Inspection on 28/09/06 for Adeyfield Road (39)

This inspection was carried out on 28th September 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 no outstanding requirements from the previous inspection report, but made 2 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) 02/11/05

Adeyfield Road (39) 19/04/05

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) 39 Adeyfield Road Hemel Hempstead Hertfordshire HP2 5DP Lead Inspector Alison Jessop Unannounced Inspection 28th September 2006 10:00 Adeyfield Road (39) DS0000019260.V313686.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Adeyfield Road (39) DS0000019260.V313686.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Adeyfield Road (39) DS0000019260.V313686.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Adeyfield Road (39) Address 39 Adeyfield Road Hemel Hempstead Hertfordshire HP2 5DP 01442 251840 01442 251840 adeyfieldrd@walsingham.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.V313686.R01.S.doc Version 5.2 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). 2nd November 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. The current accommodation fees are £1704.00 per week. A copy of the most recent inspection report can be obtained from the office. Adeyfield Road (39) DS0000019260.V313686.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over half a day by one regulatory inspector. Most of the service users were attending day care however time was spent talking to one service user. Feedback was gained from the remaining service users on their return. Time was also spent talking to staff and scrutinising records. The outcome of the inspection was very positive. What the service does well: Adeyfield Road offers a supportive, homely environment to its service users. The home is attractively decorated and adaptations are available to meet individual needs. Service users bedrooms are decorated to meet individual taste and the home is kept clean and tidy. Care practice observed was sensitive and caring and service users feedback was very positive. One service user was observed playing dominoes with a member of staff and said that he enjoys doing this when he is at home. All service users attend day care facilities and during their spare time enjoy a range of activities and outings. Recently the service users were taken to the London eye and on a Thames riverboat cruise. Another service user was planning to go to London on the train to see the Lion King. She said ‘I am really excited.’ Care plans and risk assessments comprehensive information. are regularly updated and contain Staff appear to be very dedicated and provide a caring service. Staff attend regular training and receive regular supervision. What has improved since the last inspection? What they could do better: An individual risk assessment is required for a service user who appears to sustain injury/bruising, in connected with her behaviour. It is also recommended that a body map is used to record any bruising to service users along with the accident form. Adeyfield Road (39) DS0000019260.V313686.R01.S.doc Version 5.2 Page 6 The cupboard in the hallway must be removed in order to protect the safety of service users. 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.V313686.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Adeyfield Road (39) DS0000019260.V313686.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected 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. Admissions are not made to the home until a full needs assessment has been undertaken, ensuring that so far as possible service users needs can be met. EVIDENCE: A comprehensive needs assessment is carried out and once an agreement has been made that the home is suitable, regular introductory visits are arranged so that the prospective service user can get to spend time with staff and other residents and get to know the home before moving in. Adeyfield Road (39) DS0000019260.V313686.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are developed following person centred planning principles. The plan is reviewed regularly involving the resident and, where agreed, their families. Confidentiality is safeguarded by the home’ policies and procedures. EVIDENCE: Care plans observed contained comprehensive information and offered clear, up to date information on service users individual needs. Parts of the care plan are in a pictorial format and service users are involved in planning their care. Staff can demonstrate how individual choices have been made by service users. Service users are involved in menu planning, meals are chosen from pictures of a wide variety of meals. Adeyfield Road (39) DS0000019260.V313686.R01.S.doc Version 5.2 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): 12, 13, 15, 16 & 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are able to enjoy a full and stimulating lifestyle with a variety of options to choose from. The home has sought the views of the residents and considered their varied interests when planning the routines of daily living and arranging activities both in the home and the community. EVIDENCE: All service users attend day care during the week. However they each have one day at home where they can relax or go out shopping on a one to one basis with staff. The home had recently held a party to celebrate its 10th anniversary. All service users spoken to said that they enjoyed this. Service users had also been taken on a day trip of their choice, to the London Eye and on a Thames river boat trip. Photos were taken of the day out and service users appeared to be very happy. Adeyfield Road (39) DS0000019260.V313686.R01.S.doc Version 5.2 Page 11 One service user has chosen to visit the theatre to see the Lion King, she decided that she would like to travel to London by train, so staff had made arrangements with the rail network to accommodate her wheelchair. Another service user had expressed that she would like to visit her family who live in Greece. Staff were unsure about whether the service user would cope on the long flight, so they arranged a short flight to Ireland. Adeyfield Road (39) DS0000019260.V313686.R01.S.doc Version 5.2 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): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Specialist health, nursing and dietary requirements are clearly recorded in each resident’s plan; they give a comprehensive overview of their health needs and act as an indicator of change in health requirements. Attention is given to ensuring privacy and dignity when delivering personal care and staff are sensitive to changing needs of residents. The home has a good record of compliance with the administration of medication. EVIDENCE: Residents have access to health and remedial services, staff make sure that residents are encouraged to be independent, have regular appointments and visit local health care services. Following a complaint raised by a relative about unexplained bruising to his daughter’s body, staff have comprehensively completed accident forms where unexplained bruising has appeared. Adeyfield Road (39) DS0000019260.V313686.R01.S.doc Version 5.2 Page 13 An individual risk assessment is required in relation to this, as the service user appears to sustain injury, which appears to be connected with her behaviour. It is also recommended that a body map is used to record any bruising to service users along with an accident form. The home works to an efficient medication policy supported by procedures and practice guidance. Adeyfield Road (39) DS0000019260.V313686.R01.S.doc Version 5.2 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): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The policies and procedures regarding protection of individuals are of a high quality and are regularly reviewed and updated. The service is clear when incidents need external input and who to refer the incident to. Residents and others associated with the home understand how to make a complaint and they are very clear of what can be expected to happen if a complaint is made. EVIDENCE: A complaint had been received from a resident following an incident where a visitor had a disagreement with a member of staff. The resident said that she felt very frightened at the time and felt unsafe in the home. The manager of the home dealt with the complaint appropriately and also reported the incident to Adult Care Services following the Protection of Vulnerable Adults procedure. New arrangements were agreed with the visitor and the complaint by the service user has not been upheld. The Commission received a complaint for Social Care Inspection from a relative who had concerns about bruising found on his daughter over the course of several months. The staff in the home said that the bruising although unexplained, they believe is due to certain behaviours displayed by the service user which they believe is the cause of self injury. Adeyfield Road (39) DS0000019260.V313686.R01.S.doc Version 5.2 Page 15 The home are closely monitoring and recording any accidents or bruising observed and Adult Care Services have been notified in accordance with the protection of vulnerable adults. It has been recommended that a body map is completed by staff along with an accident form. No other concerns have been received. Adeyfield Road (39) DS0000019260.V313686.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a physical environment that is appropriate to the specific needs of the residents who live there. The lay out and design of the home allows for small clusters of residents to live together in a non-institutional environment. The bathrooms and toilets are fitted with appropriate aids and adaptations to meet the needs of the people who use the service, and are in sufficient numbers. EVIDENCE: The home is attractively decorated and offers a clean, homely environment to service users. Bedrooms are decorated to reflect the individual taste of service users. Adaptations in the home such as automatic door mechanisms promote service users independence. A small cupboard was installed in the hallway, but this has become unsafe and must be removed. Adeyfield Road (39) DS0000019260.V313686.R01.S.doc Version 5.2 Page 17 Staff are aware of universal infection procedures and the home looked very clean throughout. Adeyfield Road (39) DS0000019260.V313686.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents appeared to have confidence in the staff that care for them. The service ensures that all staff within its organisation receives relevant training that is targeted and focussed on improving outcomes for residents. Staff meetings take place regularly. Supervision sessions are regular and notes are taken of meetings and sessions. EVIDENCE: The number of staff on duty was adequate to meet the needs of the service users. Not all posts are permanently filled and the use of agency staff is regular, however the same agency staff are used to ensure some consistency. Records relating to recruitment were unavailable on the day of the inspection. An arrangement has been made for the organisations recruitment records to be inspected centrally by the commission and no concerns have been reported. Staff spoken to confirmed that they are receiving regular training from induction/foundation to NVQ levels 2 & 3. The manager has completed her registered managers award. Adeyfield Road (39) DS0000019260.V313686.R01.S.doc Version 5.2 Page 19 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 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Manager has the required qualification/s and experience and is competent to run the home. There is a strong ethos of being open and transparent in all areas of running of the home. EVIDENCE: The service has sound policies and procedures, which are effectively reviewed and updated, in line with current thinking and practice. The home has a good record of meeting relevant health and safety requirements and legislation. Records are of a good standard and are routinely completed. Adeyfield Road (39) DS0000019260.V313686.R01.S.doc Version 5.2 Page 20 Monthly reports provided to the commission by the provider are very comprehensive and the home is very open and transparent reporting any concerns. Adeyfield Road (39) DS0000019260.V313686.R01.S.doc Version 5.2 Page 21 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 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 x 3 X 3 X X 3 X Adeyfield Road (39) DS0000019260.V313686.R01.S.doc Version 5.2 Page 22 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 YA19 Regulation 13(4)(c) Requirement Risk assessments must be completed for service users who are prone to bruising or whose behaviour may cause self-injury. The cupboard in the hallway must be removed in order to protect the safety of service users, staff and visitors. Timescale for action 15/11/06 2 YA24 23(2)(b) 30/11/06 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 YA19 Good Practice Recommendations It is recommended that any bruising to service users is recorded on a body map as well as an accident form. Adeyfield Road (39) DS0000019260.V313686.R01.S.doc Version 5.2 Page 23 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.V313686.R01.S.doc Version 5.2 Page 24 - 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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