Inspection on 09/01/06 for Cambstone Close 1

This inspection was carried out on 9th January 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 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cambstone Close 1 18/12/06

Cambstone Close 1 24/07/06

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 Anthony Lewis Unannounced Inspection 9th January 2006 09:00 Cambstone Close 1 DS0000010416.V269798.R01.S.doc Version 5.0 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.V269798.R01.S.doc Version 5.0 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.V269798.R01.S.doc Version 5.0 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 PentaHact Mr Adam Paul Mansell Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Cambstone Close 1 DS0000010416.V269798.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th July 2005 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. Cambstone Close 1 DS0000010416.V269798.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place on Monday 9th January 2006 at 10.30am and was completed at 3.30pm. The manager was available throughout the inspection process and was very helpful and accommodating. To gather evidence for this inspection, all four residents’ files were viewed along with five staff files, various documents, policies and procedures and safety certificates. A tour of the home was conducted with the manager. Due to communication difficulties two residents were spoken to informally, the staff were on hand to interpreted what some of their responses may mean. Nine requirements were made at the previous inspection. One recommendation was made, which has not been adopted. Seven requirements are made at this inspection, five of which are restated requirements. Further information about unmet requirements can be found in the relevant standard. Unmet requirements impact upon the welfare and safety of service users. Failure to comply by the timescale will lead to the Commission for Social Care Inspection considering enforcement action to secure compliance. All of the core standards have been inspected over the two inspections for the year. The new manager is dedicated and has the experience required to manage the home. The staff team have ensured that all areas of the home are kept clean and tidy and that residents are safe. Interaction between the residents and staff is relaxed and friendly and all residents seem comfortable, happy and well cared for. What the service does well: What has improved since the last inspection? A new manager, Paul Matthews, was appointed in September 2005 to manage the home and another PentaHact home, which is located within the same estate as Cambstone Close. His application for registration is being processed. The statement of purpose has been updated. Funeral arrangements in the event of a resident dying has been obtained and recorded in their care plan. The grass in the back garden has been cut. Staff are receiving regular supervision. A legionella test was carried out in July 2004. Cambstone Close 1 DS0000010416.V269798.R01.S.doc Version 5.0 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. Cambstone Close 1 DS0000010416.V269798.R01.S.doc Version 5.0 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.V269798.R01.S.doc Version 5.0 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): 1, 3 and 4. Although information regarding the home is available for prospective residents, they are being put at risk due to insufficient means of communicating between residents and staff. EVIDENCE: A requirement at the previous inspection for the statement of purpose to be revised was met on 3rd January 2005; the name of the new manager has been included. Residents’ assessments were viewed and contained information such as their communication difficulties and the visually impairment of one. A discussion was had with the manager regarding the everyday method of communication between residents and staff. The manager said that staff are able to understand residents by the residents’ facial expressions, physical actions and moods. There was some information in residents’ care plans regarding what may be meant by some of their physical actions and facial expressions but this was very limited. One resident was seen pulling a member of staff by the hand and leading her towards the kitchen. When asked what this meant, the member of staff said that the resident might want a drink or food. A requirement is made that a review of the way in which residents communicate their wishes and feelings within the home is undertaken in accordance with resident’s individual needs and is recorded in their care plan. Cambstone Close 1 DS0000010416.V269798.R01.S.doc Version 5.0 Page 9 The home’s moving in procedure was viewed. The procedure covers visits to the home by potential residents over a period of two – three weeks and can be adjusted to suit the person’s needs. Cambstone Close 1 DS0000010416.V269798.R01.S.doc Version 5.0 Page 10 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 and 10. The staff team are reviewing residents’ care plans, ensuring that residents’ individual needs are recorded and that their confidentiality is being respected. EVIDENCE: The manager stated that residents care plans were in the process of being updated by their keyworker. On looking through all of the residents’ files, work has begun to update their care plans, with more comprehensive information such as, personal care needs and social activities. The home has a “confidentiality and record keeping policy and procedure and guidance”. It states that on request next of kin and other relatives will be given a copy. There was also information on the limits to confidentiality and third party disclosure. Cambstone Close 1 DS0000010416.V269798.R01.S.doc Version 5.0 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, 14, 15 and 17. Staff are ensuring that residents are supported to widen their personal and social development and to socialise and build relationships and improve their health care needs. EVIDENCE: Care plans seen contained information on residents’ cultural and religious needs and of those who participate in their religious celebrations and ceremonies. One resident’s care plan contained information on the resident attending church and how they interact when there. Residents’ care plans contained information on their individual support needs with details of what activities they enjoy doing. For instance, one resident likes going out into the community, drinking beer, meeting new people, bowling and art. Cambstone Close 1 DS0000010416.V269798.R01.S.doc Version 5.0 Page 12 The manager said that none of the residents are involved in intimate relationships. Residents’ care plans contained information on their sexual awareness, such as their behaviour towards other people. The manager said that the residents socialise within their community but have not made any significant relationships. He went on to say that one resident has a close relationship with her mother and is supported by staff to visit her mother occasionally. The home’s menu was viewed for the past four weeks. A support worker said that the menu is formed from knowing what the residents’ likes and dislikes are and the variety of meals viewed indicate that the residents are receiving a nutritious and healthy diet. Residents’ care plans contained information on foods that they like and dislike. Cambstone Close 1 DS0000010416.V269798.R01.S.doc Version 5.0 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 and 21. Although staff are ensuring that residents’ personal care needs and funeral wishes are being respected, they are not ensuring that residents’ changing health care needs are monitored, which is potentially putting residents at risk. EVIDENCE: Residents with mobility problems were observed being supported by staff in a sensitive and patient manner. There was information in residents’ care plans on, “what support I need with my personal care”. Although there was information in residents’ care plans regarding health care support and intervention from health care professionals such as the GP, physiotherapist and dentist, the health care needs of all of the residents was quite dated. For instance, the residents have lived in the home for many years and their health care needs were assessed when they first moved in. There was no concrete information on a complete review of the residents changing health care needs, even though they have been having regular service reviews. A lot of the information in the residents’ care plans regarding their health care needs dated back to the late 1990s. A requirement is made that residents’ changing health care needs are reviewed and their health care plans are updated to contain their revised health care needs. Cambstone Close 1 DS0000010416.V269798.R01.S.doc Version 5.0 Page 14 The staff have ensured that residents’ funeral arrangements is recorded in their care plans. The care plans of all of the residents were viewed and each contained a section for their funeral arrangements with adequate information, although more information regarding a resident’s wishes needs to be recorded. Cambstone Close 1 DS0000010416.V269798.R01.S.doc Version 5.0 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. Staff are ensuring that any complaints made by a resident or others, will be taken seriously. EVIDENCE: The home has the company’s complaints policy and procedure. The home also has an adequate complaints book. The last recorded complaint was on 1st August 2004. The complaints procedure was discussed with the manager who demonstrated his awareness of the importance of recording all complaints. Cambstone Close 1 DS0000010416.V269798.R01.S.doc Version 5.0 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, 27 and 28. The staff have ensured that all residents live in a comfortable, clean and safe home and that private and communal areas suit residents’ individual and collective needs and lifestyles. EVIDENCE: A tour of the home was conducted with the manager. All bedrooms and shared spaces were clean, tidy, safe and free from any offensive odours. All parts of the home are accessible to residents and on the day, residents were observed moving about freely. Adaptations have been strategically placed on some walls within the home to assist one resident, who is visually impaired, to move about the home more freely. The resident was observed feeling is way around the home by touching the various objects and shapes along the walls. Two residents’ bedrooms were viewed. According to the manager, all bedrooms have been furnished and decorated to the resident’s individual tastes. On viewing two bedrooms they contained pictures of family members and of the resident’s personal interests. There was also ornaments and posters adorned on the walls. Cambstone Close 1 DS0000010416.V269798.R01.S.doc Version 5.0 Page 17 The home has an assisted bath and a hoist for residents with mobility difficulties. The bathroom is lockable with emergency access for staff if necessary. All shared spaces inside and outside the home provide space for all of the residents to move about freely. The home has no private rooms for residents to see visitors except in their bedroom or the office. Cambstone Close 1 DS0000010416.V269798.R01.S.doc Version 5.0 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): 31, 33, 34, 35 and 36. Robust recruitment and training procedures are not being followed, which is potentially putting residents at risk. EVIDENCE: One member of staff was spoken to briefly. She had a good understanding of the residents and her roles and responsibilities. She was able to describe some of the everyday support that residents require from staff and how it is given. However, on looking through five staff files, none contained a copy of their job description, which was a requirement at the previous inspection. This requirement is restated. A recommendation at the previous inspection that there is always an identified person in charge/shift leader each shift has not been implemented. This recommendation is restated. The home has the organisation’s recruitment and selection procedure. However, although the staff files viewed all contained their Criminal Records Bureau (CRB) checks, two references and an application form, there were no recent photographs of any of the staff, which was a requirement at the previous inspection, except for two black and white passport photographs, which were not sufficiently clear enough. This requirement is restated. Cambstone Close 1 DS0000010416.V269798.R01.S.doc Version 5.0 Page 19 Staff files viewed contained their supervision records, which they are receiving regularly, as was a requirement at the previous inspection. The five staff files viewed contained a variety of mandatory training certificates such as health and safety, food hygiene and moving and handling. However, one staff’s file did not contain mandatory certificates or evidence to show that they had undertaken food hygiene, moving and handling and health and safety training. Another staff member’s file contained no training certificates or evidence that they have had any training. It was a requirement at the previous inspection that all staff files contain a copy of their training certificates. This requirement is restated. Cambstone Close 1 DS0000010416.V269798.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 and 43. The new manager has the skills and experience to manage the home and is ensuring that residents benefit from a proactive self monitoring and accounting systems. However, residents, staff and visitors are at risk due to insufficient safety checks being carried out. EVIDENCE: The manager demonstrated a clear understanding of his roles and responsibilities throughout the inspection. He demonstrated a clear understanding of his roles and responsibilities and that of the staff, to the residents. He stated that he has been a manager since 2002 and is awaiting registration as the manager of the home. His National Vocational Qualification (NVQ) level 4 was seen in his file along with his counselling certificate. The manager stated that PentaHact 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. Cambstone Close 1 DS0000010416.V269798.R01.S.doc Version 5.0 Page 21 Such a questionnaire was seen and contained information on the review process, such as the results of the questionnaires, which 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. A requirement was made at the previous inspection that the London Fire and Emergency Planning Authority (LFEPA) and the agency/authority responsible for carrying out the electrical installation test be contacted to ascertain a date for their next visit has not been met. This requirement is restated. The home has the PentaHact care services financial procedures manual, which states rules governing good financial practices to protect residents and staff. The procedure was discussed with the manager along with viewing the homes monthly budget statement of income and expenditure. The home’s employer’s liability insurance certificate was seen and the level of cover is sufficient for the service. Cambstone Close 1 DS0000010416.V269798.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 X 2 3 x Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X X 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x 3 3 X X LIFESTYLES Standard No Score 11 3 12 X 13 X 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score 2 X 3 1 1 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cambstone Close 1 Score 3 2 X 3 Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 1 3 DS0000010416.V269798.R01.S.doc Version 5.0 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 YA3 Regulation 12 (2) (3) Requirement Timescale for action 31/03/06 2. YA6 15(2)(b),(c) (d) 3. YA19 14 (2) (a) (b) 4. YA31 Sch 4,6(e) The registered persons must ensure that there is a review of the way in which residents communicate their wishes and feelings in accordance with resident’s individual needs and is recorded in their care plan. The registered persons 31/03/06 must ensure that all residents care plans are regularly reviewed. The registered persons 31/03/06 must ensure that residents’ changing health care needs are reviewed and their health care plans are updated to contain their revised health care needs. (Timescale of 29/07/05 not met) This requirement is restated. The registered persons 17/02/06 must ensure that all staff files contain a copy of their job description. (Timescale of 15/07/05 not met) This requirement Version 5.0 Page 24 Cambstone Close 1 DS0000010416.V269798.R01.S.doc is restated. 5. YA34 The registered persons 10/02/06 must ensure that all staff files contain a recent photograph of them. (Timescale of 26/08/05 not met) This requirement is restated. 18 (1) c (i) The registered persons 31/03/06 must ensure that all staff receive appropriate training and that a copy of their certificates are kept in their file for inspection. (Timescale of 23 /09/05 not met) This requirement is restated. 13(4)c),23(1(a),(c) The registered persons 31/03/06 must ensure that the (LFEPA) is contacted to ascertain a date for their next visit to the home. (Timescale of 23/09/05 not met) This requirement is restated. 19(4)(b)i,Sch2(1) 6. YA35 7. YA42 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA33 Good Practice Recommendations A recommendation is made that the registered persons ensure that there is always an identified person in charge/shift leader each day and that the person is identified on the rota. This recommendation is restated. Cambstone Close 1 DS0000010416.V269798.R01.S.doc Version 5.0 Page 25 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. 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