Inspection on 25/05/06 for Chase (The)

This inspection was carried out on 25th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found 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

Chase (The) 15/04/09

Chase (The) 01/07/08

Chase (The) 27/01/08

Chase (The) 17/10/07

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 08/07/2008.

CARE HOME ADULTS 18-65 Chase (The) 165 Capel Road Forest Gate London E7 0JT Lead Inspector Sarah Greaves Key Unannounced Inspection 25 and 30th May 2006 12:00 th Chase (The) DS0000041012.V295336.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.V295336.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.V295336.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 550 0777 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) Alpam Homes Thomas Francis Byrne Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Chase (The) DS0000041012.V295336.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd November 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 provider of care services. Chase (The) DS0000041012.V295336.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was conducted on the 25th May 2006. The inspector spoke to service users and three members of staff. During this inspection visit the inspector read two care plans, checked medication practices, looked at some health and safety practices and toured the premises. The inspector undertook an announced return to the care home on the 30th May 2006 to meet the registered manager and review documents that were appropriately not available in the absence of the registered manager on the 25th May. What the service does well: What has improved since the last inspection? Three requirements and three recommendations were issued in the last inspection report. One of these requirements and all of the recommendations were met. The service had met a requirement to ensure that monthlyunannounced monitoring visits are consistently undertaken. Recommendations for the home to broaden the range of weekend activities, offer hot food choices at the midday meal and discuss the acquisition of a pet were all satisfactorily attained. Chase (The) DS0000041012.V295336.R01.S.doc Version 5.2 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. Chase (The) DS0000041012.V295336.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.V295336.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Prospective service users are assured that their needs are fully assessed and that they will be able to check if they like the service before moving in. EVIDENCE: The inspector noted that a new service user had been admitted to the home since the last inspection visit. The inspector read the care plan for this service user, which contained a pre-admission assessment by the placing authority. This assessment was supplemented by the home gathering its own information. The home had previously demonstrated that service users were provided with many opportunities to visit before deciding if they wished to move in for a trial period. The inspector confirmed that the most recently admitted service user was also offered a structured and leisurely introduction to the service (six visits) prior to admission. Chase (The) DS0000041012.V295336.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7, 8 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users are assured that their care needs are appropriately identified and addressed via good care planning. Service users are supported to make choices and take responsible risks. EVIDENCE: The inspector read two care plans during this inspection. The care plans were satisfactorily written and regularly reviewed. The inspector observed that service users were offered a choice as to whether they wished to go out to a park for the afternoon or remain at the home to participate in the inspection. One of the service users informed the inspector of her plans for the weekend. The minutes of the service users meetings demonstrated that service users were consulted about outings, holidays and other entertainments. The inspector observed that service users now more actively participated in laying the dining table, fetching drinks and taking their plates to the kitchen. The care plans contained up-to-date risk assessments, which appropriately balanced the service users entitlement to an active lifestyle in the community with their safety and welfare needs. Chase (The) DS0000041012.V295336.R01.S.doc Version 5.2 Page 10 Chase (The) DS0000041012.V295336.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 at least once during a 12 month period. 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 the service. Service users enjoy a wide variety of fulfilling activities in the community and staff have developed good links with families. Service users enjoy their food. EVIDENCE: A recommendation was issued in the previous inspection report for the service to offer more weekend activities. A service user informed the inspector that a trip to the cinema was planned for the forthcoming weekend to see ‘X Men’. The inspector noted, via reading the minutes of the service users meetings and through discussions with service users and the registered manager, that there had been recent day trips to the seaside and places of interest. Outings at the weekend included visits to parks, pub lunches and shopping centres. The registered manager stated that the home had enrolled with the ‘Blue Octopus’ discos for adults with a learning disability. The service users attended a day centre in Redbridge, which is owned and operated by the service provider. The day centre has been visited by the inspector during a previous inspection and was observed to provide a broad range of arts and crafts sessions, drama therapy and learning opportunities. Chase (The) DS0000041012.V295336.R01.S.doc Version 5.2 Page 12 The care plans viewed by the inspector demonstrated that service users utilised local facilities including a nearby pub, Wanstead Flats open spaces and a bowling alley. Service users expressed that they were looking forward to their summer vacation at a holiday centre in Sussex. A proposal for the service users to have their own pet to look after was discussed with service users and declined. Via discussion with some of the service users, the inspector established that maintaining links with family members was very important. At the time of the inspection one of the service users was staying with her family. Other service users either spent frequent weekends with their families or received regular visits at the home. The inspector looked at the responses to a recent questionnaire sent to the families of the service users; the replies indicated that the representatives of the service users had developed a positive rapport with the staff. The inspector observed that service users were supported to choose their own routine within the home; for example, one service user wished to eat their lunch privately rather than sit in the dining area. Service users were witnessed to retire to their rooms when they wished to. The care plans recorded whether keys could be provided to service users, subject to individual risk assessments. The inspector joined the service users for a meal on the first day of the inspection. One of the service users explained that they decided with staff every morning as to whether to have their main meal or a lighter meal at 12.30pm, depending on the planned activities. On this occasion a main meal had been chosen, followed by a dessert. Service users eat well and stated that the food was always enjoyable. The inspector observed that salt was served in a large container rather than being dispensed into a smaller salt pot and that some of the service users applied the salt quite liberally. The menu plans viewed by the inspector demonstrated that service users were provided with a balanced choice of foods. Chase (The) DS0000041012.V295336.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 at least once during a 12 month period. 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 the service. Service users receive suitable support to meet their personal and health care needs. The management of medication was unsatisfactory and must be promptly improved to ensure that service users are safe. EVIDENCE: The inspector observed that service users were smartly dressed and supported to take an interest in their personal appearance. One of the service users took the inspector to her room to look at her clothes, make-up and toiletries. All of the service users were dressed in age appropriate clothes that were suitable for their social interests. The care plans read by the inspector demonstrated that service users were supported to maintain their personal care needs, with assistance and prompting given as required. Via discussion with the registered manager, no current issues of concern were identified with the service users health needs or their access to health care resources. The care plans read by the inspector identified specific behavioural and emotional health needs; service users received appropriate input from community psychiatrists and psychologists. A requirement was issued in the previous inspection report for the home to ensure that the administration of medication was safely managed. The inspector checked the storage, administration and recording of medication. It Chase (The) DS0000041012.V295336.R01.S.doc Version 5.2 Page 14 was observed that different staff members had signed for a medication on nine separate occasions when it was not due to be given. The registered manager stated that staff had signed in error but had not dispensed the medication. The inspector found that this medication (which could not be contained within a blister pack due to its presentation) had not been marked with a start date in order to audit whether any of the medication was unaccounted for. The inspector noted that a service user was prescribed a medication with a fluctuating dosage. The medication chart had been marked for this medication to be given every other day, but this did not correspond with the instructions on the pharmacy label. Staff at the unannounced inspection visit were unable to inform the inspector of precisely how they were expected to administer this medication. The registered manager informed the inspector that the General Practitioner had given guidance but this was not recorded on the pharmacy label. The registered manager stated that the home had decided to change its pharmacy supplier; however, the registered manager must ensure that arrangements are in place at all times to guarantee that staff clearly understand the medication needs of the service users. The inspector looked at the home’s medication policy, which did not comprehensively address systems for auditing medication. Requirements have been issued in this report for the registered manager to improve the home’s medication system. Chase (The) DS0000041012.V295336.R01.S.doc Version 5.2 Page 15 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users are protected through a safe complaints procedure. Appropriate measures have been implemented to safeguard service users from abuse. EVIDENCE: The inspector viewed the home’s complaints procedure, which was satisfactorily written. The home also provided a pictorial complaints guide for the service users. At the time of this inspection none of the service users accessed the services of an independent advocate (for support to make a complaint or other issues requiring independent guidance); however, all of the service users received support from family members. There were no issues of concern identified regarding the home’s management of complaints. The home possessed an appropriate Adult Protection procedure and staff had accessed Adult Protection training from Redbridge Social Services as well as training from the registered manager, whom has undertaken a course to provide Adult Protection training. Chase (The) DS0000041012.V295336.R01.S.doc Version 5.2 Page 16 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users are provided with a pleasant living environment. EVIDENCE: The home was very tastefully decorated, comfortably furnished and well maintained. The inspector found the premises to be clean, hygienic and free from any offensive odours. Standard 29 is not applicable for assessment. Chase (The) DS0000041012.V295336.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Staff have generally undertaken appropriate training for their roles and responsibilities; however, the home must ensure that specific shortfalls in staff training are addressed. The welfare of the service users must be rigorously promoted through ensuring that all staff are safely recruited. Staff are supported through regular supervision; however, the quality of these supervisions should be properly documented. EVIDENCE: At the time of this inspection all of the staff team possessed a National Vocational Qualification in Care at level 2 (or a recognised equivalent). The inspector looked at the staff file for the most recently appointed member of staff. It was noted that this employee possessed an enhanced Criminal Record Bureau (CRB) check by their previous employer. The registered manager was informed that CRB checks were not portable and was advised that a Protection of Vulnerable Adults (POVA) First Check and an enhanced CRB check must be promptly undertaken. A requirement was issued in the previous inspection report for the home to ensure that all staff possess a valid first aid certificate. One member of staff did not have this qualification; the registered manager acknowledged that this employee had been rostered in sole charge of the premises overnight. Staff training records evidenced attendance at mandatory training and additional Chase (The) DS0000041012.V295336.R01.S.doc Version 5.2 Page 18 training relevant to the needs of the service users. A requirement has been issued in this report for all staff to receive ‘refresher’ medication training. The inspector looked at the supervision records for two members of staff. Formal one-to-one supervision was given at a satisfactory frequency; however, the supervision records were observed to be quite brief. The registered manager was recommended to record more details of these sessions. Chase (The) DS0000041012.V295336.R01.S.doc Version 5.2 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): 37,39 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. The management of the home demonstrated particular good practices; however, the registered manager must ensure that the areas of concern in this report are effectively improved upon. The views of the service users and their representatives were sought and acted upon in order to improve the service. The home must adopt a more rigorous approach to fully meeting the health and safety needs of the service users. EVIDENCE: Although the home identified specific strengths (such as good community inclusion and the promotion of service users self-esteem), the registered manager must effectively demonstrate that outstanding requirements will be met in a timely manner and full adherence to the Care Homes Regulations. The Commission did not receive a written notification of the medication error, in accordance to Regulation 37(e). The home evidenced that the views of the representatives of the service users were formally sought through a detailed survey, which produced positive Chase (The) DS0000041012.V295336.R01.S.doc Version 5.2 Page 20 feedback. Service users were regularly consulted via the service users meetings. The inspector checked the following health and safety practices, which were found to be satisfactory; (1) emergency lighting testing (2) water temperatures testing (3) refrigerator and freezer temperatures testing (4) smoke alarms testing (5) radiator temperatures testing and (6) maintenance checks of the home’s vehicle. It was noted that the portable electrical appliances tests and the landlord’s gas safety certificates were no longer valid. The electrical installations inspection certificate did not state a valid period. The inspector found that a number of opened food items in the refrigerator had not been marked with the date of opening. One jar of food was noted to have expired in December 2005. The staff disposed of these food items during the inspection. Chase (The) DS0000041012.V295336.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 N/A 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 X 2 X 3 X X 1 X Chase (The) DS0000041012.V295336.R01.S.doc Version 5.2 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 YA20 Regulation 13(2) Requirement The registered manager must ensure that the current medication policy is revised. The registered manager must ensure that all staff receive refresher medication training. The registered manager must ensure that a regular audit of medication practices is undertaken. A requirement was issued in the previous inspection report for the home to improve upon its management of service users medication. The registered manager must ensure that all staff possess an enhanced Criminal Record Bureau check via the service provider. The registered manager must ensure that all staff possess a valid first aid certificate. This is a repeated requirement. The registered manager must comply with informing the DS0000041012.V295336.R01.S.doc Timescale for action 30/08/06 2. YA20 and YA35 13(2) and 18(1c) 24 30/08/06 3. YA20 and YA37 01/07/06 4. YA34 Schedule 2 31/07/06 5. YA35 18(1c) 31/08/06 6. YA37 37 30/06/06 Chase (The) Version 5.2 Page 23 7. YA42 13(4) 8. YA42 13(4) Commission of any event in the care home that adversely affects the well-being or safety of any service users. The registered manager must ensure that refrigerated, opened food items are marked with the date of opening and expired food items must be disposed of. This also applies to food items belonging to staff. The registered manager must ensure that the portable electrical appliances testing and the landlord’s gas safety test are renewed. The electrical installations certificate must have an accompanying letter from the engineer stating the valid period for the certificate. 30/06/06 31/07/06 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 YA17 YA36 Good Practice Recommendations The home should serve salt in a domestic style container. The home should ensure that sufficient detail is recorded in the supervision notes to demonstrate that staff are properly supported with their role and responsibilities. Chase (The) DS0000041012.V295336.R01.S.doc Version 5.2 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 Chase (The) DS0000041012.V295336.R01.S.doc Version 5.2 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!