Inspection on 20/06/06 for Chesterfield Gardens 80

This inspection was carried out on 20th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chesterfield Gardens 80 13/09/07

Chesterfield Gardens 80 26/01/06

Chesterfield Gardens 80 30/06/05

Chesterfield Gardens 80 02/11/04

Chesterfield Gardens 80 22/04/04

Chesterfield Gardens 80 23/02/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Townley Road, 2-3

Chatsworth Care - Tudor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Chesterfield Gardens 80 London N4 1LR Lead Inspector Susan Shamash Key Unannounced Inspection 20th June 2006 02:00 Chesterfield Gardens 80 DS0000010817.V295926.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 Chesterfield Gardens 80 DS0000010817.V295926.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. Chesterfield Gardens 80 DS0000010817.V295926.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chesterfield Gardens 80 Address London N4 1LR 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) 020 8350 6468 Mr Phivos Joannides Mr Phivos Joannides Care Home 4 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (4), Mental disorder, excluding of places learning disability or dementia (4), Mental Disorder, excluding learning disability or dementia - over 65 years of age (4) Chesterfield Gardens 80 DS0000010817.V295926.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th January 2006 Brief Description of the Service: This home is registered for four people who have a learning disability or mental health needs. There are four single bedrooms but currently two residents have chosen to share a room. The spare bedroom has been temporarily turned into a lounge for these two residents to share. The house is situated close to Green Lanes, with easy access to public transport and local amenities. There is an office on the ground floor, which is also used as a staff sleeping-in room. The home is one of a number locally, owned and managed by the Joannides family. This home is owned by Mr. Phivos Joannides who is also the registered manager. Weekly fees as of July 2006 are £633.54 - £750 depending on care needs. CSCI inspection reports are available to residents from the office in the home. Chesterfield Gardens 80 DS0000010817.V295926.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken on an unannounced basis and lasted approximately four hours. There was one member of care staff on duty in the home when the inspector arrived, and the manager from another home owned by the provider also provided every assistance to the inspector. The registered manager of the home was abroad at the time of the inspection. Since the previous inspection, the home had increased the number of residents from three to four following a successful application to the CSCI. One new resident had been admitted to the home, and the inspector had the opportunity to speak with them and another two residents independently during the inspection. The fourth resident did not wish to speak to the inspector at the time of the inspection, although they confirmed that they wished to continue sharing a bedroom with another resident. These two residents also share the remaining bedroom as an extra lounge or quiet room. The inspector had the opportunity to speak to one staff member and the manager of another care home owned by the provider, who also works some shifts at the home. A tour of the building was conducted and residents’, staff and health and safety records were inspected. What the service does well: Feedback from residents regarding the home is positive about support provided to them. The general impression is that they are well cared for, and feel comfortable living at the home. The home is effective at supporting residents who are relatively independent, to maintain and improve their living skills. The home is supported by staff and management from other homes owned by the family within the local area. Residents are supported to undertake meaningful activities of their choice during the week, and have the opportunity to mix with residents with similar interests from the other homes in the local area. The home is kept clean and furnished and decorated appropriately to meet the needs of residents accommodated. Chesterfield Gardens 80 DS0000010817.V295926.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. Chesterfield Gardens 80 DS0000010817.V295926.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 Chesterfield Gardens 80 DS0000010817.V295926.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 from evidence gathered both during and before the visit to this service. An adequate system is in place to assess residents’ needs and goals effectively and ensure that these can be met. Prospective residents are able to visit the home prior to admission in order to make an informed decision about where they wish to live. EVIDENCE: Since the previous inspection, a new resident had been admitted to the home following a successful application to the CSCI to increase the number of residents from three to four. The statement of purpose and service users guide for the home had been updated appropriately. The inspector had the opportunity to talk with three residents, including the most recently admitted resident. All indicated that their needs were being met appropriately. Records indicated that each resident had been assessed and placed appropriately at the home. An occupational therapy assessment had been obtained for the most recently admitted resident, in addition to a general assessment carried out by the home. Chesterfield Gardens 80 DS0000010817.V295926.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 and 9. Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service. Insufficient recording of residents’ changing needs and support provided, places them at risk of not having needs adequately met. Residents are encouraged to make decisions regarding their lifestyles according to their preferences. They are supported to take risks in order to develop independence skills. However insufficient risk assessments may place residents’ health and safety at risk. EVIDENCE: Chesterfield Gardens 80 DS0000010817.V295926.R01.S.doc Version 5.2 Page 10 Residents spoken to indicated that their needs were being met at the home according to their choices. Care plans were available for each resident, however, with the exception of the most recently admitted resident, they had not been reviewed within the last six months as required. A requirement is made accordingly. As noted at the previous inspection, evidence was available that the local placing authority for two residents at the home had been contacted on a number of occasions in order to request a review of their needs. Letters indicated that these had not yet been undertaken due to staff shortages at the local authority. Appropriate risk assessments were available for the majority of residents specifying agreed actions to be taken to minimise risks whilst promoting their independence as far as possible. However only some but not all of these risk assessments had been reviewed within the last six months. There were also insufficient risk assessments for the most recently admitted resident regarding potential areas of risk, including staying out late and ability to self medicate. A requirement is made accordingly. Evidence was provided to the CSCI that this requirement had been met shortly after the inspection. Chesterfield Gardens 80 DS0000010817.V295926.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 from evidence gathered both during and before the visit to this service. A range of age and culturally appropriate activities are available for residents both within and outside of the home. Freedom is provided for residents to engage in personal relationships and maintain contact with family and friends. They are encouraged to be involved in all aspects of home life, and are provided with a varied selection of meals that meet their nutritional needs. EVIDENCE: Chesterfield Gardens 80 DS0000010817.V295926.R01.S.doc Version 5.2 Page 12 Residents living in the home are generally quite independent and able to say what they like and don’t like, coming and going unaccompanied. The most newly admitted resident attends college courses on several days a week including courses in numeracy, computing and independence skills. One resident attends a supported workshop where they make and sell items, and also attends a computer course at a local college on a part time basis. Another attends a day centre run by the charity Mind, in the mornings, whilst the remaining resident advised that they consider themself to be semi-retired. Residents told the inspector that they had enjoyed a trip to the coast in May 2006. Staff and residents spoken to confirmed that residents are encouraged to maintain family links and friendships. One resident told the inspector that they visit their sister regularly at weekends. All residents make use of amenities within the local community and were seen to come and go from the home independently throughout the inspection. One resident enjoys going out to local pubs until late at night. The three residents spoken to advised that they were satisfied with food served at the home. The menu indicated that a varied and balanced diet is provided. The staff member spoken to was aware of residents’ preferences in terms of lifestyle choices as well as meals. Chesterfield Gardens 80 DS0000010817.V295926.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 from evidence gathered both during and before the visit to this service. Residents receive appropriate physical and emotional support in accordance with their preferences. They are supported to take their prescribed medicines to ensure medication needs are met. However there is a need for improvement in the recording of the administration of medicines in the form of inhalers and safe storage of medicines to protect residents from harm. EVIDENCE: Residents are mainly independent with regard to their personal care. They told the inspector that they have appropriate access to healthcare services. Care plans included details of their preferences in terms of the support to be provided, and records of health care appointments attended. The majority of medication was stored appropriately, and specimen signatures were available for all staff involved in administering medicines to residents. However the inspector was concerned to note that a number of medicines were being stored in the refrigerator in the kitchen, without any safeguards to prevent access to these by the residents in the home. A requirement is made accordingly. Chesterfield Gardens 80 DS0000010817.V295926.R01.S.doc Version 5.2 Page 14 Records of receipt and disposal of medicines were complete and up to date. Medication administration records for orally taken medicines were up to date. However it is required that administration of medicines in the form of inhalers also be recorded. As noted under Standard 9, a risk assessment regarding self-medication must be undertaken for the most recently admitted resident, who may initially be able to self-medicate with regard to their inhalers, and then gradually increase in independence (having previously been self-sufficient in this area). The registered manager advised the CSCI that these requirements regarding medication were met shortly after the inspection. Chesterfield Gardens 80 DS0000010817.V295926.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 from evidence gathered both during and before the visit to this service. The home has an appropriate complaints procedure to ensure that the concerns of residents are acted upon effectively. Procedures and training are in place to ensure that residents are protected from abuse. EVIDENCE: There have been no complaints made to the Commission about the home and none recorded in the home since the last inspection. No adult protection issues have been identified since the last inspection and the adult protection procedure for the home is of an acceptable standard. The local authority’s adult protection policy and procedure area also available at the home. Staff have undertaken training in adult protection and addressing challenging behaviour as appropriate. Residents are generally very able to express any concerns that they have about the home, and appeared to feel safe and comfortable around staff members and management. Those spoken to advised that they knew who to speak to if they were unhappy with care provided to them at the home. Chesterfield Gardens 80 DS0000010817.V295926.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 from evidence gathered both during and before the visit to this service. Residents have adequate private and communal space, and the home is furnished to meet their needs. The home is kept clean, safe and well decorated to ensure residents’ comfort and protection. EVIDENCE: Building works to the home were completed prior to the previous inspection and the registered provider was successful in their application to the CSCI to increase the registration to four instead of three registered service user places. One new bedroom with en suite toilet is now provided. In addition a new bathroom and toilet had been installed on the ground floor of the home, and the lounge/dining area and kitchen had been relocated. The ground floor of the home had been redecorated and the kitchen was fitted with new units. All bedrooms had been personalised as appropriate. Residents spoken to advised that they were happy with their accommodation. Chesterfield Gardens 80 DS0000010817.V295926.R01.S.doc Version 5.2 Page 17 Two residents continue to choose to share a bedroom and the empty bedroom is used as their lounge. The provider is aware that if one of these residents were to leave the home, the home would revert to four single bedrooms. The inspector spoke to both residents sharing a room, and both confirmed that they wished to continue sharing a room. It is recommended that more garden furniture be provided for the rear garden, to meet the needs of all residents. Chesterfield Gardens 80 DS0000010817.V295926.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Staff are sufficiently competent, experienced and trained to meet the needs of residents effectively. Suitable recruitment procedures are in place for all staff, to ensure the protection of residents. EVIDENCE: The rota showed one staff on duty throughout the day and one sleeping-in staff member on duty at night. Discussion with staff and residents indicated that this staffing level was satisfactory to meet the residents’ current needs. Inspection of staff records, indicated that appropriate recruitment procedures are in place. They included evidence of satisfactory enhanced CRB disclosures, references, identity documents and application forms. As required a reference was being obtained from new applicants’ current or most recent employer, prior to their commencing work at the home. Records also indicated that staff receive an adequate induction before working unsupervised within the home, in addition to general mandatory training. Training courses undertaken included fire safety, adult protection, first aid, challenging behaviour, control of substances hazardous to health, diet and nutrition, and dying and bereavement. Chesterfield Gardens 80 DS0000010817.V295926.R01.S.doc Version 5.2 Page 19 As required at the previous inspection, staff had undertaken training in working with people with mental health problems. The registered persons are aware of the requirement for fifty percent of staff to be trained to the equivalent of NVQ level two in care. Chesterfield Gardens 80 DS0000010817.V295926.R01.S.doc Version 5.2 Page 20 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 from evidence gathered both during and before the visit to this service. Residents benefit from accountable management and quality assurance systems. However insufficiently rigorous health and safety procedures may place residents at risk. EVIDENCE: The registered manager had completed the Registered Manager’s Award at NVQ level 4 at a local college and was awaiting verification. Minutes of regular staff meetings and residents’ meetings were seen, indicating consultation regarding the running of the home. Residents’ satisfaction questionnaires had been completed by the residents of the home as part of the quality assurance procedure. They indicated that they were satisfied with the support they received within the home. Chesterfield Gardens 80 DS0000010817.V295926.R01.S.doc Version 5.2 Page 21 Inspection of residents’ finances maintained by the home indicated that appropriate support was being provided. At the previous inspection the inspector was concerned that one resident’s benefits were being paid into the business account for the home prior to being paid to the resident, which is in breach of the Care Homes Regulations 2001. The reason for this was that despite repeated requests to the resident’s local authority, they had not been able to separate out monies belonging to the resident from those payable to the home. As required, the registered person had written to the placing authority of the identified resident advising them that they are unable to receive payment of the resident’s monies into the home’s business account as this is in breach of the Care Homes Regulations (2001). Evidence was provided that the appropriate level of liability insurance was available for the home. Health and safety records for the home were inspected and included appropriate gas, electricity and portable appliance testing certificates and fire safety records. However recording of weekly fire alarm tests was inadequate to demonstrate that each call point is tested on a regular basis. In addition there were insufficient records of fire drills and fridge/freezer temperatures. Requirements are made accordingly. Chesterfield Gardens 80 DS0000010817.V295926.R01.S.doc Version 5.2 Page 22 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 X 30 3 STAFFING Standard No Score 31 X 32 3 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 3 2 X 3 X 3 X X 2 X Chesterfield Gardens 80 DS0000010817.V295926.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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(2) Requirement The registered person must ensure that care plans are reviewed at least six-monthly and that this is recorded. The registered person must ensure that risk assessments are reviewed at least six-monthly, and are available for all relevant areas for each service user including medicating, staying out late etc. The registered person must ensure that medicines stored in the fridge are stored securely, and ensure that the administration of medicines in the form of inhalers is recorded. The registered person must ensure that records of weekly fire alarm tests specify which call point is tested each week to ensure that all call points are tested regularly. Fire drills must also be undertaken regularly and recorded specifying the date, time, staff and service users involved and a brief description of each drill. Chesterfield Gardens 80 DS0000010817.V295926.R01.S.doc Version 5.2 Page 24 Timescale for action 18/08/06 2. YA9 13(4) 14(2) 18/08/06 3. YA20 13(2) 30/06/06 4. YA42 13(4) 23(4e) 04/08/06 5. YA42 13(4) The registered person must ensure that refrigerator and freezer temperatures are monitored and recorded daily to ensure that they remain at a safe temperature for the storage of perishable foods. 21/07/06 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. Refer to Standard YA24 Good Practice Recommendations It is recommended that more garden furniture be provided for the rear garden, to meet the needs of all residents. Chesterfield Gardens 80 DS0000010817.V295926.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Chesterfield Gardens 80 DS0000010817.V295926.R01.S.doc Version 5.2 Page 26 - 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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