Inspection on 22/02/06 for Amersham Park House

This inspection was carried out on 22nd February 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 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Amersham Park House 13/04/09

Amersham Park House 17/04/07

Amersham Park House 19/10/04

Amersham Park House 05/05/04

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

CARE HOME ADULTS 18-65 Amersham Park House 111 Amersham Road Harold Hill Romford Essex RM3 9JA Lead Inspector Joanna Moore Unannounced Inspection 22nd February 2006 09:30 Amersham Park House DS0000027881.V285771.R01.S.doc Version 5.1 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 Amersham Park House DS0000027881.V285771.R01.S.doc Version 5.1 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. Amersham Park House DS0000027881.V285771.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Amersham Park House Address 111 Amersham Road Harold Hill Romford Essex RM3 9JA 01708 704963 01708 704963 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) Mrs Lynne Griffin Mr Darren Griffin, Mr Robert Finlayson Mrs Lynne Griffin Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Amersham Park House DS0000027881.V285771.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th September 2005 Brief Description of the Service: Amersham Park is a home registered to provide care and support for three people with learning disabilities with overlying mental health problems. The home at the time of the inspection had one vacancy. The house is situated in a residential area of Harold Hill close to local shops and transport routes. Accommodation is spread over three floors with the office, one toilet and one bedroom being situated on the top floor. The building is well maintained and service users are encouraged to become involved in day-to-day chores and the maintaining of the rear garden. Both the manager and deputy are also registered proprietors in respect of the home and work at the establishment on a daily basis as part of the staff team. Amersham Park House DS0000027881.V285771.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out as part of the inspection program and took place over 2.5 hours. On the day of the inspection both service users were at the home and the inspector spent about half the inspection talking to both of them and the staff on duty. What the service does well: What has improved since the last inspection? The home continues to work hard to meet and exceed the national minimum standards. Amersham Park House DS0000027881.V285771.R01.S.doc Version 5.1 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. Amersham Park House DS0000027881.V285771.R01.S.doc Version 5.1 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 Amersham Park House DS0000027881.V285771.R01.S.doc Version 5.1 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): The home is required to have a clear, signed service user contract in place. EVIDENCE: The above standards were assessed as met at the last inspection other than standard 5. A signed service user contract in line with standard 5 could not be located at this inspection and therefore this requirement remains outstanding. The standards were not assessed again at this inspection. Amersham Park House DS0000027881.V285771.R01.S.doc Version 5.1 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): 6,7,8,9 &10 Service users needs are clearly detailed in a care plan and known to staff. Service users are consulted in all aspects of their care and the running of the home. Service users are supported in decision making and taking appropriate risks within their daily lives. EVIDENCE: The care plan viewed was comprehensive setting out mental health, social and leisure needs. The service user advised the inspector that they were involved in the development of the care plan and fully agreed its contents. The placing authority had reviewed the care plan. Amersham Park House DS0000027881.V285771.R01.S.doc Version 5.1 Page 10 Risk assessments were in place and regularly reviewed and updated. The service users advised the inspector that they were consulted on all aspects of their care and that their rights were maintained at all times. The service users confirmed that they were able to make decisions regarding their food, activities and personal care. The service users stated that they were encouraged to participate in all household tasks. Service users were recorded as being offered keys to their bedrooms and the front door and sign to say that these have been accepted or declined. One service user was subject to a cigarette limitation program which effectively meant that they were allowed only one cigarette an hour as they would continually smoke one after another and would suffer immediate health problems as well as long term issues. This had been discussed with the service user and social worker and was documented on the care plan. Records were held securely and confidentially. Amersham Park House DS0000027881.V285771.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16 &17 Service users benefit from a service, which operates according to their choices including leisure and dietary needs. Service users are encouraged and supported in maintaining and developing relationships with their family and friends. EVIDENCE: One service user who has been at the home for just over a year leads a very active life. They regularly enjoy a manicure and nail paint, attend a variety of clubs, attend college two days a week and aerobics once a week. In addition to this they go shopping almost everyday often having lunch or coffee in a particular café. The other service user has over the years been offered many opportunities to take part in formal clubs and college sessions but is adamant that they do not want to do this. This service user says they prefer to just relax. They do however visit the shops almost daily and are involved in doing the household shopping. The service user also visits their local café almost daily, which for them is a great social thing. The home has responded to this and the service user’s small appetite at the home, by paying for their meals at the café. This service user said they liked the café because they had many friends there and they can watch the world go by. One service user had an Amersham Park House DS0000027881.V285771.R01.S.doc Version 5.1 Page 12 active time at Christmas attending a variety of parties and the pantomime, which they said they greatly enjoyed. Service users have very different interests but this appears to work very well within the home with each being supported individually. The service users appear to have developed a friendship based on mutual respect and get on well together which is essential in a small home such as this. One service user said they went home to their family for Christmas but said that the staff at Amersham Park had made the house really nice and decorated it festively. Both the service users said they liked the food very much at the home. One said they liked pie and mash the other said they liked it when BOB cooked as “he makes curries and Chinese”, which she particularly enjoyed. Amersham Park House DS0000027881.V285771.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 &19 Service users receive personal support in the way they prefer. Service users healthcare needs are effectively met. EVIDENCE: The service users said they were happy with the way personal care was provided. As staff are working on their own there are clear guidelines in one service users file that personal care should not be given to the service user by male staff. In reality both service users are able to wash and dress themselves but need assistance with washing hair and showering. Records showed that support was provided by a variety of professionals such as the psychiatrist, GP, Community psychiatric nurse, dentist and chiropodist. It was evidenced through the care records that well women checks had taken place as had audiology and dental checks. Where any concern had arisen regarding service users health this had been referred to the gp/ hospital. Staff comments included” this is a really nice place. The residents are treated well and if I had a family member then this would be somewhere I would be happy to have them live.” Amersham Park House DS0000027881.V285771.R01.S.doc Version 5.1 Page 14 Medication was assessed as satisfactory at the last inspection and was not assessed as part of this inspection. Amersham Park House DS0000027881.V285771.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 Service users feel their views are listened to and acted upon. EVIDENCE: Both service users said they were happy at the home and said “they had no complaints”. The home in the past two years has received no complaints regarding the care of the service users. Any complaints have been from neighbours in relation to noise or service users behaviour but such complaints are rare and the home feels it maintains good relationships with its neighbours. Service users said that they felt they could complain to Lyn (manager) or Bob (deputy) if they were unhappy about anything. A complaints procedure is in place. Protecting service users from harm was assessed as satisfactory at the last inspection and no concerns have arisen, this standard was not assessed as part of this inspection. Amersham Park House DS0000027881.V285771.R01.S.doc Version 5.1 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, 25,26,27,28,29 &30 Service users live in a homely, safe, and well-maintained home that meets their needs. EVIDENCE: Spatial requirements per service user are exceeded. The premises were safe, welcoming, homely, well decorated and comfortably furnished. A fan is provided in the lounge, in an attempt to introduce fresh air into what can become a rather smoky room. A conservatory is in the finishing stages, which it is hoped will improve living arrangements for service users, as the intention is that it will become a designated smoking area. Service users were very keen and said that they were going to help choose the furniture. The home is located near to local shops, leisure facilities and transport routes to Romford, London and Essex. The home is situated five minutes drive from the A12/ M25. Each service user has a single room, which have previously been seen to be individually decorated and furnished according to their choice. Bedrooms were not viewed as part of this inspection. All rooms have a lockable bedroom door with an override device. One bathroom and one shower room both of which include a toilet are available for service users. All bedrooms are provided with a wash hand basin. The premises were safe, welcoming, well Amersham Park House DS0000027881.V285771.R01.S.doc Version 5.1 Page 17 decorated and appropriately furnished. The building consists of a lounge, kitchen/ diner, three bedrooms, two bathrooms and office. The house is a normal family type dwelling which has had the loft area converted to give an office area, bedroom and the second bathroom. The garden to the rear was attractively set out and well maintained. The front provided parking for two cars. The establishment was found to be clean, well maintained and odour free. The deputy manager advised the inspector that a conservatory is to be built by April 2006 to enhance service users living areas. The laundry area is situated in the kitchen, which the environmental health department has confirmed is satisfactory. A control of infection policy and procedure have previously been found to be in place. The premises were last inspected by the Environmental Health Officer for food safety in July 2005 and health and safety in August of 2002 and found to be satisfactory. One service users room was visited with their permission and this was decorated according to their tastes and gave a real sense of her personality by displaying photos and her art and needlework, which she enjoys. This room also had lost of bits and pieces such as nail varnishes which made it feel comfortable and “lived in”. Amersham Park House DS0000027881.V285771.R01.S.doc Version 5.1 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): 32,33&35 Service users benefit from familiar and competent staff who are clearly able to meet their needs. Staff and service users benefit from a commitment to staff training. EVIDENCE: The minimum staffing level for the home is one staff 24 hours per day however on most days a second member of staff or manager is available to facilitate taking service users out. The staff interviewed said that they had undertaken NVQ level 2 training in care and that they were looking at doing level 3. They had undertaken training in first aid, health and safety, food hygiene, adult protection, abuse awareness. An epilepsy awareness course was booked for the following week. In house medication training had been given as part of their induction but an outside trainer was planned to provide further training. This staff said that the proprietors were committed to keeping staff up to date and provided a variety of training opportunities. In discussions with staff and service users the inspector was satisfied that the levels of staffing reflect service users needs and supported them to undertake a wide variety of activities and live fulfilling lives. Staff clearly were familiar with the needs and personalities of the two service users and worked closely with them to help them undertake tasks and make decisions. Amersham Park House DS0000027881.V285771.R01.S.doc Version 5.1 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): Service users and staff benefit from clear management of the home. Service users and staff are provided with a safe and pleasant environment in which to live and work. EVIDENCE: The manager has a Diploma in Health and Social Care and has completed the Registered Managers Award. Both the manager and the deputy are registered persons in control of the home and have over ten years experience working with the client group. Statutory records viewed were satisfactory these included the visitor’s book, complaints record, accident book, fire records, building safety certificates, service users assessments and care records and service users finances. Portable appliances were last tested in June 2005. The electrical safety certificate was issued in 2001 and remains valid. The gas safety certificate was issued in February 2005 and remains valid. The home has a system of wired in smoke detectors without a central control panel this is serviced annually in line with fire prevention guidance. Amersham Park House DS0000027881.V285771.R01.S.doc Version 5.1 Page 20 Fridge freezer temperatures are recorded on a daily basis. One service user has their benefits paid into the bank and the post office card scheme is used. The security arrangements for this gave the inspector some concern. The home has reviewed the security arrangements since the inspection. The cash held was audited against the records of income and expenditure and found to be accurate. Receipts were held to evidence all expenditure incurred. The accident book recorded one accident and one incident in the past six months. Staff comments included: “this is a very good place to work, Lynn and Bob are very accessible and will sort out any issues. It’s a very friendly place. Lynn and Bob are keen on training for all staff. Put it this way I’m not leaving.” Service user meetings are held every two months, these are not pre-planned but held according to service users mental health status on that day. One to one discussions with service users are held daily and there a high percentage of the working day is spent with service users talking with them. Issues discussed are key to the day-to-day running of the home such as staffing, menus and activities. The home does not have a quality audit system in place. It is required that the home develop a formal quality assurance system in line with regulation 24. It may be useful for the home to look at the ways it already obtains feedback from service users, relatives and professionals on the quality of service and incorporate these informal feedback opportunities into a system of formally reviewing the quality of the home. Amersham Park House DS0000027881.V285771.R01.S.doc Version 5.1 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 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 X ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 X 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X x 3 3 2 3 3 3 x Amersham Park House DS0000027881.V285771.R01.S.doc Version 5.1 Page 22 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA5 Regulation 5 Requirement It is required that the home signs the service user contract and requests that the service user sign it. This is a repeated requirement previous timescale 01/11/05 It is required that the home develop a formal quality assurance system in line with regulation 24. Timescale for action 01/04/06 2 YA39 24 01/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Amersham Park House DS0000027881.V285771.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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 Amersham Park House DS0000027881.V285771.R01.S.doc Version 5.1 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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