Inspection on 19/05/06 for Bedford Road 7

This inspection was carried out on 19th May 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bedford Road 7 11/11/08

Bedford Road 7 10/06/08

Bedford Road 7 16/07/07

Bedford Road 7 12/01/06

Bedford Road 7 29/11/05

Bedford Road 7 13/09/04

Bedford Road 7 26/04/04

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 Bedford Road 7 London N15 4HA Lead Inspector Mr Teferi Degeneh Key Unannounced Inspection 19th and 22nd May 2006 11:00 Bedford Road 7 DS0000010716.V291388.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 Bedford Road 7 DS0000010716.V291388.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. Bedford Road 7 DS0000010716.V291388.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Bedford Road 7 Address London N15 4HA 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) 020 8800 2864 020 8800 2864 bedfordrhailltd@btinternet.com HAIL (Haringey Association for Independent Living Limited) Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places Bedford Road 7 DS0000010716.V291388.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Limited to 6 people of either gender who have a learning disability (LD) and who may also have a physical disability (PD) 12th January 2006 Date of last inspection Brief Description of the Service: 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 are a lounge, a kitchen, a dining room and a large garden at the rear of the building. The ground floor of the home is wheelchair accessible even though the current service users do not require this. The home has stated objectives of enabling service users 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 including service users’ guide and the CSCI Inspection reports are available from the home by contacting the provider. The weekly fees of the home depend on the assessed needs of service users but currently the average weekly fee is £1053.54. Bedford Road 7 DS0000010716.V291388.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on two days, 19th and 22nd May 2006. The inspection on the 19th May was unannounced and the activities undertaken included the assessment of service users’ files, health and safety records, rotas and menus. Ms Dawn Kelly was available throughout this inspection. The inspection on the 22nd Ma May was announced to ensure that an assistant Manager would be on shift and the keys to the filing cabinet containing the staff files would be available. The activities on this day included the inspection of medication cabinets, staff files and discussion with the staff. The premises were also inspected on both days. What the service does well: What has improved since the last inspection? What they could do better: Five requirements have been made. Two of these, which are restated, are the need to ensure that there are hand-drying facilities in toilet rooms and the need for the registered person to employ a manager who can apply for registration by the Commission for Social Care Inspection. The registered person must take appropriate action to ensure that medication is administered and recorded without delay. The keys to the medication cabinet must remain in the home at all times. All staff employed at the home must have a satisfactory CRB check and evidence must be available for this. Records of all staff employed to work at the home must be kept at the home and the files must be available for inspection. Bedford Road 7 DS0000010716.V291388.R01.S.doc Version 5.1 Page 6 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. Bedford Road 7 DS0000010716.V291388.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 Bedford Road 7 DS0000010716.V291388.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New service users are confident that their needs are assessed by the home and by their social workers before their admission. EVIDENCE: Records and discussions with care staff showed that an assessment is being carried out for a prospective service user. It was noted that the service user has had overnight and weekend stays as part of their assessment. Assessments have also been completed by the service user’s social worker and additional information has been obtained from health professionals. The responsible person stated that the staff have also visited the service user at their home. She said that she is waiting for more information from the care home where the prospective service user currently lives. The assessment carried out by the staff included details of the physical, emotional, personal care, dietary and social needs of the service user. The staff have also made observations of their opinions of the prospective service user’s compatibility with the existing people who live at the home. Bedford Road 7 DS0000010716.V291388.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, and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at the home can be confident that their care plans and risk assessments are reviewed regularly and that there are appropriate services to meet their needs. EVIDENCE: Four service users’ files were assessed. It was evident from these files that care pans and risk assessments have been reviewed and families and representatives have been involved. The home operates a key working system and discussions with the staff and an examination of the files indicated that each key worker writes a monthly summary of significant events and activities of service users. The care plans and risk assessments are detailed and cover various areas of needs and how these can be met. It was clear from discussions that the home encourages people to realise their potential by adopting suitable methods of supporting each individual. From conversations with the staff it was clear that service users are supported to take some risks as part of their independent living. The staff spoken to provided satisfactory explanations of how they ensure privacy, dignity, human rights and equality of service users while supporting them with personal, social and emotional care. Bedford Road 7 DS0000010716.V291388.R01.S.doc Version 5.1 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, and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at the home are satisfied with the range of activities organised and facilitated by the home. The food provided at the home is good and service users’ dietary needs are met. EVIDENCE: All the people who live at the home attend day services five days a week. From service users’ files and documents seen at the home it was evident that the home liaises with day centres. Records and discussions with the staff showed that service users are supported to go on day trips. On the day of the inspection two service users were away on a day trip with a member of staff. Discussions with the responsible person indicated that people who live at the home are supported to go to local shops, cafés and the parks. Service users have opportunities to access communal areas in the home and there are no bedtime restrictions. Service users are supported with financial management. There are two safes where personal allowances are kept. Keys to the safes are kept by the staff on shift and at the end of each shift the staff check the Bedford Road 7 DS0000010716.V291388.R01.S.doc Version 5.1 Page 11 money and records and handover to the staff on the next shift. Receipts are kept for all transactions regarding the service users’ finances and the home’s petty cash. The responsible person confirmed that service users are registered on the electoral roll. It was evident from discussions from the registered person and an examination of care plans that service users spiritual needs are discussed and provisions are made to enable service users to attend places of worship. It was also evident from service users files and discussions with the staff that service users enjoy visits by family and friends. The home has a four weekly rotating menu. The menu is displayed in the dining room. The staff spoken to gave satisfactory description of how they support people to choose meals and how they ensure that a person with sensory difficulties eats their meal. Records and discussion with the staff indicated that the staff have attended basic food hygiene and Makaton training. Bedford Road 7 DS0000010716.V291388.R01.S.doc Version 5.1 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, and 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users’ personal and health care needs are met by the home’s procedures and by the experienced staff who ensure that people see relevant health officers regularly. The process of recording the administration of medication can be improved. EVIDENCE: The keys to the medication cabinet were not available on the first day (19/05/06) of the inspection and it was not possible to inspect medication on that day. However, an inspection of the medication administration record sheets (MARS) on the same day showed that the morning (8am) medicines were not administered to any of the people who live at the home. The person in charge of the shift said medicines were administered but a member of staff had forgotten to sign the MARS. On the second visit, on 22/05/06, the medicines and the MARS were checked and were found out to be in order. The home monitors and daily records the temperature of the area where medicines are kept. Records showed that the temperature of the area where the medication cabinet is kept is maintained at below 25˚C. As stated above the home has a procedure of regularly updating service users’ assessments and care plans. A service user has recently been supported to move to a more suitable accommodation following a reassessment of their Bedford Road 7 DS0000010716.V291388.R01.S.doc Version 5.1 Page 13 needs. The home works closely with health professionals and day centre officers. It was clear from a discussion with the responsible person and an assessment of the home’s diary and service users’ files that that service users are supported to see their general practitioners, dentists, opticians and chiropodists. Bedford Road 7 DS0000010716.V291388.R01.S.doc Version 5.1 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, and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has satisfactory policies and procedures to ensure that service users are protected from abuse and that their concerns and complaints are listened to and dealt with. EVIDENCE: The complaints procedure has been updated to include the address of the local CSCI office. The complaints procedure is written with pictorial illustrations for use by non-verbal service users. A copy of the procedure is included in the service users’ guide and the statement of purpose. There have been no recorded complaints since the last inspection. At the last inspection certificates were seen in staff files to indicate that the staff have attended training on adult protection. The staff spoken to were confident of their knowledge of how to protect vulnerable people and how to deal with abuse. The staff confirmed that they have read the home’s policies including the whistle blowing policy. There is a copy of the placing authority’s adult protection policy and procedure. Bedford Road 7 DS0000010716.V291388.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The registered person has made encouraging progress in terms of the temperature regulation of the hot water. There is, however, a need for the registered person to provide handdrying facilities for people to use after washing their hands. EVIDENCE: At the last inspection the registered person was required to ensure that the temperature of the hot water in the bathrooms and toilet rooms is regulated and that hand drying facilities are provided in the toilet rooms. The temperature of the hot water in the bathroom and toilet rooms is now controlled. However, there were no hand-drying facilities in any of the toilet rooms seen on the day of the inspection. The premises were clean, bright and there were no offensive odours. There were handrails in the corridors, adaptations in bathrooms, toilets, and shower rooms. All bedroom windows have restrictors and the radiators are guarded. The home is located in a residential area close to local shops and public transport facilities. The Seven Sisters Underground Station (Victoria Line) is within walking distance from the home. The home has a policy on infection control. Bedford Road 7 DS0000010716.V291388.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34, and 35 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The system of file keeping and the vetting procedures of the staff are below expectations to give service users confidence that their needs can appropriately and safely met. EVIDENCE: An assessment of the staff files revealed that a member of staff had a CRB from a previous employer. All the other staff employed by the home have successfully undergone a CRB check. It was also evident from the files that the home has obtained two written references for each member of staff. The responsible confirmed that the files for the bank staff are kept at the head office. Because of this it was not possible to check if they have all necessary items in their files. The responsible person stated that the staff have attended a range of training programmes including infection control, basic food hygiene, health and safety, adult protection, fire safety, and moving and handling. The home has a training plan for staff in areas such as person centre plan, incontinence, and risk and needs assessment. Bedford Road 7 DS0000010716.V291388.R01.S.doc Version 5.1 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Lack of a registered permanent manager has negatively impacted on the services provided at the home and service users are not reassured that there is a registered manager with full responsibility and accountability to run the home. The registered person has done a good job in implementing a system of quality assurance and in analysing the outcome of the feedback obtained through the process of consultation. Appropriate health and safety procedures have been undertaken to ensure that service users live in a safe environment. EVIDENCE: Two assistant managers run the home on a job share basis. At the last inspection a requirement was made for the registered person to ensure that a manager is appointed and that an application is submitted to the CSCI by the individual to be a registered manager. The registered person has made good progress in employing an acting manager. However, the acting manager was not able to undergo the registration process. The registered person is aware Bedford Road 7 DS0000010716.V291388.R01.S.doc Version 5.1 Page 18 that there is a need for the home to have a manager registered by the Commission for Social Care Inspection. The gas boiler was serviced on 14/02/06 and is in good working condition. The fire extinguishers were tested on 30/01/06 and safety checks of call points, switch mechanisms, heat and smoke detectors were undertaken on 19/5/06. Records showed that fire drills regularly take place. It has been mentioned above that care plans and risk assessments have been completed for all service users. Adaptations are provided in the bathrooms and toilets. The home was clean, bright and spacious. All bedrooms windows have restrictors and the radiators are guarded. A system of quality assurance has been implemented. It was evident from discussions with the responsible person and an assessment of the records that quality assurance questionnaires have been completed by the people who live at the home and relatives and returned to the home. The responsible person has collated and summarised the outcome of the consultation. An action plan detailing how the service can be improved has been devised and circulated to the respondents. The responsible person confirmed that service users and visitors are also informally consulted about the quality of the services and facilities. Bedford Road 7 DS0000010716.V291388.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME 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 3 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 X 33 X 34 2 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 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 3 X X 3 X Bedford Road 7 DS0000010716.V291388.R01.S.doc Version 5.1 Page 20 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 YA20 Regulation 13(2); 17 Requirement The registered person must ensure that medication is appropriately administered to service users and medication administration record sheets (MARS) signed by trained and competent staff. The registered person must investigate why the MARS were not signed on 19th May 2006 am and why the keys to medication cabinet were not available at the home. The registered person must put in place a satisfactory action plan, which prevents a similar incident from happening and forward a copy of the investigation report to the CSCI inspector. The registered person must provide hand-drying facilities in toilet rooms. (Timescale of 15/02/06 not met.) The registered person must ensure that all staff employed by and working at the home have satisfactory current CRB checks undertaken for the purpose of working at the home. The DS0000010716.V291388.R01.S.doc Timescale for action 30/06/06 2. YA30 13(3) 30/06/06 3 YA34 19(1)(2) (3) 31/07/06 Bedford Road 7 Version 5.1 Page 21 4 YA34 17(2); Sch. 4(6) 5 YA37 9(1)(2) registered person must conduct a POVAFirst check in respect of one staff without a current CRB certificate and ensure that the person applies for a CRB check. The registered person must ensure that records of all people employed to work at the home are kept at the home. The registered person must ensure that all items listed under Schedule 4(6) of Care Homes Regulations 2001 are maintained in staff files. The registered person must ensure that a manager is appointed to run the home and that an application for registration is submitted to the CSCI by this individual. (Timescale of 25/02/06 not met.) 30/06/06 31/08/06 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 Bedford Road 7 DS0000010716.V291388.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Bedford Road 7 DS0000010716.V291388.R01.S.doc Version 5.1 Page 23 - 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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