Inspection on 21/04/05 for Chant Square (15 &17)

This inspection was carried out on 21st April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 10 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) 19/12/05

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 15 & 17 Chant Square 15 & 17 Chant Square Stratford London E15 Lead Inspector Sarah Greaves Unannounced Inspection 21st April 2005 at 17:00 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 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 Stationary 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. 15 & 17 Chant Square G57 G06 S22832 Chant Square V222296 210405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service 15 & 17 Chant Square Address 15 & 17 Chant Square, Stratford, London, E15 Telephone number Fax number Email 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 8519 0551 East Living Limited Ms Frances Carr Care Home 8 Category(ies) of Learning disability (8) registration, with number of places 15 & 17 Chant Square G57 G06 S22832 Chant Square V222296 210405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th December 2004 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 bedroomed flat (no.17). 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. 15-17 Chant Square is managed by East Living, which is a local care provider and housing association. 15 & 17 Chant Square G57 G06 S22832 Chant Square V222296 210405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place during one afternoon. The inspector spoke to all of the service users present; there were no visitors or visiting professionals at the time of the inspection. The inspector also gathered information from staff via a telephone discussion with the registered manager during the inspection and discussions with the four support workers present (a permanently employed member of staff at no.17 and three agency workers at no.15). Six requirements and one recommendation were issued in the previous inspection report; five of these requirements were due to be met between 31/05/06 and 30/06/05, and one requirement was due to be met at the time of this inspection. The requirement due to be met at the time of the inspection and one other requirement were found to be met. The one recommendation had been met. Five new requirements and one recommendation have been issued as a result of this inspection visit. What the service does well: What has improved since the last inspection? The service had implemented a broader programme of ‘in-house’ activities and entertainments, which recognised that some of the service users might not wish to access community facilities as regularly as before, due to factors such as increasing frailty linked to the ageing process. At the last inspection, the home possessed an acting manager; it has now been confirmed that this appointment is permanent. 15 & 17 Chant Square G57 G06 S22832 Chant Square V222296 210405 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 15 & 17 Chant Square G57 G06 S22832 Chant Square V222296 210405 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection 15 & 17 Chant Square G57 G06 S22832 Chant Square V222296 210405 Stage 4.doc Version 1.20 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 standard(s) 2, 3 and 5. The holistic needs of service users were clearly assessed before their admission to 15-17 Chant Square. Prospective service users were provided with good support and information in order to move in for trial periods. Service users were issued with a fairly presented contract. EVIDENCE: The inspector viewed two randomly selected care plans. The care plans contained assessments from the placing authorities, received by the home prior to the admission of the service users. These assessments had been supplemented with additional assessments and information gathering undertaken by the home. The care plans possessed documentation to evidence that service users had undertaken visits to the home before moving in for a trial period. In addition to a programme of pre-visits, a flexible and individualised approach was implemented (for example, staff visited prospective service users at their place of residence and developed links with their day centres). The two care plans viewed contained written contracts. 15 & 17 Chant Square G57 G06 S22832 Chant Square V222296 210405 Stage 4.doc Version 1.20 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 8, 9 and 10. The assessed needs of the service users were documented in their care plans; however, these care plans required additional development in order to present as a fully holistic and accurate measure of whether personal goals have been attained and /or new objectives have been established. The home needed to ensure that all risk assessments are updated in order to comprehensively demonstrate that service users are supported to take any chosen risks. The service presented a commitment to listening to the views of service users. Confidentiality was promoted. EVIDENCE: The inspector noted in one of the care plans that the documentation for an internally arranged review meeting did not record the date of the meeting or the name of the staff member who wrote the document. A requirement was issued in the previous inspection report for the home to improve upon the quality of the care plans and risk assessments by June 2005. Via the reading of two care plans and their accompanying risk assessments, the inspector noted that some improvements had been achieved. The majority of the service users are not able to participate in formal, structured participatory activities (for example, staff recruitment panels) due to their learning disabilities and nonverbal communication. The inspector observed that the service provider did 15 & 17 Chant Square G57 G06 S22832 Chant Square V222296 210405 Stage 4.doc Version 1.20 Page 10 offer service users forums for enabling service users to contribute to the development of policies, although this type of forum would only be suitable for a limited number of service users at Chant Square. The inspector found that service users with verbal communication were able to express their preferences and these preferences were observed to be met. The home used other methods of communication (such as objects of reference and developing detailed knowledge of the preferences of individuals). The confidential information relating to the service users was securely stored in an office which is kept locked when not in use. 15 & 17 Chant Square G57 G06 S22832 Chant Square V222296 210405 Stage 4.doc Version 1.20 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 standard(s) 11, 12, 13, 14, 15 and 17. Service users were offered opportunities for personal development, community activities, entertainments and leisure pursuits. Service users were enabled to maintain external relationships. EVIDENCE: The inspector observed that the home had introduced a programme of activities which included gardening, herbs potting, baking, painting, music and movement, foot spa treatments, bingo and coffee mornings. The care plans read by the inspector demonstrated that service users attended activities in the community ( including day centres, People First self-advocacy and trampoline exercises). The inspector spoke to a service user who likes to go out grocery shopping every day with the support of a member of staff. The home had recently been visited by musical entertainers and individual outings were arranged in accordance to the expressed preferences of service users, such as trips to West End shows. The visiting policy encouraged a flexible and welcoming approach for visitors. One of the service users informed the inspector of the links that they 15 & 17 Chant Square G57 G06 S22832 Chant Square V222296 210405 Stage 4.doc Version 1.20 Page 12 maintained with their relatives. The inspector viewed the weekly menu plan; this demonstrated a balanced and healthy choice of meals and snacks. The inspector observed the support given to service users during the main meal; this support ensured the dignity of individuals who required verbal and physical assistance at mealtimes. 15 & 17 Chant Square G57 G06 S22832 Chant Square V222296 210405 Stage 4.doc Version 1.20 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 standard(s) 20 The home needed to ensure a more robust system for the storage and administration of medications. EVIDENCE: The inspector checked the medication cabinet and the medication administration records. Two different medications that were no longer prescribed to service users were found in the medication cabinet. The medication administration records evidenced gaps where medication had not been signed for. The medication guide (British National Formulary-BNF) was dated September 2000 and should be replaced with an updated version; advice was recorded in the previous inspection report for the home to replace the BNF. 15 & 17 Chant Square G57 G06 S22832 Chant Square V222296 210405 Stage 4.doc Version 1.20 Page 14 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 standard(s) 22 and 23 The home’s approach to welcoming and managing complaints enabled service users to feel that their views and concerns were professionally responded to. The clearly written Adult Protection policies and staff training promoted the protection and safety of the service users. EVIDENCE: The inspector viewed the written complaints procedure (separate pictorial information was also provided for service users). The written complaints procedure was comprehensively presented. Some of the service users had attended independent groups (such as meetings held by People First selfadvocacy) and understood that they could access advocacy support in the event of a complaint. The complaints policy designed for the service users clearly emphasised this entitlement. A requirement was issued in the previous inspection report for the service to amend the whistle-blowing policy in order to advise staff of their right to contact the CSCI of any concerns relating to the conduct of the home; this requirement was found to be met. The Adult Protection policy was satisfactorily written, in accordance to Department of Health ‘No Secrets’ and staff were provided with training related to the Protection of Vulnerable Adults. 15 & 17 Chant Square G57 G06 S22832 Chant Square V222296 210405 Stage 4.doc Version 1.20 Page 15 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 standard(s) 25, 26 and 30 The service users were provided with bedrooms that met their needs for privacy, space, individuality and space. The service users general environment was clean and hygienic. EVIDENCE: The inspector was permitted to view the bedrooms of three of the service users. The bedrooms were of a satisfactory size in accordance to the specifications of the National Minimum Standards. The inspector observed that the bedrooms were well maintained, comfortable and tidy. Service users confirmed that they were consulted regarding the décor and furnishings for their room; the inspector also noticed that ‘personal decorations’ such as ornaments and soft furnishings were encouraged. The home was found to be clean and free from any offensive odours. 15 & 17 Chant Square G57 G06 S22832 Chant Square V222296 210405 Stage 4.doc Version 1.20 Page 16 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 Service users benefited from good staffing levels which facilitated one-to-one activities with staff. The skill mix of staffing ensured that any complex needs of service users were addressed by one of the deputy managers, in the absence of the manager. EVIDENCE: The inspector viewed the staffing rota, which demonstrated that staffing levels for each shift are good. At the time of the inspection, three care workers were on duty at no.15 (registered for up to seven service users) and one member of staff was working in no.17 (registered for one service user). The staffing levels for the daytime demonstrated that service users could be supported to undertake one-to-one activities such as shopping trips, which was documented in the home’s diary. The scheduling of staff also ensured that service users could be escorted to hospital and other appointments. The rota evidenced that in addition to the presence of a permanent manager, the home also had two full-time deputy managers. At the time of the inspection, the three staff present at no.15 were from an agency. Via the reading of the home’s diary, viewing of the staff rota and discussion with the manager, the inspector was satisfied that this staffing arrangement had occurred due to specific circumstances and was not a regular occurrence. 15 & 17 Chant Square G57 G06 S22832 Chant Square V222296 210405 Stage 4.doc Version 1.20 Page 17 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The health, safety and welfare of service users was not consistently promoted. The inspector has issued four requirements in this report, related to the maintenance of a safe environment. EVIDENCE: The inspector checked the storage of opened food items in the refrigerator. Six items were found to not have a label with the date of opening. The refrigerator, freezer and food temperatures were not consistently on a daily basis. The laundry room was not locked and detergents (washing liquid and fabric conditioner) were left on an accessible shelf. The inspector rang the alarm to summon assistance; a member of the agency staff did not search the premises to establish who was calling for assistance until the third time that the alarm was activated. The fire alarms were evidenced to be professionally checked on an annual basis and the portable electrical appliances testing was noted to be valid. 15 & 17 Chant Square G57 G06 S22832 Chant Square V222296 210405 Stage 4.doc Version 1.20 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x 3 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x x 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score x 3 3 x x x 3 Standard No 11 12 13 14 15 15 & 17 Chant Square 3 3 3 3 2 Standard No 31 32 33 34 35 36 Score x x 3 x x x Version 1.20 Page 19 G57 G06 S22832 Chant Square V222296 210405 Stage 4.doc 16 17 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 1 x 15 & 17 Chant Square G57 G06 S22832 Chant Square V222296 210405 Stage 4.doc Version 1.20 Page 20 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(1) (c) Requirement Timescale for action 31/05/05 2. 3. YA1 YA6 and YA9 YA20 5 15 4. 13 5. 6. YA36 YA42 18(2) 13(4) (c) 7. YA42 13(4) (c) 8. YA42 13(4) (c) The Registered Person must ensure that theStatement of Purpose includes more detailed information regarding the qualifications and experience of the staff, as per Schedule 1 of the Care Homes Regulations. The Registered Person must 30/06/05 ensure that the home produces a Service User Guide. The Registered Person must 30/06/05 ensure that the care plans and risk assessments are regularly reviewed. The Registered Person must 31/05/05 ensure that the system for the storage and administration of medication complies with the homes policy. The Registered Person must 31/05/05 ensure that staff receive appropriate formal supervision. The Registered Person must 31/05/05 ensure that all opened food items are labelled date of opening. The Registered Person must 31/05/05 ensure that the temperatures for food, the refrigerator and the freezer are recorded daily. The Registered Person must 31/05/05 Version 1.20 15 & 17 Chant Square G57 G06 S22832 Chant Square V222296 210405 Stage 4.doc Page 21 9. YA42 13(6) ensure that washing liquid and fabric conditioner are stored in a locked cupboard in the laundry room. The Registered Person must ensure that all staff are aware of the need to investigate the source of an activated alarm. 31/05/05 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 YA20 Good Practice Recommendations The Registered Person should obtain an updated guide to medications. 15 & 17 Chant Square G57 G06 S22832 Chant Square V222296 210405 Stage 4.doc Version 1.20 Page 22 Commission for Social Care Inspection 4th Floor, 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. 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