adeyfield Road (39) DS0000019260.V262540.R01.S.doc Version 5.0 Page 13 The home does not currently have the means to store the small amounts of medication that occasionally require refrigeration it is therefore recommended that a small, locked container be obtained to enable the storage of any medication requiring refrigeration to be done safely in the home’s refrigerator. Adeyfield Road (39) DS0000019260.V262540.R01.S.doc Version 5.0 Page 14 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): No complaints have been received by the home or by the Commission for Social Care Inspection since the last inspection. This set of standards were fully assessed during the inspection of the 19th April 2005, please refer to the report of that inspection for details. EVIDENCE: Adeyfield Road (39) DS0000019260.V262540.R01.S.doc Version 5.0 Page 15 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): 26,27,29 The physical environment of the home, is appropriate to meet the needs of the residents and individual residents are provided with any aids and adaptations required for their convenience, safety and care. EVIDENCE: Residents’ bedrooms have been seen to be individually furnished and personalised to provide for their needs. The home’s toilet and bathroom facilities are provided with aids and adaptations to permit the appropriate and safe care of residents. Care records include details of the input in the care of residents of a range of professionals such as occupational therapists and the home has its own specially adapted mini-bus for the transport of residents. Adeyfield Road (39) DS0000019260.V262540.R01.S.doc Version 5.0 Page 16 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 and 36 The number of staff on duty, with the appropriate skills required, is adequate to meet the current needs of the residents. Staff receive a good standard of training and support and the recruitment policies and practice of Walsingham are robust and thorough. EVIDENCE: Staff rotas were seen and there were adequate numbers of staff on duty throughout this inspection to meet the needs of the residents. Staff spoken to confirm that they are receiving training from foundation/induction, through regular updates to NVQ at levels 2 and 3. The interaction of staff and residents and the way that care was seen to be given, provides evidence that knowledge of good practice gained through training and supported through supervision, is being put into practice on a day-to-day basis. A schedule of CRB records was made available during this inspection. Adeyfield Road (39) DS0000019260.V262540.R01.S.doc Version 5.0 Page 17 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): 37,38,40,43 The home is well managed by its management team and there are robust policies and procedures in place to protect the rights and interests of residents. EVIDENCE: Residents appeared at ease, were appropriately dressed and were encouraged to express their preferences and dislikes. The manager has recently completed the Registered Managers Award and awaits confirmation of the result. The procedure and audit process for resident’s money was looked at and found to be satisfactory. An audit by Walsingham’s finance team had taken place in September this year. A pharmacist audit had been conducted by the home’s pharmacy in October. Adeyfield Road (39) DS0000019260.V262540.R01.S.doc Version 5.0 Page 18 The monthly reports carried out by the Operations Manager are thorough, robust and very open and provide a very positive basis for any future move towards increased self-assessment within the regulation of Social Care. Adeyfield Road (39) DS0000019260.V262540.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X 3 X 3 Standard No 24 25 26 27 28 29 30 STAFFING Score X X 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 X 13 X 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 X 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Adeyfield Road (39) Score X X 2 X Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X X 3 DS0000019260.V262540.R01.S.doc Version 5.0 Page 20 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. Standard Regulation Requirement Timescale for action 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 Where medication is provided for administration by third parties whilst service users are out of the home temporarily, the home should take reasonable steps to satisfy themselves that this has been administered as required. Consideration should be given to the provision of a suitable air conditioning unit to ensure that the storage of medication is within the recommended temperature range. A suitable locked container should be obtained for the storage of medication in the home’s refrigerator. 2 3 YA20 YA20 Adeyfield Road (39) DS0000019260.V262540.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire 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 (39) DS0000019260.V262540.R01.S.doc Version 5.0 Page 22 - 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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