Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 11/11/08 for Bedford Road 7

Also see our care home review for Bedford Road 7 for more information

This inspection was carried out on 11th November 2008.

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

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Random inspection report Care homes for adults (18-65 years) Name: Address: Bedford Road 7 7 Bedford Road London London N15 4HA one star adequate service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Susan Shamash Date: 1 1 1 1 2 0 0 8 Information about the care home Name of care home: Address: Bedford Road 7 7 Bedford Road London London N15 4HA 02088002864 02088002864 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : HAIL (Haringey Association for Independent Living Limited) care home 6 Number of places (if applicable): Under 65 Over 65 0 0 learning disability physical disability Conditions of registration: 6 6 The Registered Person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD Physical Disability - Code PD The maximum number of service users who can be accommodated is: 6 Date of last inspection Brief description of the care home Bedford Road is a home registered to provide residential care to six people who may have learning disability or physical disability. The building is provided by Circle 33 Housing Association and the services are provided by Haringey Association for Independent Living (HAIL). The home is located in a residential area close to the Seven Sisters Underground and shopping facilities. There are six single bedrooms, three bathrooms/showers and three toilets. There is a lounge, a kitchen, a dining room and a Care Homes for Adults (18-65 years) Page 2 of 13 Brief description of the care home large garden at the rear of the building. The ground floor of the home is wheelchair accessible even though the current people living at the home do not require this. The home has stated objectives of enabling people to live as independently as possible, with the same range of choices as any other citizen, mixing as equals with others and being members of their own community. Information about the home is including in the homes brochure and the CSCI inspection reports are available from the home by contacting the provider or from the CSCI website - www.csci.org.uk. The weekly fees of the home depend on peoples assessed needs, but the average weekly fee is 1053.44GBP as of July 2008. Care Homes for Adults (18-65 years) Page 3 of 13 What we found: This unannounced inspection was carried out as a routine key standards inspection of the home and lasted approximately five hours from 3pm to 8pm. The deputy manager was not available at the time of the visit, but I was assisted by three staff members on duty that afternoon. Most of the residents were out during the day, when I commenced the visit, but returned to the home later during the inspection. I had the opportunity to talk with and spend time with all people living at the home and spoke to three staff members independently. The inspection also included a tour of the building, assessment of three peoples care files, staff training files, health and safety records, rotas and menus and medication administration records. Information provided in the Annual Quality Assurance Assessment for the home was also taken into account as part of this inspection. I spoke to the deputy manager by phone after the visit to confirm information obtained during the visit. No new people had been admitted to the home since the previous inspection (Standards 1-5 were therefore not inspected). Three peoples care files were inspected in detail and these were found to take account of cultural needs and lifestyle choices indicating how these needs were being met. Care plans and risk assessments were generally being reviewed at least six-monthly and indicated consultation with families and representatives regarding support provided. The home continues to operates a key working system and key workers produce a monthly summary of significant events and activities for people living at the home. Although more accessible person centred plans had been developed for each person, these were not always complete, and were in need of regular review - particularly with regard to specific goals set. Care plans and risk assessments clearly specified any restrictions placed on service users. Discussion with staff members made it clear that the home encourages people to realise their potential by adopting suitable methods of supporting each individual. I observed staff treating people living at the home with respect, maintaining their privacy, dignity and respecting their cultural and lifestyle choices whilst supporting them with personal, social and emotional care. All the people who live at the home attend day services on the majority of weekdays including such activities as drama, swimming, cinema, museum and trips to other places of interest. From their personal files and documents it was evident that the home liaises with day centres, and that staff support people to attend other activities within the local community. Staff advised that people at the home continue to be involved in a wide range of activities during the day. Only one resident had been on a holiday this year, with an external organisation, and the deputy manager advised that no holidays for other residents had yet been booked. One person had wanted to travel abroad, however it Care Homes for Adults (18-65 years) Page 4 of 13 was not clear whether this project will be financially viable. Other activities recorded in residents files included regular massages, bowling, cycling, playing football in the park, trips to local parks, a social club, pub and restaurant visits and shopping trips. At the previous inspection I was concerned to see that several routine activities planned for people particluarly in the evenings and weekends within the local community, were being cancelled due to insufficient staff support. At the current visit, staff spoken to, indicated that there were now less problems of insufficient staffing, and that they were planning more activities with people living in the home. However inspection of daily records for people living at the home did not confirm an improvement in this area. The deputy manager advised that she is currently taking action to address this issue. Discussions with members of the staff team and an examination of care plans indicated that people living at the home enjoy visits by and to family and friends. My observations of people living at the home showed that they were very relaxed and comfortable within the home accessing communal areas as they wished. Staff continue to encourage residents to be as independent as possible and showed patience and awareness of peoples abilities and preferences throughout the shift. The home has a four weekly rotating menu. The pictorial menu that is usually displayed in the dining room, was temporarily unavailable due to one resident taking it down, and new more secure notice boards had been provided instead for this purpose. I noted that people appeared to enjoy the evening meal served at the home, and that the mealtime atmosphere was pleasant and unrushed. The home was well stocked with food including fresh fruit and vegetables, and people living at the home indicated that they enjoyed the food provided. However although staff were aware of peoples preferences, including cultural alternatives such as curries and West Indian foods, there was no clear record of which meals were eaten by which residents. This is required to evidence that peoples cultural and nutritional needs are met. I observed all residents being treated with respect by staff members, and it was clear that trusting relationships had been formed between staff and residents. There was not a great deal of interaction between residents and staff members during the evening of my visit, however residents appeared comfortable and relaxed, and their physical needs were met appropriately. It was clear from discussion with staff and an assessment of the homes diary and peoples files that people living at the home are supported to see healthcare professionals such as general practitioners, dentists, opticians and chiropodists on a regular basis. As required at the previous inspection, more regular records were available of peoples weights, and any significant changes were noted, so that appropriate action might be taken if necessary. The home monitors and records the temperature of the area where medicines are kept on a daily basis as appropriate. Medication administration records were complete with no gaps indicating that people had been receiving their medicines appropriately, and I observed medicines being administered to one resident, in an appropriate manner. Medicines were also being signed in and out of the home as required. Care Homes for Adults (18-65 years) Page 5 of 13 However clearer directions are needed regarding the administration of PRN (as and when) medicines, rather than as directed. One medicine prescribed as when required was being given nightly, and this should be reviewed with the persons GP. There remains a need for discontinued medicines to be removed from medication administration records to avoid confusion. Copies of staff training certificates in the Protection of Vulnerable Adults were available in the training file for the home. Staff spoken to confirmed that they had undertaken this training and were aware of action to be taken in the event of a disclosure or suspicion of abuse. They confirmed that they have read the homes policies including the whistle blowing policy. There is also a copy of the placing authoritys adult protection policy and procedure within the home. The carpet in the hallways and stairways of the home had been replaced, however there appeared to be some issues regarding the quality of the carpet with parts of the carpet worn away after just a few weeks. Staff and the deputy manager confirmed that the company responsible would be replacing this carpet atributing the problem to a faulty batch. The home was generally clean and tidy, and appropriately furnished, making it comfortable for staff and residents. All bedrooms were personalised appropriately, and the kitchen and other facilities were well equiped. As required at the previous inspection, a new armchair had been provided in an identified persons bedroom, and the extractor fan in the ground floor toilet had been repaired. Hand-drying facilities had been installed in the toilet rooms. There are handrails in the corridors, adaptations in bathrooms, toilets, and shower rooms and the radiators are guarded. Staff confirmed that issues with the hot water supply to the home had been addressed, although this had taken some time. However the central heating in certain areas in the home (including the lounge, and the first floor bathroom) was not sufficiently warm to meet the needs of people living at the home. The housing association had provided plug-in heaters which were being used in these areas, so that residents did not experience discomfort. Three full clinical waste bins were stored in the ground floor toilet room, which is a warm and humid room. It is recommended that the clinical waste contractors be contacted to see whether provision might be made to store this externally, or more frequent collections might be arranged, to promote better infection control procedures. I spoke to three staff members including two new staff members, and I observed staff interacting sensitively with people living at the home. Discussion with them indicated that they are very aware of peoples needs and that the staffing numbers provided within the home had improved since the previous inspection. This was confirmed by the current rota, which I examined. It was not possible to inspect individual staff files, as the deputy manager was not Care Homes for Adults (18-65 years) Page 6 of 13 present during the inspection. However I was able to inspect training certificates for eight staff members who work at the home. These indicated that a wide range of training had been undertaken including relevant learning disabilities training, protection of vulnerable adults, medication, health and safety, manual handling, risk assessment, communication awareness, fire safety, food hygiene and first aid training. A large proportion of staff had undertaken or were undertaking relevant NVQ qualifications. Following the previous inspection enforcement action was taken regarding the provision of training updates in food hygiene, first aid to ensure that these qualifications are current for the safety of people living at the home. Records showed further training in these areas and the deputy manager confirmed further training dates books for people to undertake updates in these areas. Staff advised that they attend regular meetings, and this was confirmed by records maintained. Supervision records indicated that staff are now having one-to-one supervisions sessions on a monthly basis. Staff and the deputy manager confirmed that this high frequency of sessions are useful, particularly whilst there is no registered manager. Staff members spoken to advised that they generally felt well supported, but were concerned that there was no full time manager for the home. The previous registered manager for the home has left employment with HAIL. Staff and the deputy manager advised that it had been very difficult managing without a full time manager for the home. The deputy manager is only able to work on three days weekly, and previous support provided by another project manager on the other two days has also now been withdrawn. No successful candidates had been selected from HAILs latest recruitment. This issue must be addressed without delay in the interests of people living at the home. Records maintained at the home indicated that unannounced visits undertaken on behalf of the provider organisation had been undertaken in the months since the previous inspection, however they did not appear to be happening in the last month following the previous person responsible leaving the organisation. The Annual Quality Assurance Assessment, had been completed and returned to the CSCI as appropriate. However no other quality assurance audit appeared to have been undertaken by the provider organisation. A quality assurance audit must also be undertaken for the home including feedback from all stakeholders. Gas safety certificates, and portable appliances testing certificates were available for the home as appropriate. In response to a requirement made at the previous inspection, Code 1 faults found on the most recent electrical installation certificate for the home had been addressed. Records indicated that there are regular fire drills as required, including drills at different times of the day. Records showed that there had generally been regular weekly fire alarm call point tests, however there were some gaps in the records from the last few weeks. The frequency of fire alarm testing must be addressed as a matter of urgency for the protection of people living and working at the home. A warning letter was sent regarding this at the previous inspection, failure to address this issue may result in enforcement action being taken to ensure compliance in this area. Care Homes for Adults (18-65 years) Page 7 of 13 What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 8 of 13 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action 1 17 16(2i) The registered persons must 11/07/2008 ensure that clearer records are maintained of meals served to individual people living at the home, to ensure that their cultural and nutritional needs are met. The registered persons must 04/07/2008 ensure that weekly fire alarm tests are carried out without any gaps, for the protection of people living and working at the home. (Previous timescales of 17/08/07 and 11/01/08 not met). Failure to comply with the requirement may result in enforcement action being taken against the home. 2 42 23(4c(v)e) Care Homes for Adults (18-65 years) Page 9 of 13 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 15 The registered person must ensure that the Person Centred Plans for each resident are complete and that these are reviewed regularly with particular regard to goals that are set, to help people to meet their aspirations. . 30/01/2009 2 12 16 The registered person must ensure that a greater selection of activities, including more trips outside of the home at weekends and in the evenings, are provided to residents according to their preferences. . 19/12/2008 3 17 16 The registered persons must 12/12/2008 ensure that clearer records are maintained of meals served to individual people living at the home, to ensure that their cultural and nutritional needs are met. . Care Homes for Adults (18-65 years) Page 10 of 13 4 20 13 The registered persons must 19/12/2008 ensure that discontinued medications are removed from medication administration records and that clear written guidelines are in place regarding administration of PRN (as and when) medicines to ensure that peoples medication needs are met safely. . 5 24 23 The registered person must ensure that the central heating system within the home is fit for purpose to ensure a comfortable temperature in all areas of the home. . 12/12/2008 6 37 9 The registered person must 30/01/2009 ensure that a new full time manager is recruited for the home and registers with the CSCI. Until this is achieved full time management arrangements must be put in place for the home. . 7 39 24 The registered person must 27/02/2009 ensure that a quality assurance audit is undertaken for the home including feedback from all stakeholders, with the results of this sent to the CSCI, to ensure that the home is run in the best interests of residents. Failure to comply with this requirement may result in enforcement action being taken against the home. Care Homes for Adults (18-65 years) Page 11 of 13 . 8 39 26 The registered person must 19/12/2008 ensure that following the departure of the previous individual responsible, unannounced visits are undertaken to the home by a representative of the provider organisation on a monthly basis to ensure the quality of services provided to people living at the home. . 9 42 23 The registered person must 13/12/2008 ensure that weekly fire alarm tests are carried out without any gaps, for the protection of people living and working at the home. Failure to comply with the requirement may result in enforcement action being taken against the home. . Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 30 It is recommended that enquiries be made regarding the possibility of having an external clinical waste bin for the home, or more frequent clinical waste collections, to avoid storing large amounts of clinical waste within the home and to provide better infection control. Care Homes for Adults (18-65 years) Page 12 of 13 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 13 of 13 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!