Inspection on 18/12/06 for Cambstone Close 1

This inspection was carried out on 18th December 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cambstone Close 1 24/07/06

Cambstone Close 1 09/01/06

Cambstone Close 1 07/07/05

Cambstone Close 1 11/01/05

Cambstone Close 1 09/08/04

Cambstone Close 1 15/01/04

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

CARE HOME ADULTS 18-65 Cambstone Close 1 New Southgate London N11 1JQ Lead Inspector Linda Kapambe Key Unannounced Inspection 18th December 2006 10:00 Cambstone Close 1 DS0000010416.V321324.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 Cambstone Close 1 DS0000010416.V321324.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. Cambstone Close 1 DS0000010416.V321324.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cambstone Close 1 Address New Southgate London N11 1JQ 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 8368 5169 amansell@pentahact.org.uk www.Adepta.org.uk Adepta Mr Adam Paul Mansell Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Cambstone Close 1 DS0000010416.V321324.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th July 2006 Brief Description of the Service: 1 Cambstone Close is a care home registered to provide care for four adults who have learning and physical difficulties. The home is a large bungalow with off street parking for one vehicle to the front. The home is situated on a relatively new housing estate in New Southgate near local shops, a library, Barnet College campus and Brunswick Park. All service users have their own single furnished bedrooms, which are decorated and furnished to the service users personal preferences reflecting their hobbies and interests and with pictures of their family and various activities. There is a large nicely decorated lounge, which has sensory equipment at one corner for service users. There is a large kitchen/diner. There are two male and two female service users living in the home. All have learning, physical and sensory disabilities. Sanctuary Housing Association own the building and the home is operated by PentaHact, a company limited by guarantee, which provide a number of registered and care services in London and the South East of England. The staff team aims to provide a Person Centred Approach to service users individual needs, ensuring that they adhere to the principles of choice, respect, dignity, community presence and community participation. The fee for residents living in the home is £1,600 per week. Cambstone Close 1 DS0000010416.V321324.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day on December 18th 2006. The deputy manager and staff members assisted with the inspection. A tour of the house took place and a variety of records were looked at, including care plans, training records and health and safety documents. What the service does well: What has improved since the last inspection? To ensure that the staff can meet all of the needs of the residents the communication methods between residents and staff have been reviewed. Evidence of this was seen in care plans, by way of a communication box and professional input. Staff are already seeing improvements. Residents’ risk assessments are being reviewed regularly and every effort is being made to find appropriate representatives for service users who have no family support. Individual residents needs are being appropriately assessed to enable them to maintain links with the community. Staff have made great improvements to ensure residents meal requirements are being met, and that the food offered is done so in an appealing and appetising manner. To ensure that residents are not put at risk, staff are following the correct procedures when administering medication. All complaints are taken seriously and the correct procedures are being adhered to. Staff are receiving the appropriate POVA (Protection of Vulnerable Adults) training to ensure residents are to being protected from abuse. The home has been recently decorated in consultation with the service users and is being maintained to ensure that the residents live in a homely environment. Cambstone Close 1 DS0000010416.V321324.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Cambstone Close 1 DS0000010416.V321324.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 Cambstone Close 1 DS0000010416.V321324.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): 2&3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is an effective assessment process in place for perspective residents. There is a clear and consistent assessment process, which gives support staff all the information they require to meet the needs of the service users. EVIDENCE: All of the residents have lived in the home since it opened in 1997. Their assessments were not available to view however; the service users’ guide was viewed and contained detailed information, in pictorial format, that described the assessment process for prospective residents. All of the residents have some form of communication difficulty and each communicate on a different level. An example of a communication box was seen for one resident with clear guidelines to help him communicate in a specific way. The service user is being well supported and great efforts are being made to continue to improve communications. Cambstone Close 1 DS0000010416.V321324.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 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a good care planning system in place to provide staff with the information they need to ensure that service users’ needs and wishes are fulfilled. EVIDENCE: An example of care plans was viewed. The care plans for all of the residents were viewed and were comprehensive containing information such as personal care, domestic skills, health care, and social understanding. Efforts are being made to find representatives for service users who have no relatives, to be involved in drawing up the care plans. Advocates and volunteers are proving hard to find for the work that is required. Staff support residents to make decisions, examples described were when carrying out the residents’ personal care, when choosing clothing and with Cambstone Close 1 DS0000010416.V321324.R01.S.doc Version 5.2 Page 10 regards to meals. Observations throughout the day saw staff offering guidance so that service users were able to make informed decisions. The risk management system supports the need for service users to be independent within their capabilities. Service users files contained risk assessments that are reviewed every four months. Cambstone Close 1 DS0000010416.V321324.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 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The services users access community facilities for social, leisure and educational opportunities. EVIDENCE: Each resident has an activities timetable, which contains details of all of their activities throughout the week, in the home and outside in the community. Activities are also displayed in the office. On the day of the inspection residents were accessing various activities in the run up to Christmas. Residents are relatively active in the community and attend social activities such as, shopping, swimming, and going to restaurants. Evidence was seen Cambstone Close 1 DS0000010416.V321324.R01.S.doc Version 5.2 Page 12 and a key worker was spoken to, around the support systems and help available for a resident that is not able to access outside activities. Professional input continues to be sort for this individual. Most of the residents have no contact with their relatives and no friends. The assistant manager stated that one resident sees members of their family. Residents are supported to access their community with the potential of meeting new people. She went on to say that some of the residents are known within their local community and at some of the local shops. Some residents were observed moving about the home freely and with staff support when required. Staff were observed and overheard interacting with residents in a supportive, patient and courteous manner at all times. Residents seemed comfortable when in the company of staff. The menu for the past four weeks was viewed and contained a variety of adequately nourishing and healthy meals. One resident was helping with the food shopping on the day of the inspection and was also seen setting the table for lunch. I was also informed he likes to help make drinks for people. Staff make every effort to make the food presentation for one resident that has his food blended, to be as attractive as possible. Separating the foodstuffs does this and presenting it in moulded shapes that represent the food he is eating. Cambstone Close 1 DS0000010416.V321324.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 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal support in this home is offered in such a way as to promote and protect resident’s privacy, dignity and independence. EVIDENCE: The care plans of all of the residents were viewed and all contained information on the residents’ preferences and choices with regards to their personal care, such as whether they prefer a bath or a shower, dressing and how staff should support them with their oral hygiene. This was reinforced by the information received when talking to staff. Health care professionals assess residents’ health care needs and advice is given to staff on how to support the residents with their health care. In addition, each resident’s care plan contained an updated “Health Action Plan,” with information on their present health and changing needs and professional Cambstone Close 1 DS0000010416.V321324.R01.S.doc Version 5.2 Page 14 intervention. Some assessed health care needs require funding so residents have to wait until it can be accessed. The assistant manager stated that none of the residents administer their own medication. Medication Administration Record (MAR) sheets, were completed correctly which was reassuring after a number of unexplained gaps were found at the last inspection. Cambstone Close 1 DS0000010416.V321324.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 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s policies and procedure protect service user from harm. EVIDENCE: The home has Adepta’s complaints policy and procedure, which states clearly the philosophy and aims of the organisation. In addition, the home also has a book to record all complaints made. No complaints had been received since the last inspection. There is also a system for recording and monitoring complaints within the quality assurance assessments. The home has Adepta’s policy and procedure for the protection of vulnerable persons from abuse, which contains information on how to recognise signs of potential abuse and the steps to take when an abuse situation to an adult is suspected or occurs. Staff have received POVA (Protection of Vulnerable Adults) training and evidence of this was seen from certificates and training records. Cambstone Close 1 DS0000010416.V321324.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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offers a comfortable place to live. EVIDENCE: The house is well presented and homely in it’s appearance and feels like a proper home rather than a care home. The service users have their own single room and there are sufficient toilets and bathrooms to meet the respective needs. The service users have had an input in to the décor. When it was redecorated in August they chose the colour. The maintenance book was seeing and reports to the housing association were seen for any repairs needed. Cambstone Close 1 DS0000010416.V321324.R01.S.doc Version 5.2 Page 17 The home has a dedicated part-time cleaner who ensures that all areas are clean and tidy and free from any offensive odours. Cambstone Close 1 DS0000010416.V321324.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by staff that have the knowledge and skills to meet their needs. However one staff member needs to update and attend training in line with his colleagues. EVIDENCE: The staff rota indicates that there is at least two staff on the early and late shifts. In addition there is also the registered manager. A member of staff said that she felt that there are enough staff on duty to meet the needs of the residents. Throughout the day the staff seemed able to cope with supporting the residents and other duties. The personal files of five staff were viewed and all contained the required recruitment information such as a recent photograph, two references, an application form and a Criminal Records Bureau (CRB) check. Cambstone Close 1 DS0000010416.V321324.R01.S.doc Version 5.2 Page 19 Training records and certificates were seen. Staff have access to a good selection of training. All but one member of staff seemed to be up to date with their training. An explanation was made that the staff member had had a lot of absence. It was discussed that immediate plans need to be in place to rectify this and must be evidenced by way of the training plan and discussions in supervision. Individual training sheets on the front of staff files need to be updated if they are to be kept on file. Cambstone Close 1 DS0000010416.V321324.R01.S.doc Version 5.2 Page 20 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 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has the background experience and knowledge to manage the home effectively. EVIDENCE: The registered manager is a qualified counsellor and has a National Vocational Qualification (NVQ) level 4. Adepta has a quality assurance manager, whose role is to co-ordinate reviews of the quality of service provided, through sending out questionnaires to residents, staff and other stakeholders. Residents are supported to complete the questionnaires by the staff, who ask the questions and record the answers. Cambstone Close 1 DS0000010416.V321324.R01.S.doc Version 5.2 Page 21 The information from the questionnaires received back are forwarded to operations managers and registered managers who will structure their development plan according to the views and comments from the questionnaires based on their overall findings. The staff are ensuring that all health and safety checks are carried out regularly. Fire drills and tests have been occurring regularly and all safety certificates such as gas, London Fire and Emergency Planning Authority (LFEPA) and the Portable Appliances Test (PAT) were seen and were up to date and in order. Cambstone Close 1 DS0000010416.V321324.R01.S.doc Version 5.2 Page 22 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 4 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 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Cambstone Close 1 DS0000010416.V321324.R01.S.doc Version 5.2 Page 23 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 YA35 Regulation 18 (1) c (i) Requirement The registered persons must ensure that all staff receive appropriate training and that a copy of their certificates are kept in their file for inspection. (Timescale of 24/11/06 not met) This requirement is revised and restated. Timescale for action 01/04/07 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 Cambstone Close 1 DS0000010416.V321324.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Cambstone Close 1 DS0000010416.V321324.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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