Inspection on 01/07/08 for Chase (The)

This inspection was carried out on 1st July 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Chase (The) 15/04/09

Chase (The) 27/01/08

Chase (The) 17/10/07

Chase (The) 25/05/06

Chase (The) 03/11/05

Chase (The) 10/06/05

Chase (The) 16/03/05

Chase (The) 30/11/04

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 27/09/2008.

CARE HOME ADULTS 18-65 Chase (The) 165 Capel Road Forest Gate London E7 0JT Lead Inspector Anne Chamberlain Unannounced Inspection 1st - 11th July 2008 10:00 Chase (The) DS0000041012.V365576.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 Chase (The) DS0000041012.V365576.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. Chase (The) DS0000041012.V365576.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chase (The) Address 165 Capel Road Forest Gate London E7 0JT 0208 478 7702 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) tom@roselock.com Alpam Homes Thomas Francis Byrne Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Chase (The) DS0000041012.V365576.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th October 2007 Brief Description of the Service: The Chase is a residential home, which is registered for up to eight service users, with a learning disability. The home is situated within a short walking distance of Manor Park over ground station, and some local shops and amenities. The home is comprised of an older end of terrace house with a new double story extension at the rear. The home is owned by Alpam Homes, a local provider of care services. Fees at the home range from £1,250 - £2,000. Chase (The) DS0000041012.V365576.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means that service users experience adequate quality outcomes. The inspection was conducted by an inspector, on behalf of the Commission for Social Care Inspection (CSCI). The terms we and us we will be used throughout the report to. Prior to the site visit the home completed an Annual Quality Assurance Assessment. The site visit took place over one day. The manager assisted us and we were able to observe service users having lunch. Two service users showed us their rooms and chatted with us. We also consulted with one stakeholder. We looked at the files for three service users and the administration of their medication. We looked at staff files and a tour of the house and garden. What the service does well: The service is committed to providing a varied, challenging, programme of activities for service users. It is understood that the service users are young people who need lots of fun and opportunities to use their considerable energies. Service users are encouraged to grow in independence and to fulfil their potential. The manager works directly with service users and understands their individual needs. A professional who works with the services stated that the manager and staff have always been polite and willing to be helpful. The environment at the home is spacious and comfortable. Chase (The) DS0000041012.V365576.R01.S.doc Version 5.2 Page 6 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. Chase (The) DS0000041012.V365576.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 Chase (The) DS0000041012.V365576.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. The manager and staff make sound assessments of the needs of prospective service users. EVIDENCE: Two new service users have recently been admitted to the home. We looked at their files and felt that their assessment prior to induction was comprehensive. In one case it included staff from the home spending two days with the prospective service user at his old home. Chase (The) DS0000041012.V365576.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users have many opportunities to take decision. Their service user plans can be improved and they could sign key documents. EVIDENCE: We inspected service user plans. Generally they were of a reasonable standard but some aspects of care were not covered. The plans must include information on how service users prefer their personal care support to be given. One service user is very reluctant to undergo any dental work. His care plan must include a programme for maintaining oral health. Another service user must not be left alone in the bathroom due to epilepsy. This should be stated in her personal plan. Two service users of the three case-tracked need to have Chase (The) DS0000041012.V365576.R01.S.doc Version 5.2 Page 10 their weight monitored regularly and this should be stated in their personal plans. Service user plans must be signed by service users to show that they have shared in them. If a service user is not able to sign (for whatever reason), then this can be stated where the signature would be. The signatures must be dated. Service users have opportunities to take many decisions about their own lives. They have personal autonomy over when they get up, go to bed etc. Daily logs evidenced this. They also attend residents meetings where issues which affect everyone are discussed. The home has rearranged the rooms so that two female service users who get on well, have their rooms close together. They also have the use of a nearby room for socialising together. We saw risk assessments on the three files we inspected. The risk assessments were satisfactory but had not been signed and dated by both parties. Service users must have an opportunity to sign their own key documents to show they or their representative has been consulted over them. Chase (The) DS0000041012.V365576.R01.S.doc Version 5.2 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. 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. Service users are offered a variety of opportunities to have fun and develop their skills. The home supports contact with families and friends and provides wholesome and tasty food in nice surroundings. EVIDENCE: The service users at the home, with one exception, attend day services run by the same organisation. They come home for lunch. We have visited the day services in the past and formed a good impression of them. The manager stated that the day services have been further developed and now focus on life skills rather than education. However everyone has their own individual learning plan. There are four homes in the organisation and most service users attend. They are organised into new groups so that social circles are widened. There are many opportunities open to service users. Trips out are a Chase (The) DS0000041012.V365576.R01.S.doc Version 5.2 Page 12 major feature, especially in the summer. We saw on the notice board a whole variety of trips which are planned for the next few weeks. Service users also go swimming and sailing and to the leisure centre and cinema once a month, and visit museums and theatres. They also attend a Wednesday club which the manager said they really enjoy. Most service users have good contact with their families and this is well supported by the home. Families visit the home as often as they want to. One service user goes home regularly for visits. Service users have keys to their rooms and they are encouraged to keep them rtidy and undertake tasks at home. One service user likes peeling vegetables and does them perfectly. We observed service users having lunch and noted how appropriately they all behaved at the table and that the dining room environment is pleasant. Lunch was sandwiches and the service users would have a cooked meal for dinner. There are no fixed rules and meals fit in with what service users are doing. The manager stated that there is always an alternative food choice. Two service users are inclined to be of low weight and it was recorded that they should be weighed regularly every month. This is dealt with elsewhere in the report. The manager stated that service users visit the farm shop as a group to choose their own vegetables. The home keeps a record of what meals are eaten and we looked at this. There was a reasonable variety and choice of wholesome foods. Chase (The) DS0000041012.V365576.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users receive personal support in the way they prefer and their physical and emotional needs are met. The policy, procedure and administration of medication in the home needs significant improvement. EVIDENCE: Based on this and other inspections at the home we believe that service users receive personal support as they prefer and need. However as mentioned earlier service user plans do not guide workers in how to offer an individual personal care support. We noted that on two of the files we inspected it was stated that the service user should be weighed every month to ensure that they are maintaining a healthy weight. The weight charts were present in the files but the evidence was that the service users were not weighed on a regularly monthly basis as some months were missing. Chase (The) DS0000041012.V365576.R01.S.doc Version 5.2 Page 14 On the file of one service user it stated that he was allergic to three quite important foods. The manager stated that he didnt know whether this information was correct or not. It is strongly recommended that this information be explored and it is determined whether or not this service user is allergic to these foods. If necessary medical help should be sought to undertake this work. The manager was able to talk in some depth about the emotional needs of the service users and the relationships between service users and staff. We felt that the manager provides good leadership to the staff, in this area. The manager stated that the keys to the medication cupboard are always kept on the shift leader. We looked at the medication policy. It needs to be developed and expanded to include a full procedure of how medication is received into the home, administered and disposed of. It also needs to cover PRN or as required medications. We inspected the arrangements for the administration of medication. We noted that when medicines which are in MDS blistered cards are returned to the pharmacist the home is not treating them as disposed of and recording the disposal. They need to do this. We noted that a staff member had been signing for administration of medication but there was no specimen of his signature in the medication folder. The home must have specimen signatures for all members of staff who dispense medication. The medication administration charts MAR for three service users were inspected. The MAR chart for one service user showed that he should have a certain medication three times a day, including a dose in the afternoon. The dispensing instructions on the MAR chart and on the medicine container both stated this, but the actual time of administration of the afternoon dose had been omitted by the pharmacy from the MAR chart. The home had only been administering the medication twice a day, not in the afternoons. This omission had occurred for three days since the beginning that particular MAR chart. MAR sheets must be carefully checked when they arrive in the home. We noted that two bottles of a liquid medication had been started together, which is not good practice. The manager put a memo in the medication cabinet about this whilst we were at the home. It was impossible to balance the stock of one liquid medication because only some of the medication had been recorded as coming in to the home. The manager had to telephone the pharmacist to check how much medication had been dispensed to them since the person had been at the home. Even Chase (The) DS0000041012.V365576.R01.S.doc Version 5.2 Page 15 assuming that empty bottles had been disposed of, we still could not balance the stock and the manager believed that medication had been brought in from home and not recorded. All medication brought into the home must be recorded. The stock of liquid medication for another service user could not be accounted for. Around 300 mls should have been administered but only 75mls could be evidenced as having been used, again the manager stated that he believed this service user who had recently been admitted to the home had brought medication in with him, which had not been recorded. One MAR chart had one empty administration entry box and the manager stated he believed this was an error, that the medication had been administered but not signed for. Chase (The) DS0000041012.V365576.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home listens to the views of service users and protects them from harm. However there are two shortfalls. EVIDENCE: The home has complaints information for service users. The manager stated that if a service user makes a verbal complaint the issue is addressed immediately. One service user had complaints information at back of his file which gave a previous address of The Commission for Social Care Inspection (CSCI). Also the complaints information on the notice board gave the same previous address. The complaints information needs to be updated with the correct address for the CSCI. The home has two new service users but they have not yet (with their permission) taken photographs of them. These photographs are needed for the medication file and for the missing persons information. They would help protect service users if they were missing in the community. The home must obtain photographs of the two new service users in order to properly protect them. Chase (The) DS0000041012.V365576.R01.S.doc Version 5.2 Page 17 The manager stated that the homes policy and procedure for managing safeguarding, is to follow the Redbridge social services policy. He had the manual to hand. Chase (The) DS0000041012.V365576.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home environment is safe and comfortable. It is clean and hygienic. EVIDENCE: We made an inspection of the premises. The home is comfortable and the environment is good but showing some signs of wear and tear now. The manager stated that the handyman deals with all maintenance issues promptly and showed us the book where these are recorded for him by staff. There is a cracked pane in a front window which needs to be replaced. One of the new service users at the home has visual loss and we noted that some adaptations have been made for him. Objects of reference have been added to doors so that he can identify rooms. The manager stated that the service users have been very aware and co-operative in not moving furniture around or leaving things on the floor which could trip this person up. Chase (The) DS0000041012.V365576.R01.S.doc Version 5.2 Page 19 When we saw two service users bedrooms they were both very pleasant and had been personalised by the service users with their favourite things around them. None of the service users has an infectious or contagious disease and the laundry facilities are located away from the kitchen. The home was clean and hygienic with no unpleasant odours. Chase (The) DS0000041012.V365576.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff at the home are competent and qualified. Staff are safely recruited and well trained. EVIDENCE: Some of the staff at the home have been there for a number of years. We looked at three staff files and checked on recruitment practice which was satisfactory. The organisation has appointed a worker to keep track of staff training. She notifies managers when training is due. We noted from files that the level of staff training was improved with workers renewing core training on a more regular basis. Chase (The) DS0000041012.V365576.R01.S.doc Version 5.2 Page 21 At the site visit the manager stated that there were two workers who had not had First aid training (one being very new) but that this could be rectified very quickly. Before the report was completed the manager advised the CSCI, in writing, that both workers have now had First Aid training and 100 of workers at the home have now had First Aid training. Chase (The) DS0000041012.V365576.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run and service users views are taken into account. Health and safety are promoted. EVIDENCE: There was evidence that the home is well run. The manager is experienced and provides strong leadership. There are structures and systems in place to encourage staff to work in a professional way. The ethos of the home is caring and supportive. Chase (The) DS0000041012.V365576.R01.S.doc Version 5.2 Page 23 The method of obtaining quality assurance information in the organisation is for managers to inspect each others homes on an annual basis. The manager stated that he wants to start a parents and advocates group with a rotating chair by staff members. This would be good in terms of providing a broader range of quality assurance information. Feedback obtained from one stakeholder, consulted as part of this inspection, was that the manager and staff are pleasant and helpful. Chase (The) DS0000041012.V365576.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 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 x 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 2 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 2 x x x 3 x 3 x x Chase (The) DS0000041012.V365576.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? YES 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 YA6 Regulation 15 Requirement Service user plans must include all necessary information as to how the service users needs in respect of his health and welfare are to be met. Service user plans must evidence consultation with the service user or his representative, in the form of a signature and date. Risk assessments must evidence consultation with service users or their representatives, in the form of a signature and date. Health plans made for service users must be properly implemented, including weight monitoring. The medication policy needs to be developed and expanded to include a full procedure of how medication is received into the home, administered and disposed of. It also needs to cover PRN or as required medications. Medicines which are in MDS blistered cards, and are returned Chase (The) DS0000041012.V365576.R01.S.doc Version 5.2 Page 26 Timescale for action 01/08/08 2. YA6 15 01/08/08 3. YA9 13 01/08/08 4. YA19 12 01/08/08 5. YA20 13 01/08/08 to the pharmacist, must be as disposed of and the disposal recorded. The home must have specimen signatures for all members of staff who dispense medication. MAR sheets must be carefully checked when they arrive in the home, to ensure safe administration of medication. Where medication is not dispensed in an MDS blistered card, in whatever form it is, only one container should be opened at once. All medication brought into the home must be recorded, to ensue the safe administration of medication. Whenever medication is dispensed the MAR sheet must be signed. Outdated CSCI contact details on complaints information must be updated. In order the protect service users a photograph must be obtained of them The cracked pane in the front window must be replaced. 6. 7. 8. YA22 YA23 YA24 22 13 (6) 23 2 (b) 01/08/08 01/08/08 01/08/08 Chase (The) DS0000041012.V365576.R01.S.doc Version 5.2 Page 27 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 YA19 Good Practice Recommendations It is strongly recommended that information regarding allergies be explored and it is determined whether or not a particular service user is allergic to certain foods. If necessary medical help should be sought to undertake this work. Chase (The) DS0000041012.V365576.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Chase (The) DS0000041012.V365576.R01.S.doc Version 5.2 Page 29 - 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. 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