Inspection on 19/12/05 for Chant Square (15 &17)

This inspection was carried out on 19th December 2005.

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 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

Chant Square (15 &17) 15/05/07

Chant Square (15 &17) 22/05/06

Chant Square (15 &17) 21/04/05

Chant Square (15 &17) 09/12/04

Chant Square (15 &17) 04/05/04

Chant Square (15 &17) 29/09/03

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 Chant Square (15&17) 15 & 17 Chant Square Stratford London E15 Lead Inspector Sarah Greaves Announced Inspection 19th December 2005 10:00 Chant Square (15&17) DS0000022832.V259447.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 Chant Square (15&17) DS0000022832.V259447.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. Chant Square (15&17) DS0000022832.V259447.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Chant Square (15&17) Address 15 & 17 Chant Square Stratford London E15 020 8519 0551 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) East Living Limited Ms Frances Carr Care Home 8 Category(ies) of Learning disability (24) registration, with number of places Chant Square (15&17) DS0000022832.V259447.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st April 2005 Brief Description of the Service: 15-17 Chant Square is a registered care home for people with a learning disability. The home comprises of a seven- bedded unit (no.15) and a one bedded flat (no.1). The home is situated in Stratford, close to local shops, amenities and public transport facilities. The home occupies two ordinary domestic properties in a residential street. East Living manages 15-17 Chant Square, which is a local care provider and housing association. Chant Square (15&17) DS0000022832.V259447.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was conducted in one day. The purpose of this inspection was to assess the thirteen National Minimum Standards not assessed at the last inspection (unannounced inspection visit on 21st April 2005) and to check the home’s compliance with meeting nine requirements and one recommendation issued in the April 05 report. The inspector spoke to service users, the registered manager and staff. Information was also gathered from reading care plans, the Statement of Purpose, the Service Users Guide, policies and procedures, and other relevant documents. The inspector did not meet any personal or professional visitors to the home during this inspection. What the service does well: What has improved since the last inspection? Nine requirements and one recommendation were issued in the previous inspection report; the inspector found that seven of the requirements had been met, one requirement was partly met and one requirement has been repeated. The recommendation was also met. The main improvements within the home are the care plans, staff supervision and staff training. Other improvements are still in progress, such as increasing the daily involvement of service users in decision making about their life at the home, and the widening of social and recreational opportunities for the service users. This was a positive inspection visit, which demonstrated that the service is benefiting from an effective management approach. Chant Square (15&17) DS0000022832.V259447.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. Chant Square (15&17) DS0000022832.V259447.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 Chant Square (15&17) DS0000022832.V259447.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 and 4 The home needed to make some minor amendments to the Statement of Purpose and Service Users Guide; otherwise, a good level of written and pictorial information about the service was provided to service users and their representatives. The staff undertook thorough measures to sensitively introduce prospective service users to their new home. EVIDENCE: Standards 2,3 and 5 were assessed and met at the previous inspection. The inspector read the home’s Statement of Purpose; it was noted that this document still contained references to the previous registration and inspection authority (London Borough of Newham). The inspector advised that there should be more detailed information regarding how the staff could support individuals to meet their religious needs and to maintain contact with relatives and friends. A current good practice at the home has enabled service users to visit a relative who lives at a different care home; this type of flexible support should be contained within the Statement of Purpose. The Service Users Guide was produced in a pictorial format and was well presented. The inspector found that there was some irrelevant information attached to this document (such as information for people who live in more independent types of accommodation offered by East Living); it was suggested by the inspector that this additional material should be removed to enable service users (and their representatives) to focus upon the essential details about 15-17 Chant Square. The inspector was informed that there had been no new admissions to the care home in the past twelve months. Although Standard 4 could not be specifically Chant Square (15&17) DS0000022832.V259447.R01.S.doc Version 5.0 Page 9 assessed at this inspection, existing care plans clearly evidenced that the staff undertook detailed multi-disciplinary work to enable prospective service users to move into the home in a well planned for manner that took into account individual’s needs and wishes. Chant Square (15&17) DS0000022832.V259447.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): 6,8 and 9 There was a very good improvement upon the quality of the care plans, although some continued work was needed to ensure the comprehensive presentation of the risk assessments. The manager was developing strategies to enable service users to have a more active role in the daily management of the home. EVIDENCE: Standards 7 and 10 were assessed and met at the previous inspection. The inspector looked at a randomly selected sample of the care plans and found that there had been a considerable improvement. The manager confirmed that new care plans had been developed for all of the service users. These care plans were ‘person centred’ and represented joint working with service users to establish how they wished to be supported by staff. Reviews were regularly undertaken by the home, in addition to separate annual statutory reviews chaired by social services departments. The manager stated that some of the service users participated in the ‘People First’ advocacy project and independent advocacy could be accessed if required. It was identified that the home did not offer an on-going arrangement to ensure that service users had a regular forum to express their views on how the home should be managed (for example, monthly meetings Chant Square (15&17) DS0000022832.V259447.R01.S.doc Version 5.0 Page 11 facilitated by an independent advocate). The manager stated that she was keen to find this type of resource and would make enquiries with local organisations. A grocery shopping/ menu planning pictorial board was being developed to enable service users to be fully involved in these household decisions (some of the service users do not communicate verbally). The inspector found that there was still some progress required with the risk assessments for service users. The manager was advised that each service user should have an ‘initial’ holistic assessment to determine and properly document that all aspects of a person’s physical, emotional, health and social life had been assessed to identify the presence of any risks. Chant Square (15&17) DS0000022832.V259447.R01.S.doc Version 5.0 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): 15 and 16 Service users are supported to maintain community links and develop new friendships. The entitlements of service users are respected. EVIDENCE: Standards 11,12,13,14,16 and 17 were assessed and met at the previous inspection. The inspector found via the reading of the care plans and through discussion with the manager that service users had opportunities to meet people outside of the home through their attendance at external groups (such as arts and crafts and a women’s discussion group at local resource centre). The service users had been away for holidays and accessed facilities such as cafes, shops and parks. The manager stated that through the person centred planning, staff had found that a few of the service users would like to attend church, which the staff will now facilitate for individuals. The care plans clearly identified the support networks for people (relatives and friends) and the home’s visiting policy encouraged service users to receive visitors. During this inspection, service users were consulted by staff regarding their preferences for activities and food choices. Service users were able to express a positive account of how their rights were respected, such as making choices Chant Square (15&17) DS0000022832.V259447.R01.S.doc Version 5.0 Page 13 when they went out with staff or declining upon activities that they had previously wished to engage in. Chant Square (15&17) DS0000022832.V259447.R01.S.doc Version 5.0 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 and 21 Service users received good support for their personal care and health needs; however, the home must apply a more rigorous approach to the management of medications. EVIDENCE: The care plans for the service users appropriately addressed their personal care needs and preferences. Service users presented as being well groomed; one of the service users showed the inspector her newly purchased clothes (bought on a shopping trip with a member of staff) and a wide selection of essential and ‘pampering’ toiletries. Staff recognised the importance of positive body image and self-esteem for individuals; during the inspection service users were offered manicures and an aroma therapist visited weekly. There was also equipment for the use of service users, such as a foot spa. The inspector discussed the individual health needs of service users with the manager. The service users received appropriate external health care support from general practitioners and district nurses. The manager had identified difficulties in the frequency of obtaining visiting NHS chiropody services at a previous inspection; although this external situation had not improved, the home had accessed alternative chiropody services (via attendance at NHS chiropody clinics and privately, if wished for by service users and their representatives). The inspector was aware of the recent hospitalisation of a Chant Square (15&17) DS0000022832.V259447.R01.S.doc Version 5.0 Page 15 service user; the staff had cared very well for this individual at the home and when the service user was in hospital. The inspector checked the home’s storage and administration of medication. The following discrepancies were noted; 1) a medication had expired 2) a medication did not have an expiry date and 3) a medication had not been written up on the current medication administration record. Apart from these issues, all other aspects of the home’s management of medication was found to be satisfactory. At the time of this inspection, four of the service users were aged over 60 years old. The service was committed to provide ‘a home for life’ unless the assessed needs of an individual required admission to a nursing home. Chant Square (15&17) DS0000022832.V259447.R01.S.doc Version 5.0 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 and 23. The home provided appropriate systems for managing complaints and protecting the needs of the service users; however, minor amendments must be made to the existing policies to ensure complete accuracy of information. EVIDENCE: The inspector read the home’s complaints procedure, which was provided in a pictorial format for service users and in a written version for their representatives. The pictorial version referred to the Commission for Social Care Inspection (CSCI) but did not state the role of the CSCI. A ‘quick guide to making complaints’ within the Service Users Guide did not contain any reference to the CSCI and a national address was provided, as opposed to the local Stratford office. The home possessed an appropriate Adult Protection policy and staff received Adult Protection training. A requirement was issued last year for the home to ensure that staff were informed of their entitlement to contact the CSCI (anonymously, if they wished to) regarding any concerns related to the conduct of the service. This requirement was subsequently deleted as the whistle-blowing policy was amended to include reference to the CSCI. At this inspection visit, the inspector was shown a whistle-blowing policy that did not refer to the CSCI. A new requirement has been issued in this report. Chant Square (15&17) DS0000022832.V259447.R01.S.doc Version 5.0 Page 17 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): 24,27,28,29 and 30. A pleasant, homely and clean environment is provided for service users. The programme of redecoration and refurbishment will improve upon the existing comfortable premises. EVIDENCE: Standards 25,26 and 30 were assessed and met at the previous inspection. A refurbishment programme was being undertaken at the time of this inspection, which included the re-decorating of communal and bedroom areas. The inspector was shown the pictorial plans for future decorations. The bedrooms were observed to reflect the individual preferences of service users and were comfortably furnished. Due to the assessed needs of the service users, the home was equipped with some specialist equipment for bathing and mobility. Service users had a choice of two lounge areas and a rear garden. The home was found to be clean, hygienic and free from any offensive odours. Chant Square (15&17) DS0000022832.V259447.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): 31,32,34,35 and 36. Noticeable improvements in staff supervision, training and mentorship had positively impacted upon the quality of the service. Service users are assured that responsibly recruited and suitably qualified staff meets their needs, with safe staffing levels per shift. EVIDENCE: Standard 33 was assessed and met at the previous inspection. The inspector looked at a randomly selected sample of the staff files, which contained applicable job descriptions and evidence of safe recruitment procedures in accordance to the stipulations of the Care Homes Regulations. The staffing rota demonstrated that a sufficient number of staff were allocated on each shift to meet the assessed needs of the service users, taking into account their different dependency levels. The home demonstrated that there has been a good focus upon meeting the training needs of staff within the past twelve months; in addition to undertaking National Vocational Qualifications, staff had attended training on ‘person centred care planning’, the ageing process, death and dying, equality/diversity and multi-media skills (used for developing the new care plans). The sample of individual supervision records checked by the inspector demonstrated that staff were receiving regular supervision, in accordance with the National Minimum Standards and the team meeting book evidenced monthly staff meetings. Chant Square (15&17) DS0000022832.V259447.R01.S.doc Version 5.0 Page 19 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): 37,38,39,40,41,42 and 43. The management of the home had significantly improved upon the quality of individualised care and support delivered to service users. The home needs to continue its progress of enabling service users to more actively express their views about 15-17 Chant Square. EVIDENCE: The current manager has been in post for approximately a year and was previously the manager of another local East Living care home for people with learning disabilities. There have been significant improvements achieved within the past twelve months and the manager expressed on-going plans to continue upon the improvements already attained. Staff had attended a training day for team building and to discuss how they could contribute to an improved service for the people who live at 15-17 Chant Square. At the time of this inspection, the quality assurance monitoring within the home was predominantly undertaken through the unannounced monthly visits from the area manager. These reports were found to be detailed and transparent in reporting upon any issues that needed to be addressed. The manager stated that she was now in a position to implement her own monthly Chant Square (15&17) DS0000022832.V259447.R01.S.doc Version 5.0 Page 20 audits, having addressed other specific needs within the home such as the care planning system. The need for audits was identified during this inspection (for example, the presence of an expired medication). Due to the varying needs of the service users, formal approaches to including their views in the development of the home would present some difficulties (particularly for service users who are non-verbal). The manager acknowledged that this needs to be addressed and the home has started this process through its recent focus upon person centred planning for each service user. Four requirements were issued in the previous inspection report related to the health and safety of the service users. The inspector checked the following health and safety practices, which were found to be satisfactory; 1) Environmental risk assessments 2) First aid box 3) Electrical installations inspection by a competent person 4) Fire points testing 5) Fire evacuation drills 6) Annual maintenance of fire equipment 7) Refrigerator and freezer temperatures and 8) Labelling of opened food items. The landlord’s gas safety check and the portable electrical appliances testing were due within December 2005. Three of the requirements were met and one was partly met. The home must ensure that food probe temperatures are recorded at the weekends and photocopies of the two health and safety checks due by the end of December 05 must be sent to the CSCI. Chant Square (15&17) DS0000022832.V259447.R01.S.doc Version 5.0 Page 21 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 2 X X 3 X Standard No 22 23 Score 2 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X 3 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 X 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Chant Square (15&17) Score 3 3 2 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 2 3 DS0000022832.V259447.R01.S.doc Version 5.0 Page 22 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 YA1 Regulation 4 and 5 Requirement The references to the former registration authority must be removed from the Statement of Purpose and replaced with references to the CSCI. All service users care plans must contain comprehensive risk assessments. The medication needs of the service users must be managed in accordance to the homes own medication policy, to ensure that a consistently rigorous and safe service is provided. All versions of the complaints procedures must inform prospective complainants of the CSCI, its function and local contact details. The whistle-blowing policy must include information to advise staff of their entitlement to contact the CSCI. Evidence of the gas safety and portable appliances testing (due by 31/12/05) must be sent to the CSCI. Staff must record food temperatures at the weekend or any other occasion that a cook is DS0000022832.V259447.R01.S.doc Timescale for action 31/03/06 2 3 YA9 YA20 15 13 (2) 31/03/06 31/01/06 4 YA22 22 28/02/06 5 YA23 13 (6) 31/03/06 6 YA42 13 (3) 15/02/06 7 YA42 13 (3) 31/01/06 Chant Square (15&17) Version 5.0 Page 23 not rostered for duty. 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 YA1 Good Practice Recommendations The Statement of Purpose should contain more information as to how the service will support people to meet their religious/spiritual needs and how support will be offered for maintaining contact with relatives and friends. The home needs to develop more opportunities to enable service users to actively contribute to the daily management of the home. 2 YA8 Chant Square (15&17) DS0000022832.V259447.R01.S.doc Version 5.0 Page 24 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 Chant Square (15&17) DS0000022832.V259447.R01.S.doc Version 5.0 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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