Inspection on 10/06/05 for Chase (The)

This inspection was carried out on 10th June 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 but made no statutory requirements on the home.

Other inspections for this house

Chase (The) 15/04/09

Chase (The) 01/07/08

Chase (The) 27/01/08

Chase (The) 17/10/07

Chase (The) 25/05/06

Chase (The) 03/11/05

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 08/07/2008.

CARE HOME ADULTS 18-65 Chase (The) Chase (The) 165 Capel Road London E7 0JT Lead Inspector Sarah Greaves Unannounced Inspection 10th June 2005 10:00am 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. Chase (The) G57 G06 S41012 Chase (The) V227168 100605 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service The Chase Address 165 Capel Road, Forest Gate, London E7 OJT 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) 0208 550 0777 Alpam Homes Thomas Francis Byrne Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Chase (The) G57 G06 S41012 Chase (The) V227168 100605 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 16th March 2005 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 overground station, and some local shops and amenities. The home is an ordinary domestic property with a ground and first floor. The home is owned by Alpam Homes, a local private sector provider of care services. Chase (The) G57 G06 S41012 Chase (The) V227168 100605 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 evening, between 5pm and 8pm. The inspector spoke to all five of the service users present; there were no visitors or visiting professionals at the time of the inspection. The inspector also gathered information from the two members of staff on duty and looked at policies and procedures. Three care plans were read during this inspection. The service users had just finished their supper at the time of the inspector’s arrival. The inspector joined the service users for their evening recreation and was invited by a service user to look at their room. Further information has been sought from the registered manager following this inspection regarding first aid training for staff that are in charge of the home on a daytime or overnight shift. A total of nine requirements and two recommendations have been issued in this report; one of the nine requirements was issued in the previous inspection report (March 2005) and was not due to be met at the time of this inspection. What the service does well: What has improved since the last inspection? A requirement was issued in a previous inspection report for the home to establish a permanent staff team. This requirement arose at a time that the Chase (The) G57 G06 S41012 Chase (The) V227168 100605 Stage 4.doc Version 1.20 Page 6 home was newly operative and the number of service users expected to move in was not known. Experienced care workers from a ‘sister’ home and regular agency staff then staffed the home. The inspector found that the home had now made satisfactory permanent arrangements for staffing. 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. Chase (The) G57 G06 S41012 Chase (The) V227168 100605 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 Chase (The) G57 G06 S41012 Chase (The) V227168 100605 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) 1,2 and 5 Prospective service users are provided with good information about the home prior to moving in for a trial period and receive a detailed assessment of their needs by relevant professionals involved in their care. Current and prospective service users would benefit from receiving pictorial ‘user friendly’ contracts to assist them to understand their rights and responsibilities at their home. EVIDENCE: The inspector viewed the Statement of Purpose and the Service Users Guide. These documents have been viewed on previous inspections and found to be satisfactory; evidence was presented to demonstrate that these documents are reviewed on an annual basis or more frequently if necessary. The inspector viewed three care plans, which were found to contain satisfactory social and healthcare assessments, conducted by external professionals prior to the service users moving in. The individual files of service users contained a comprehensively written contract, however, a recommendation for the service users to receive pictorial contracts had not been met at the time of this inspection. Chase (The) G57 G06 S41012 Chase (The) V227168 100605 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 and 10. The care plans need to be designed in a manner which clearly demonstrates that there is a straight-forward system for regularly reviewing and updating the individual needs and goals of service users. Service users are supported to participate in the daily management of the home; however, the hand-written minutes for their meetings should be maintained within the premises. Confidentiality for service users was upheld. EVIDENCE: The inspector read three of the care plans. The presentation of the care plans did not enable the inspector to clearly identify that all of the objectives had been reviewed within the designated timescales. The inspector noted that one of the care plans did not contain evidence of a six-monthly review, although the service user had lived at the home for approximately eight months. A member of staff informed the inspector that some information relating to the care plans was stored on the home’s computer, which could not be accessed during this inspection. Service users are allocated a key worker, however, there was no indication that key workers are actively involved in the care planning and reviewing process. The inspector has taken into account that the home became operative in August 2004 and has gradually built up a team of permanent staff team, which has increased in accordance to the admissions of Chase (The) G57 G06 S41012 Chase (The) V227168 100605 Stage 4.doc Version 1.20 Page 10 new service users. It is therefore acknowledged that some aspects of the care planning process needed to be commenced by the registered manager prior to the establishment of the present key working system. The inspector requested to view the minutes of the service users meetings in order to establish that a formal system was in place to enable service users to contribute to the daily and wider management of the home. Staff were unable to produce these minutes as these were also held electronically at the time of the inspection. Via observation and through discussion with service users, the inspector found that service users were fully consulted regarding their daily routine, menu choices and whether they wished to be actively involved in this inspection visit. The inspector viewed the home’s satisfactorily written confidentiality policy, and found that the care plans and other confidential information relating to service users are securely stored in a lockable office. Chase (The) G57 G06 S41012 Chase (The) V227168 100605 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 are offered good opportunities for personal development, community activities, entertainments and leisure pursuits. Service users are supported to maintain external relationships and staff recognised the value of these relationships/friendships for service users. EVIDENCE: Through the reading of three care plans and via discussion with service users and staff, the inspector found that a varied programme of activities and entertainments was offered. The service users attended regular day centre groups and had recently visited Southend and Brighton. A holiday to a Pontins centre has been arranged for this summer, which will be attended by all of the service users; the inspector considered the planning of a holiday which met with the approval of all of the service users to be a good achievement since the home has been open for less than a year. The inspector was informed by staff that the home had recently found out about a local weekly evening disco for people with learning disabilities and will support service users to attend, if they wish to. The visiting policy encouraged a flexible and welcoming approach for visitors. Service users told the inspector that they regularly visited their Chase (The) G57 G06 S41012 Chase (The) V227168 100605 Stage 4.doc Version 1.20 Page 12 families, including weekend stays. Staff demonstrated via discussion with the service users and the inspector that they possessed a good knowledge of each service users family background and the importance of service users maintaining regular contact with their relatives and friends. The service users had just completed their evening meal at the time of the inspector’s arrival; it was observed that service users were having different desserts according to their own choices. A recommendation was issued in the previous inspection report for the home to maintain a more detailed record of meals served; however, the documentation viewed by the inspector was found to be inconsistent at times and a requirement has been issued in this inspection report. Chase (The) G57 G06 S41012 Chase (The) V227168 100605 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 Service users needs for safe administration of their medications were not satisfactorily met. The home must ensure that a rigorous approach to the management of medication is applied, in accordance to the requirements issued in this report. EVIDENCE: The inspector checked the medication cabinet and medication records. It was observed that a medication was signed for as having been given to a service user on three separate occasions but the medication was still present in the blister pack. Three different medications had been placed in the blister pack by the pharmacist for administering in the evening; however, these medications had been prescribed for different times. The staff informed the inspector that they has noted these errors and were administering the medications at the correct prescribed time. The topically applied medications (such as creams and ointments) did not have full instructions on the pharmacy label regarding where the medication should be applied. Chase (The) G57 G06 S41012 Chase (The) V227168 100605 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 Further work is required upon the written complaints procedure although service users expressed confidence in how they would make a complaint, if necessary. The procedures and internally provided training safeguarded service users and the forthcoming additional external training for staff will ensure increased competency in the protection of service users from potential abuse. EVIDENCE: A requirement was issued in the previous inspection report for the home to amend the written complaints procedure to ensure that complainants are aware of their entitlement to inform the Commission for Social Care Inspection at any stage of their complaint. This requirement is due to be met by 30/06/05. The complaints procedure had not been updated at the time of this inspection. Service users are provided with a well-presented pictorial guide for making complaints, which informs them of the role of the Commission. Via discussion with service users, the inspector was advised that their choice would be to notify their families if they had a concern. The home produced a satisfactorily written Adult Protection procedure. A recommendation was issued in the previous inspection report for the home to offer external Adult Protection training to staff (to complement the internally provided training); this recommendation has been removed, as this training will be available from Newham Social Services. Chase (The) G57 G06 S41012 Chase (The) V227168 100605 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) 24, 25, 26, 28 and 30. Service users are provided with comfortable and pleasant individual and communal areas. EVIDENCE: The inspector was invited to view one of the bedrooms at this inspection visit. The bedroom was very pleasantly decorated, comfortable and evidenced that the service user had been encouraged to personalise their individual space. All of the bedrooms are of a satisfactory size; the inspector at the announced inspection last year established this. The home has a choice of communal spaces (large combined lounge and dining room, a conservatory style room and a rear garden). The indoor communal rooms were noted to be tastefully decorated, relaxing and homely. The garden was well maintained and spacious. At the time of the inspection the home was very clean and free from any offensive odours. Standard 29 was not assessed, as it is not applicable to the service. Chase (The) G57 G06 S41012 Chase (The) V227168 100605 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 are supported by a sufficient number of staff per shift to ensure that their identified needs are suitably met. The staff on duty at the time of the inspection were experienced and had received relevant training. EVIDENCE: The inspector viewed the staffing rota, which demonstrated that staffing levels for each shift are satisfactory. At the time of the inspection, two members of staff were on duty for five service users. The staffing numbers allowed for staff to spend uninterrupted ‘one-to-one’ time with service users as necessary. A requirement was issued in the previous inspection report for the registered manager to demonstrate that a permanent staff team had been recruited by 30/04/05; this requirement has been met. The inspector noted that the staffing rota did not fully correlate with the staff on duty as two members of staff had swapped shifts, although there was evidence of previous duty swaps having been documented correctly on the rota. A requirement regarding correct recording on rotas has been issued in this report. Although the inspector was not able to access individual training records for staff at this inspection visit, via discussion with the staff on duty it was noted that mandatory training (inclusive of National Vocational Qualifications in Care) had been provided. The provision of training for staff will be assessed at the next inspection visit. Chase (The) G57 G06 S41012 Chase (The) V227168 100605 Stage 4.doc Version 1.20 Page 17 Chase (The) G57 G06 S41012 Chase (The) V227168 100605 Stage 4.doc Version 1.20 Page 18 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 were not fully attained at this inspection visit. The inspector has issued one requirement in this report, related to the maintenance of a safe environment and a recommendation for the registered manager to audit the current position of all staff members in regard to their practicing first aid status. EVIDENCE: The inspector checked the storage of opened food items in the refrigerator, which was found to be in accordance with Food Hygiene legislation. The recording of refrigerator, freezer and water temperatures was satisfactory. The inspector found that a shed in the garden containing paint was not locked. The staff on duty at the time of the inspection informed the inspector that they had undertaken first aid training but were not sure if their first aid training and certification was still within its valid period. The registered manager has been requested to send copies of all first aid certificates to the inspector, in order to demonstrate that at least one person on each shift is a qualified First Aider as required by the Care Homes Regulations. Chase (The) G57 G06 S41012 Chase (The) V227168 100605 Stage 4.doc Version 1.20 Page 19 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 2 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 3 3 3 x x N/A 3 Standard No 11 12 13 14 15 Chase (The) 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x 3 x x x Version 1.20 Page 20 G57 G06 S41012 Chase (The) V227168 100605 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 1 x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x Chase (The) G57 G06 S41012 Chase (The) V227168 100605 Stage 4.doc Version 1.20 Page 21 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 6 Regulation 15(2) Requirement The registered manager must ensure that the care plans contain clear evidence of the reviewing of service users objectives/goals. The registered manager must ensure that key workers assigned to work with individual service users are fully involved in the care planning and reviewing process, including attendance at statutory reviews. The registered manager must ensure that the records of the food provided for service users is recorded in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory in relation to nutrition. The registered manager must ensure that the medication is administered in accordance to the instructions of the prescribing doctor and/or health practitioner. The registered manager must promptly return to the pharmacist any medications which are incorrectly placed in the blister packs. Timescale for action 30/09/05 2. 6 12(5)(b) 30/09/05 3. 17 17(2) 31/08/05 4. 20 13(2) 31/07/05 5. 20 13(2) 31/07/05 Chase (The) G57 G06 S41012 Chase (The) V227168 100605 Stage 4.doc Version 1.20 Page 22 6. 20 13(2) 7. 22 22(7) 8. 33 17(2) 9. 42 13(4)(a) The registered manager must liaise with the pharmacist to ensure that full instructions for application of topical medications are recorded on the prescription labels. The registered manager must ensure that the written complaints procedure advises any complainants of their entitlement to notify the CSCI of their complaint at any stage. The registered manager must ensure that an accurate staff duty roster is maintained which records whether the roster was actually worked. The registered manager must ensure that the garden shed is kept locked. 31/07/05 31/07/05 15/08/05 31/07/05 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. 2. Refer to Standard 5 8 Good Practice Recommendations The home should develop pictorial contracts for service users, produced in a similar manner to the existing pictorial complaints guide for service users. The home should retain the hand-written minutes taken during the service users meetings. Chase (The) G57 G06 S41012 Chase (The) V227168 100605 Stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection Gredley House 1-11 Broadway 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 Chase (The) G57 G06 S41012 Chase (The) V227168 100605 Stage 4.doc Version 1.20 Page 24 - 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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