Inspection on 23/08/06 for Cascade Care Ltd (Cascade 4)

This inspection was carried out on 23rd August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cascade Care Ltd (Cascade 4) 23/08/07

Similar services:

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Delrose House Ltd

Clovelly House Residential Home Ltd

Abbey Road [53]

Cherry Tree House

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

CARE HOME ADULTS 18-65 Cascade Care Ltd (Cascade 4) 40 Newick Rd Lower Clapton Hackney E5 0RR Lead Inspector Robert Sobotka Unannounced Inspection 23rd August 2006 10:00 Cascade Care Ltd (Cascade 4) DS0000067297.V307553.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 Cascade Care Ltd (Cascade 4) DS0000067297.V307553.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. Cascade Care Ltd (Cascade 4) DS0000067297.V307553.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cascade Care Ltd (Cascade 4) Address 40 Newick Rd Lower Clapton Hackney E5 0RR 020 8525 0866 020 8985 2589 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) Cascade Care Ltd Mr Nelson Svosva Gudza Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5) of places Cascade Care Ltd (Cascade 4) DS0000067297.V307553.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 07/02/2007 Brief Description of the Service: Cascade 4 is a residential care home, which offers care, support and accommodation for maximum of five male service users within a community setting, who have mental health needs. The home is situated in Lower Clapton in Hackney E5. The property is a large Victorian terraced house, which comprises five large bedrooms; a large communal lounge with cable TV and a music centre; separate laundry area with a dryer; bathroom and WC; separate WC, large dining room; fully equipped modern kitchen and a well-maintained garden at the rear of the building. The premises are not wheelchair accessible. The company has recently been bought as a going concern and subsequently re-registered with the Commission for Social Care Inspection on 20/07/06 with the new name of Cascade Care Ltd. Cascade Care Ltd (Cascade 4) DS0000067297.V307553.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day (morning and early afternoon) and was unannounced. As part of the visit, the inspector spoke to some of the service users and two care staff working in the home. He also conducted a tour of the premises and viewed various records. The inspector has also met the new Responsible Person prior to this inspection, whilst undertaking an unannounced inspection at the sister home. Some information given by the Responsible Individual, such as plans in relation to care planning process, staff training and review of policies and procedures, which applied across all projects, have been used in this inspection reports. The registered manager was not present during this inspection, as he was on emergency leave. The aim of this unannounced inspection was to check the home’s compliance with the National Minimum Standards for Care Homes for Adults (18-65) and The Care Homes Regulations 2001. What the service does well: What has improved since the last inspection? Cascade Care Ltd (Cascade 4) DS0000067297.V307553.R01.S.doc Version 5.2 Page 6 All food was now being appropriately labelled and stored once opened. There has been an improvement in recording of medication administered to service users. Staff personnel files were kept up-to-date. 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. Cascade Care Ltd (Cascade 4) DS0000067297.V307553.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 Cascade Care Ltd (Cascade 4) DS0000067297.V307553.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s statement of purpose required minor amendment. Appropriate admission systems were in place. The home was meeting the needs of those accommodated there. Prospective service users have an opportunity to “test drive” the home, prior to moving in. EVIDENCE: The home’s statement of purpose has recently been amended to reflect the recent change of ownership of the business. It however required further minor amendment, as at the time of this inspection, it stated that the home provided services to “men with past or present history of drug and alcohol abuse”. This statement must be removed, as the home is not registered under this category. The service user’s guide was also in place and it gave potential residents useful information about the home. There has been one admission to the home since the last inspection. The inspector viewed a care plan of the most recently admitted service user. His file contained a comprehensive assessment. There was also evidence that appropriate and relevant information had been obtained from the placing authority. The inspector spoke to the service user who confirmed that he visited the home on several occasions prior to moving there. Record to that effect was also seen on his file. Cascade Care Ltd (Cascade 4) DS0000067297.V307553.R01.S.doc Version 5.2 Page 9 Following discussion with those who lived in the home, staff working in the home, reviewing documentation such as care plans, and direct and indirect observation, the inspector was satisfied that the home was meeting the needs of those living in the home. Each service user had a contract, which included statement of terms and conditions in place. Cascade Care Ltd (Cascade 4) DS0000067297.V307553.R01.S.doc Version 5.2 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, 7, 9, 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had a good care planning system in place and those who lived in the home were taking part in the care planning process. Service users were encouraged to take part in making decisions relating to the care they needed. EVIDENCE: As part of this visit, the inspector viewed care plans of four service users. Documents viewed were well maintained and were reviewed on regular basis. Minutes from the Care Planning Approach meetings were also in place. There was evidence that service users are encouraged to participate in their care planning process and their views were taken into account. They are also encouraged to write down their comments about their progress in meeting agreed goals. During the inspection visit at the sister home, the Responsible Individual informed the inspector that for the foreseeable future service users care plans would be reviewed on a monthly basis. They also showed the inspector a new format, which would be used for care planning. There was also evidence that this has been discussed with staff during team meetings. Cascade Care Ltd (Cascade 4) DS0000067297.V307553.R01.S.doc Version 5.2 Page 11 Service users are also consulted as to how the home should be run. Their views are obtained during individual keyworking sessions and residents meetings. Each file viewed contained appropriate risk assessments, which were reviewed on regular basis. Confidentiality was being maintained. All confidential information was kept in the office, which was kept locked when not in use. Staff working in the home shared information about the service users with the inspector on a need-toknow basis. Cascade Care Ltd (Cascade 4) DS0000067297.V307553.R01.S.doc Version 5.2 Page 12 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, 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are encouraged and supported to be part of the local community and to develop and maintain friendships and family links. The service user’s rights and choices were respected and they had opportunities for personal development. Service users enjoyed food in the home. EVIDENCE: The inspector spoke to two service users during this inspection, who said that they were happy with the quality of care provided and activities offered to them by the home. As previously mentioned, one of the service users said that he felt very settled in the home and living in the home was like staying in a 5 star hotel. Service users accessed a wide range of activities both inside and outside of the home. Those who lived in the home and were able to go out independently were free to do so. Additional staff support was offered to service users who required escorting whilst out in the community. Cascade Care Ltd (Cascade 4) DS0000067297.V307553.R01.S.doc Version 5.2 Page 13 Service users were able to plan their leisure activities during regular house meetings. The majority of service users went on their annual holiday to Butlins earlier on in the year. Visitors were allowed in the home. Visitor’s book was maintained. Service users were also encouraged and supported to maintain appropriate relationships with their families and friends. The requirement met at the last inspection that food is labelled when opened has now been met. There were appropriate food supplies in the home. Cascade Care Ltd (Cascade 4) DS0000067297.V307553.R01.S.doc Version 5.2 Page 14 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, 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was appropriately meeting the physical and emotional needs of the service users. Appropriate medication systems were in place. EVIDENCE: At the time of this inspection, all service users who lived in the home at the time of this inspection attended their own personal care and staff only offered verbal prompts as and when required. There was evidence of an input from Psychiatrists, Community Psychiatric Nurses and Social Workers. The majority of the psychiatric reviews were carried out promptly. The majority of the service users choose to attend their GP surgeries and hospital appointments independently. In some cases staff accompanied service users to appointments. Appropriate medication systems were in place. The home has just started using the new medication dosage system. All medication was appropriately Cascade Care Ltd (Cascade 4) DS0000067297.V307553.R01.S.doc Version 5.2 Page 15 stored and records of medication received into the home, administered and disposed of were maintained. Cascade Care Ltd (Cascade 4) DS0000067297.V307553.R01.S.doc Version 5.2 Page 16 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, 23. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home had a good complaints system in place and any concerns are dealt with without delay. Those living in the home were protected from abuse, neglect and self-harm, however the registered person must ensure that the Commission is informed on any “notifiable occurrence”, as required by law. EVIDENCE: The home continues to have appropriate system for dealing with complaints in place. There was evidence that all complaints are appropriately and promptly dealt with. The inspector spoke one of the service users, who said that he would talk to the manager if he was not happy about anything in the home. The home had a complaints policy in place, which included details of the Commission for Social Care Inspection. Adult protection procedure and the Whistleblowing policy were in place. All incidents were clearly recorded and all records/ documentation were reviewed by the manager on a regular basis. During this visit, the inspector was informed that there has been a problem with hot water supply in the home for the last couple of weeks. This should have been reported to the Commission as required by Regulation 37 of the Care Homes Regulations. The registered person must ensure that the Commission is informed on any notifiable occurrence in line with Regulation 37 of the Care Homes Regulations. Cascade Care Ltd (Cascade 4) DS0000067297.V307553.R01.S.doc Version 5.2 Page 17 The majority of people managed their own finances. Where it is felt that support or guidance in managing finances is needed by service users, this is readily available from members of staff. Cascade Care Ltd (Cascade 4) DS0000067297.V307553.R01.S.doc Version 5.2 Page 18 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, 30. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Service users benefit from a homely, comfortable and clean environment, however hot water supplies needed to be urgently restored. EVIDENCE: The home is an ordinary domestic property situated in a residential street. The majority of service users who spoke to the inspector stated that they were happy with their bedrooms and communal areas, however it was brought to the inspector’s attention that at there have been problems with the hot water supplies in the home. As a result, an immediate requirement was issued for the registered person to ensure that the supply of hot water it restored. One of the service users showed the inspector a couple minor jobs that needed to be done in his bathroom. This had been reported to the maintenance person. The home does not accommodate people with physical disabilities. Cascade Care Ltd (Cascade 4) DS0000067297.V307553.R01.S.doc Version 5.2 Page 19 The premises were well maintained, clean and hygienic at the time of this unannounced visit. Cascade Care Ltd (Cascade 4) DS0000067297.V307553.R01.S.doc Version 5.2 Page 20 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): 32, 33, 35, 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Those who use the service are supported by staff who are committed to providing good quality of care, however some staff required additional training. EVIDENCE: The Responsible Person stated that there have been no changes to the staffing levels since the last inspection and the change of the provider. She also said that the organisation was currently in the process of carrying out an assessment/audit of staff training needs and that refresher training courses were being organised for the existing staff. The inspector viewed duty rosters, which showed that there were sufficient numbers of staff on duty. There are two members on each shift, including nights. Night staff remain awake throughout the night. Staff spoken to stated that they felt that staffing levels were sufficient. The majority of staff either have obtained the NVQ qualification or were in the process of obtaining one. The inspector was unable to access staff personnel records, as the manager who holds the key was not working on the day of the inspection. Staff personnel files, were however checked during the inspection visit, where a Cascade Care Ltd (Cascade 4) DS0000067297.V307553.R01.S.doc Version 5.2 Page 21 copy of the files of staff working in this home are kept by the organisations administrator, and that documentation audit was satisfactory. Staff spoken to stated that they have received supervision and appraisals. Cascade Care Ltd (Cascade 4) DS0000067297.V307553.R01.S.doc Version 5.2 Page 22 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): 39, 40, 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some of the home’s policies and procedures required reviewing. The majority of health and safety checks were in place, however the hot water supply must be restored and the home’s fire fighting equipment required servicing. EVIDENCE: The Standard is relation to the Registered Manager was not assessed during this visit, as the manager was away on emergency leave. The inspector received, however positive feedback from both service users and staff working in the home about the registered manager’s management style. He was also in possession of appropriate qualification required by the legislation. The new Responsible Individual has been carrying out “the Regulation 26 visits”, reports from which were being forwarded to the Commission. Cascade Care Ltd (Cascade 4) DS0000067297.V307553.R01.S.doc Version 5.2 Page 23 The Responsible Individual informed the inspector that the new company was in the process of reviewing all policies and procedures. The responsible individual must ensure that all policies and procedures are up-to-date and kept under review. The majority of health and safety checks were in place, however the registered person must ensure that the fire equipment is serviced without delay and that the hot water supplies are restored. The home was adequately insured for its purpose. Cascade Care Ltd (Cascade 4) DS0000067297.V307553.R01.S.doc Version 5.2 Page 24 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 2 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 1 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 x 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 3 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 3 x x x 3 2 x 2 x Cascade Care Ltd (Cascade 4) DS0000067297.V307553.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No 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 YA1 Regulation 4 Requirement The home’s statement of purpose requires amendment. The statement that the home provides services to “men who have past or present history of drug dependence or alcohol abuse” must be removed. The responsible individual must ensure that all policies and procedures listed in Appendix 2 of the National Minimum Standards are up-to-date and kept under review. The responsible person must ensure that all care staff receive all mandatory training, as required by law. The registered person must ensure that the Commission is informed on any notifiable occurrence in line with Regulation 37 of the Care Homes Regulations. The responsible person must ensure that the supply of hot water is restored within set timescale. The registered person must ensure that the fire equipment is serviced without delay. DS0000067297.V307553.R01.S.doc Timescale for action 01/10/06 2. YA40 3. YA35 22(1) Appendix 2 of the National Minimum Standards 19(5)(b), 23(4)(d) 37 01/10/06 01/12/06 4. YA23 28/08/06 5. YA24 23(2)(j) 27/08/06 6. YA42 23(4)(c) 15/10/06 Cascade Care Ltd (Cascade 4) Version 5.2 Page 26 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 Cascade Care Ltd (Cascade 4) DS0000067297.V307553.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford London E15 4BQ 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 Cascade Care Ltd (Cascade 4) DS0000067297.V307553.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!