Inspection on 14/11/07 for Carlingford Road, 181

This inspection was carried out on 14th November 2007.

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 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Carlingford Road, 181 02/07/08

Carlingford Road, 181 19/04/07

Carlingford Road, 181 03/10/06

Carlingford Road, 181 24/11/05

Carlingford Road, 181 17/05/05

Carlingford Road, 181 16/09/04

Carlingford Road, 181 20/05/04

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 Carlingford Road, 181 181 Carlingford Road South Tottenham London N15 3ET Lead Inspector Jackie Izzard Key Unannounced Inspection 14th November 2007 09:30 Carlingford Road, 181 DS0000060630.V359018.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 Carlingford Road, 181 DS0000060630.V359018.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. Carlingford Road, 181 DS0000060630.V359018.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Carlingford Road, 181 Address 181 Carlingford Road South Tottenham London N15 3ET 020 7261 4100 020 8299 4818 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) www.choicesupport.org.uk Choice Support Care Home 4 Category(ies) of Learning disability (0) registration, with number of places Carlingford Road, 181 DS0000060630.V359018.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th April 2007 Brief Description of the Service: 181 Carlingford Road is a residential care home registered to provide personal care to up to four people over the age of eighteen and who have a learning disability. The home is situated in a residential area of Tottenham in North London, with good public transport links and close to Wood Green shopping and leisure facilities. The home is a converted mid-terrace house, arranged over three storeys, with four bedrooms, two bathrooms, a garden, lounge and kitchen. On the 1st April 2004, Choice Support took over the registration of the home, and Sanctuary Housing Association provides the housing support. Choice Support is a charitable organisation that has been in business for 20 years supporting people with learning disabilities in the community. The home provides 24 hour care and it’s stated aim is to provide the people living there with a secure, relaxed and homely environment in which their care, well being and comfort is of the prime importance. Placements at the home costs £1411.16 for each person per week. People living at the home are expected to pay separately for some items and activities, such as holidays, transport, activities, eating out, take away meals and rental of a water cooler. Following Inspecting for Better Lives the provider must make information available about the service, including inspection reports, to service users and other stakeholders. Inspection reports produced by the Commission of Social Care Inspection (CSCI) are available upon request from the registered manager/provider. At the time of this inspection, there were three men and one woman living at the home. Carlingford Road, 181 DS0000060630.V359018.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspector conducted this unannounced inspection over the course of one day. Most of the day was spent with the Manager Designate going through the previous report’s requirements. The Inspector also spoke with staff who were knowledgeable and helpful in the inspection process. The Inspector also toured the home, examined documentation and observed resident interaction with staff. None of the residents are able to verbally communicate so the Inspector was unable to seek their views during the inspection. Surveys obtained prior to this inspection have also been used in the writing of this report. What the service does well: What has improved since the last inspection? 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. Carlingford Road, 181 DS0000060630.V359018.R01.S.doc Version 5.2 Page 6 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 Carlingford Road, 181 DS0000060630.V359018.R01.S.doc Version 5.2 Page 7 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 and 5. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Assessments have been carried out to a satisfactory service and although contracts have been amended to reflect any additional charges these were still incomplete. EVIDENCE: The Inspector examined the service user guide and found all in order and saw evidence that all four residents had had completed assessments. The Inspector also examined two resident’s contracts and although these had been updated to reflect the contributions that residents make these did not reflect any additional cost associated with upkeep of water cooler. Carlingford Road, 181 DS0000060630.V359018.R01.S.doc Version 5.2 Page 8 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 and 9. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users have up to date person centred care plans that reflect resident’s decision making as part of a supported independent lifestyle. EVIDENCE: The Inspector examined all four resident person centred care plans which also included all appropriate references to individual resident’s cultural needs. Two risk assessments were also viewed that also matched the person centred care planning approach. The inspector was pleased to note the overall improvement in the care plans since the last inspection. Carlingford Road, 181 DS0000060630.V359018.R01.S.doc Version 5.2 Page 9 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 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy a full and varied lifestyle that recognises their rights and responsibilities and includes a healthy diet and quality of meals. EVIDENCE: Staff informed the Inspector that residents had recently enjoyed a holiday in Dorset. All residents have regular contact with their family which is often facilitated by staff. Residents participate in a number of activities that include trampolining, walks, shopping and going to café’s and pubs and supported cycling. Residents only go out accompanied by staff. The menus reflect resident’s different cultures and residents’ favourite foods are also featured on menu. On the day of the inspection there was a good stock of fresh food available in the home. Carlingford Road, 181 DS0000060630.V359018.R01.S.doc Version 5.2 Page 10 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 and 20. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Resident’s health and personal health care needs are met in a satisfactory manner. The home has safe medication systems in place. EVIDENCE: The Inspector checked all four resident health care profiles. All were complete and in order except for one resident. The Manager Designate informed the Inspector this resident’s health was being monitored appropriately but there was no documentation to confirm this. All residents have consent for medication and the three staff files checked by the Inspector all indicated that they had received medication training. The Inspector also checked the medication administration sheets and found all in order. Staff were observed interacting with residents in a kind and gentle way and used their skills to pacify one resident who became agitated when his bus for the day centre was running late. Staff have also been addressing known individual resident medical conditions by working with other agencies. Carlingford Road, 181 DS0000060630.V359018.R01.S.doc Version 5.2 Page 11 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 and 23. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Resident’s views are taken into account and the home has good systems in place to minimise the risk of abuse, neglect and self-harm. EVIDENCE: Information received via surveys indicated that residents have their views listened to and these views are also reflected in their person centred plans. The Registered Manager also told the inspector that the home now has the correct adult protection procedure. There has been an incident that saw a staff member being sacked and placed on the POVA list for stealing a resident’s money. Safeguards have been put in place to prevent this happening again in the future. The Inspector discussed with the Manager Designate the advisability of her being a signatory for all four residents. Financial assessments are all up to date. The Inspector carried out an examination of two residents’ finances which were up to date and correct. Carlingford Road, 181 DS0000060630.V359018.R01.S.doc Version 5.2 Page 12 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, 27 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The overall environment of the home has much improved but there remain some specific shortcomings. EVIDENCE: The Inspector had a tour of the home and noted that there was new flooring and curtains in each resident’s bedroom and the bathrooms had been redecorated. The overall internal environment and hygiene of the home had much improved since the last inspection and the garden was now hazard free. The Inspector noted the need for new bedside furniture for one resident, paint to be cleaned off the sofa, new floor covering for first floor bathroom and new pillows to replace the badly worn ones seen by the Inspector. Carlingford Road, 181 DS0000060630.V359018.R01.S.doc Version 5.2 Page 13 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, 33, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents benefit from having a sufficient staff team who are trained to a satisfactory standard and have been through a robust recruitment procedure and who are well supported. EVIDENCE: The Inspector noted that there are adequate staff levels both during the day and night. An examination of staff files indicated a good level of training that included training on autism, health and safety, POVA, challenging behaviour breakaway techniques and medication. Supervision was observed to be an ongoing feature for staff and robust recruitment procedures were seen to be in place. Although staff had undertaken a lot of internal training and several staff were pursuing a professional qualification in their own right no staff were in process of undertaking NVQ training. Carlingford Road, 181 DS0000060630.V359018.R01.S.doc Version 5.2 Page 14 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, 40 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The overall running of the home has improved but the lack of a Registered Manager and absence of some Regulation 26 visit reports indicate that there are overall shortcomings in the management of the home. EVIDENCE: An examination of various health and safety records indicated that these were complete and up to date. The overall running of the home has improved as witnessed by the reduction in number of requirements (see end of report) but the home still does not have a Registered Manager and two Regulation 26 reports could not be produced on the day of the inspection. Even though Choice have employed a consultant to work along side the Manager Designate, no application for registration has been received. In addition, no Quality Assurance information was available. Carlingford Road, 181 DS0000060630.V359018.R01.S.doc Version 5.2 Page 15 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 2 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 2 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 3 34 3 35 3 36 3 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 2 3 x 2 3 2 3 x x x Carlingford Road, 181 DS0000060630.V359018.R01.S.doc Version 5.2 Page 16 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA5 Regulation 5(b) Requirement The registered persons must ensure that the total cost and charges for the service are updated in the individual service user guides, and reflect the total cost for the service and who is responsible for payment and that any additional cost associated with a water cooler must also be clearly reflected. This requirement is restated from previous inspection. The registered person must ensure that people’s health needs are addressed and records kept of all appointments. This requirement is restated from previous report. The registered persons must ensure that the first floor bathroom has new flooring. The registered persons must ensure paint is cleaned off the sofa. The registered persons must advise the CSCI of how Choice Support intend to meet the requirement for 50 of staff to DS0000060630.V359018.R01.S.doc Timescale for action 30/03/08 2. YA19 12 30/03/08 3. 4. 5. YA27 YA27 YA32 23 23 18 30/03/08 30/03/08 30/03/08 Carlingford Road, 181 Version 5.2 Page 17 be trained to NVQ 2. This requirement is restated from previous report. The registered persons must 30/03/08 ensure that a manager applies to the Commission to be registered. This requirement has been restated from last two previous inspections The registered persons must provide the CSCI with a copy of the most recent quality assurance exercise and annual development plan for this home. This requirement is restated from previous report. The responsible individual must undertake visits to the care home on a monthly basis as required by Regulation 26, provide a copy of the written reports of these visits to the manager (to be kept in the home) and to the CSCI. This requirement has been restated from last two previous reports. 6. YA37 9 7. YA39 24 30/03/08 8. YA39 26 30/03/08 Carlingford Road, 181 DS0000060630.V359018.R01.S.doc Version 5.2 Page 18 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. 2. Refer to Standard YA16 YA33 Good Practice Recommendations Staff should not write letters on behalf of residents who cannot understand the content of such letters. Staff should contact the placing authority social workers for advice. It is recommended that the registered person ensures that the service users’ pending placement reviews include discussion with the placing authority regarding the current levels of support that are provided to service users at night. This recommendation has been restated from previous inspections The registered persons should show evidence of monitoring CSCI requirements as part of Regulation 26 visits 3. YA39 Carlingford Road, 181 DS0000060630.V359018.R01.S.doc Version 5.2 Page 19 Commission for Social Care Inspection Harrow Area Office 4th Floor, Aspect Gate 166 College Road Harrow London HA1 1BH 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 Carlingford Road, 181 DS0000060630.V359018.R01.S.doc Version 5.2 Page 20 - 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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