Inspection on 28/01/08 for Alnwick Road (4)

This inspection was carried out on 28th January 2008.

CSCI found this care home to be providing an Adequate service.

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

Other inspections for this house

Alnwick Road (4) 25/07/08

Alnwick Road (4) 12/10/06

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Alnwick Road (4) 4 Alnwick Road Canning Town London E16 3EX Lead Inspector Mohammad Peerbux Unannounced Inspection 28 January 2008 10:15 th Alnwick Road (4) DS0000066795.V354137.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 Alnwick Road (4) DS0000066795.V354137.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. Alnwick Road (4) DS0000066795.V354137.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alnwick Road (4) Address 4 Alnwick Road Canning Town London E16 3EX 020 7511 4854 F/P 020 7511 4845 bertram.okeke@heritagecare.co.uk www.heritagecare.co.uk Heritage Care 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) Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Alnwick Road (4) DS0000066795.V354137.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd February 2007 Brief Description of the Service: Alnwick Road is a care home for six adults with severe learning difficulties that first registered in 1994. The home is divided into three self-contained flats, the largest of which also accommodates staff and administration offices. The exterior of the building is in keeping with the surrounding properties. The home is situated in Custom House, close to public transport and other amenities. Presently there are four residents at the home. On the day of the inspection the range of fees for the home was between £1859.69 and £1895.81 per week. Alnwick Road (4) DS0000066795.V354137.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This is the first announced inspection for the year 2007/2008. This inspection was facilitated by a Development Supported Living Manager who is overlooking the transition of the service from residential care to supported living. Presently the home is in the process of cancelling their registration. Various records were looked at as well as staff files for the three care workers employed. All registered adult services are now required to to fill in an annual quality assurance assessment (AQAA) .It is a self-assessment that the provider (owner) must complete every year. The completed assessment is used to show how well the service is delivering good outcomes for the people using it. Some of the residents were spoken to, however as some of them are not able to express themselves verbally it was difficult to seek their views regarding the care and support they receive. One resident stated, “They are good to me”. Observation of the staff team interacting with the residents showed that the carers were mindful how they addressed residents, and they were seen to be polite and friendly. A tour of the building was also carried out. They are all thanked for their time and all of those who provided feedback for their support in the inspection process. What the service does well: The home was evidenced to have appropriate assessments and care plans in place. Generally healthcare needs are monitored and the home liaises with a range of health care professionals in meeting individual needs. There are good opportunities for the residents to maintain contact with their families and friends. Residents were observed to be treated with respect by staff and to have their privacy and dignity respected. The home encourages residents to make decisions about all aspects of their lives; this includes what to eat, where to go on holiday, for days out, and what clothes to buy. The home has a medication policy which is accessible to staff, medication records are generally up to date for each resident and medicines received, administered and disposed of are recorded. Alnwick Road (4) DS0000066795.V354137.R01.S.doc Version 5.2 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Alnwick Road (4) DS0000066795.V354137.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 Alnwick Road (4) DS0000066795.V354137.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 People using this service experience adequate quality outcomes in this area. There have been no admissions since the last inspection when it was identified that potential residents could not be sure their care needs would be met., as they were not always assessed by the home prior to their admission. EVIDENCE: Since there has not been any new admission to the home it was difficult to assess this standard fully. At the last insppection it was assessed as adequate as not all potential residents care needs were assessed by the home prior to their admission. Alnwick Road (4) DS0000066795.V354137.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Generally residents’ care plans include detailed information about their needs and personal goals. This helps staff to know the residents’ needs and how to meet them. EVIDENCE: Staff understand the importance of residents being supported to take control of their own lives. They are trying to establish a very positive way of communicating with the residents based on their invented mode of communication. A pictorial Care Plan and Person Centred Plan has been introduced. An accessible format for a Health Action Plan has also been introduced. This will facilitate the smooth transition into the Supported Living Scheme being proposed. The plan is written in plain language, is easy to understand and looks at all areas of the individual’s life. The plans are reviewed and updated to reflect changes in the individuals needs or wishes. Alnwick Road (4) DS0000066795.V354137.R01.S.doc Version 5.2 Page 10 Residents are continually consulted on how the service runs. As some of the residents cannot communicate verbally, the home has introduced pictures to enable them to participate fully in these meetings. An individualised guideline on working with each individual has been provided. Each care plan includes a risk assessment, which is reviewed regularly. This is in line with a requirement made at the last inspection. Management of risk is positive addressing safety issues whilst aiming for better quality of life. Where limitations are in place, the decisions have been made with the person and are recorded. Alnwick Road (4) DS0000066795.V354137.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are being provided with a range of opportunities for recreational and social activity that is in accord with their social, cultural and religious needs. They are assisted to maintain contact with family and friends, and links with the local community are encouraged. Dietary needs are well catered for and a well balanced diet is provided, to ensure health and enjoyment of food. EVIDENCE: Central to the home’s aims and objectives is the promotion of the individual’s right to live an ordinary and meaningful life, both in the home and in the community appropriate to their peer group, and to enjoy all the rights and responsibilities of citizenship. The home understands the importance of enabling younger adults to achieve their goals, follow their interests and be Alnwick Road (4) DS0000066795.V354137.R01.S.doc Version 5.2 Page 12 integrated into community life and leisure activities in a way that is directed by the person using the service. The home has a strong commitment to enabling people who use services to develop their skills, including social, emotional, communication, and independent living skills. People who use services are involved in meaningful daytime activities of their own choice and according to their individual interests and capability. People who use the service have the opportunity to develop and maintain important personal and family relationships. The practice of staff promotes individual rights and choice, but also considers protection of individuals, supporting people to make informed choices. Family members are periodically invited for parties, birth days etc. The home actively supports people who use services to be independent and involved in all areas of daily living in the home. This includes where appropriate, taking responsibility for shopping and planning meals. Some of the residents were spoken to however as some of them are not able to express themselves verbally it was difficult to seek their views regarding the care and support they receive. One resident stated, “They are good to me”. The meals are balanced and nutritional and cater for the varying cultural and dietary needs of the individuals using the service. The residents contribute to the planning and preparation of meals through the introduction of individual menu - Pictorial Format and objects of reference. Alnwick Road (4) DS0000066795.V354137.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Generally the arrangement for health care needs of the residents is good and they receive personal support in the way they prefer. EVIDENCE: The delivery of personal care is individual, flexible and person centred. Staff respect the privacy and dignity of the residents and are sensitive to their changing needs. Where needed, guidance and support regarding personal hygiene is provided. People who use services have access to health care services both within the home and in the local community. Generally health needs are monitored and appropriate action and intervention taken. The home has a medication policy which is accessible to staff, medication records are generally up to date for each resident and medicines received, administered and disposed of are recorded. A refresher course on medication course for staff remains outstanding and therefore this requirement will be Alnwick Road (4) DS0000066795.V354137.R01.S.doc Version 5.2 Page 14 repeated.During this inspection it was noted that a prescribed medication (Balneum Plus Bath Oil) was left unattended and unlocked in one of the bathrooms. All prescribed medication in the custody of the home must be kept locked in accordance to the requirements of the Medicines Act 1968, guidelines from the Royal Pharmaceutical Society and the requirements of the Misuse of Drugs Act 1971. The allergies of the residents must also be recorded on either their medication profiles or on their medication records. Alnwick Road (4) DS0000066795.V354137.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are generally managed well, which should ensure that residents’ and relatives’ concerns are listened to. EVIDENCE: The home has a complaints procedure that is clearly written and easy to understand. The procedure is also available in picture format. The home keeps a full record of complaints and this includes details of the investigation and any actions taken. Policies and procedures regarding Safeguarding Adults are available to staff and give them clear guidance about what action should be taken. People using the service and/or their representatives are made aware of what abuse is and the safeguards in place for their protection should they need them. Access to external agencies is actively promoted. The Development Supported Living Manager stated that all staff have had abuse awareness training. Alnwick Road (4) DS0000066795.V354137.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment does not always meet the residents’ needs however there is a rolling programme in place to improve the decoration, fixtures and fittings and general environment. EVIDENCE: A number of requirements were made at the last inspection regarding the environment, some of them have been met while others remain outstanding and will be repeated. The Development Supported Living Manager stated the whole building would be redecorated by March 2008. The home was kept clean and free from offensive odours during the tour of the premises. However there were chemicals left unlocked in the kitchen (see standard 42). Alnwick Road (4) DS0000066795.V354137.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 and 36 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff numbers are of sufficient quantity to meet the residents’ needs and provide consistency and to ensure their safety. However care staff are not receiving supervision on a regular basis, which might impact on the standards of care being provided to residents. EVIDENCE: There are consistently enough staff available to meet the needs of the people using the service. The staffing structure is based around delivering outcomes for the people using the service. The Development Supported Living Manager stated that all staff working at the home hold a NVQ 2 qualification in care. It was previously required that the Registered Person must ensure that current CRB checks are obtained for all staff, two satisfactory references must be obtained prior to an appointment being made and all records required by regulation must be available for inspection. During this inspection three staff files were sampled and they did not have all the documents as per schedule 2 Alnwick Road (4) DS0000066795.V354137.R01.S.doc Version 5.2 Page 18 of the National Minimum Standard. One staff’s file was not available in the home at the time of this inspection. Therefore this requirement remains outstanding and will be repeated. Staff files must contain all relevant documentations as per schedule 2 of the revised Care Homes Regulations 2001 for the delivery of good quality services and for the protection of residents. Standard 35.From staff records sampled at random, it was very difficult to ascertain if the staff were up to date with their training, however some certificates were seen. This standard was not assessed in full and therefore would not been rated on this occasion. This would be checked in more depth at the next inspection as the records were being updated. Three staff supervision records were sampled and it was noted that they were not having supervision on a regular basis. Formal supervision sessions must be held with all care staff at least six times a year for the delivery of good quality services. This was a requirement at the last inspection and will be repeated. Alnwick Road (4) DS0000066795.V354137.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are shortfalls in the management of health and safety in the home, which could impact on the welfare and safety of residents and staff. EVIDENCE: Since the last inspection the registered manager has been made redundant and presently a Development Supported Living Manager is overlooking the transition of the service from residential care to supported living. In the meantime the registered provider must ensure that the home is run in the best interests of the residents and work to the basic processes set out in the NMS. The Development Supported Living Manager informed that they are introducing monthly meeting for each resident where they will be able to comment on the Alnwick Road (4) DS0000066795.V354137.R01.S.doc Version 5.2 Page 20 care they are being provided. The meeting will involve all the people involved in caring for the resident. Three health and safety issues arose during this inspection and they were as follows: -Two fire doors were wedged open and two fire doors were not closing fully. Fire doors must not be wedged open unless held open by a magnetic door holder that responds to the fire warning system for the safety of staff and residents. This is very concerning to the Commission as the safety of staff and residents are being compromised. - COSHH materials were left unlocked in the kitchen. Again this is very concerning to the Commission due to some residents’ cognitive abilities. All COSHH materials must be kept locked in accordance to Control of Substances Hazardous to Health Regulations (COSHH) 1999 for the safety of staff and residents. - The hot water cylinder cupboard was unlocked and there were a number of objects stored on top of the cylinder itself, which might be a fire risk. The hot water cylinder cupboard must be kept locked at all times for the safety of residents. Actions were taken on the day of the inspection to rectify the above three requirements. Certificates relating to health and safety were up to date servicing certificates. Records are of a good standard and are routinely completed. Alnwick Road (4) DS0000066795.V354137.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 X 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 2 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 X 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 X 3 X 3 X X 1 X Alnwick Road (4) DS0000066795.V354137.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 YA20 Regulation Requirement Timescale for action 29/01/08 2. YA20 3. YA20 4. YA24 12,13,17,S3 All prescribed medication in the custody of the home are now being kept locked in accordance to the requirements of the Medicines Act 1968, guidelines from the Royal Pharmaceutical Society and the requirements of the Misuse of Drugs Act 1971. 12,13,17,S3 The allergies of the residents 04/02/08 must be recorded on either their medication profiles or on the medication records. 12,13,17,S3 Staff must receive refresher 29/02/08 medication training that should include an element of assessment of their capabilities to administer medication. (Previous timescale of 30/09/07 not met). 23 The following maintenance 31/03/08 works must be carried out: In the three bed house: The damaged kitchen work surface should be replaced. In the two bed flat: Alnwick Road (4) DS0000066795.V354137.R01.S.doc Version 5.2 Page 23 Damaged kitchen work tops should be replaced. (Previous timescale of 30/09/07 not met). Staff files must contain all relevant documentations as per schedule 2 of the revised Care Homes Regulations 2001 for the delivery of good quality services and for the protection of residents. (Previous timescale of 30/06/07 not met). Staff must receive regular supervision sessions, at least six times per year. (Previous timescale of 30/06/07 not met). Fire doors must not be wedged open unless held open by a magnetic door holder that responds to the fire warning system for the safety of staff and residents. COSHH materials must be kept locked in accordance to Control of Substances Hazardous to Health Regulations (COSHH) 1999 for the safety of staff and residents. The hot water cylinder cupboard must be kept locked at all times for the safety of residents. 5. YA34 19 & Sch2 29/02/08 6. YA36 18 31/03/08 7. YA42 13(4) 29/01/08 8. YA42 13(4) 29/01/08 9. YA42 13(4) 29/01/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Alnwick Road (4) DS0000066795.V354137.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Alnwick Road (4) DS0000066795.V354137.R01.S.doc Version 5.2 Page 25 - 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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