Inspection on 05/07/05 for Cloudesley Road (92)

This inspection was carried out on 5th July 2005.

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 but made no statutory requirements on the home.

Other inspections for this house

Cloudesley Road (92) 27/07/06

Cloudesley Road (92) 17/02/06

Cloudesley Road (92) 19/01/05

Cloudesley Road (92) 25/06/04

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

CARE HOME ADULTS 18-65 Cloudesley Road 92 Cloudesley Road Islington London N1 0EB Lead Inspector Joyce Grant Unannounced 5 July 2005 10:00am th 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. Cloudesley Road G58 s20971 Cloudesley v182594 050706 Stage 2.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Cloudesley Road Address 92 Cloudesley Road Islington London N1 0EB 020 7700 6399 020 7700 6399 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) Psychiatric Rehabilitation Association Mr Joseph Kissoon Care Home 7 Category(ies) of LD Learning Disability (1) MD Mental Disorder registration, with number (0) MD(E) Mental Disorder - over 65 (0) of places Cloudesley Road G58 s20971 Cloudesley v182594 050706 Stage 2.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The home is registered for adults (male and female) with needs relating to mental disorder including old age, and including one adult with learning disabilities. Date of last inspection 19th January 2005 Brief Description of the Service: Cloudesley Road is situated in a residential street, which blends in with the surroundings. It is located in the Islington area with easy access to local shops, amenities and transport links. The home supports up to seven residents, of either gender with mental health difficulties. At present the home has full occupancy. All residents have own bedrooms and access to communal areas. The Home is operated by the Psychiatric Rehabilitation Association whose philosphy is to motivate residents to develop the life-skills required to progress towards more independent living through support and encouragement. New Islington and Hackney Housing Association own the house and have responsibility for the property’s maintenance. Cloudesley Road G58 s20971 Cloudesley v182594 050706 Stage 2.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first unannounced Inspection to Cloudesley Road for 2005. The Inspection was conducted over 7 hours, in the main key standards were assessed and the two previous requirements were followed up. The Requirement in relation to Standard 34 was not assessed as the confidential files are held centrally, in light of the new arrangements for Inspections this Standard will need to be assessed by arrangement with the provider. What the service does well: 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. Cloudesley Road G58 s20971 Cloudesley v182594 050706 Stage 2.doc Version 1.40 Page 6 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 Cloudesley Road G58 s20971 Cloudesley v182594 050706 Stage 2.doc Version 1.40 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 Ther is a general lack of documentation in respect of the assessment of service users’ needs. There was lack of a robust system in place to demonstrate arrangements for regular review of service users needs, in order to meet their changing needs. EVIDENCE: Service users have been placed in the unit on long term placements. Three service users’ files inspected. There were no initial assessments. Assessments made upon placement were no longer on file. However , staff reported recent reviews had been carried out for each service user but the reports of such reviews were not yet available. Risk assessments were filed despite the absence of initial assessments. Documentation checked demonstrated reviews were not carried out regularly, with some reviews being months to one year overdue . There was also two different types of care planning documentation in place, with potential to affect the continuity of care. Service Users who are Outpatients remain subject to regular statutory reviews of which there are two whilst the remainder reviews take place on a more Cloudesley Road G58 s20971 Cloudesley v182594 050706 Stage 2.doc Version 1.40 Page 8 informal basis making it unclear whether there are any processes to activate such a review. Cloudesley Road G58 s20971 Cloudesley v182594 050706 Stage 2.doc Version 1.40 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) 6,7,8 & 9 The changing personal care needs of service users are reflected in current care plans. However, reviews of this information is inconsistent and the plans do not reflect participation of the service user. Rotas reflect the participation of service users in tasks around the home. Service Users enjoy the benefit of attending day centres and supported to maintain a level of independence. EVIDENCE: Three Service User care plans were inspected. Care Plans reflect personal and support the needs of service users and identify how support will be given by the staff. However, the plan fails to reflect the participation and involvement of the service User. The plan does not include a personal profile outlining any preferences, hobbies or achievement of the service user. Though it is clear from recording and general conversation that residents are encouraged to take part in the chores and tasks around the home. One resident is a keen gardener. His talent is well observed by the upkeep of the communal garden. During a discussion with the resident he was able to share how much value he gains from gardening ‘it is quite easy …it is like therapy’ Service Users are encouraged to take part in their local community. All but two residents were in attendance of the local day centre. The inspector was a Cloudesley Road G58 s20971 Cloudesley v182594 050706 Stage 2.doc Version 1.40 Page 10 able to observe the management of two residents being supported to attend the day centre. The residents clearly enjoy the freedom of movement and independence offered within the home. Service Users appear to enjoy good relationship with the staff and the freedom of coming into the office to share the events of the day with the staff. During the two conversations it is clear that residents are free to make their own choices about daytime activities. Cloudesley Road G58 s20971 Cloudesley v182594 050706 Stage 2.doc Version 1.40 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) 12, 13, 15, 16 Service Users benefit from a living independently within a supported environment. Service users care plans are not sufficiently robust to demonstrate demonstrate arrangements for social activities for each individual service user. EVIDENCE: Individual Activities Record on one of files inspected had not been updated since 2004 yet this form was not evident in the other two files and the weekly group record of activities is in need of revision, this further demonstrates a lack of consistency, regular reviewing and planning. The Individual activity record sheet too is obsolete and scheduled to be removed from the file. Service Users are encouraged to attend the Local Day Centre, whilst this offers some structure and routine to the day, a level of independence is also encouraged. One Service User during our discussion shared his knowledge and experience of the living in the community, his visits to shops and café’s provided not just social experience of integration but also the more negative experience of ‘prejudice’ against the mentally ill which he clearly sees as ‘their problem.’ Cloudesley Road G58 s20971 Cloudesley v182594 050706 Stage 2.doc Version 1.40 Page 12 Housekeeping record on file is supported by a laundry rota posted on the laundry door each resident is allocated a laundry slot on a particular day. Each resident has a lock on his/her door and staff members are permitted to enter on request. One Service User declined to speak to the Inspector explaining that they were ‘not feeling too good.’ Case tracking of this resident raised questions as to the suitability of the placement because of her age and current needs. Her unwillingness to attend day centre means that whilst this respects rights and choices the individual remains in danger of isolation. No other resident is of her age whilst her mental health needs are being met the difficulty of engaging her in activities or external pursuits would suggest a need for a reassessment of her needs. This resident like many of the others have no social work support. Cloudesley Road G58 s20971 Cloudesley v182594 050706 Stage 2.doc Version 1.40 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) 18, 19 Service Users are offered personal support in such a way that promotes dignity and independence. EVIDENCE: During the Inspection a member of staff supported two service users by assisting with personal Care. One individual needed assistance with hairdressing and the other was supported with personal hygiene and medication. One Service User declined to speak to the Inspector explaining that they were ‘not feeling too good.’ Case tracking of this resident raised questions as to the suitability of the placement because of her age and current needs. Her unwillingness to attend day centre means that whilst this respects rights and choices the individual remains in danger of isolation. This would suggest that her condition needs to be re-assessed to ensure all her needs are being met. Cloudesley Road G58 s20971 Cloudesley v182594 050706 Stage 2.doc Version 1.40 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) 23 The home has an Adult Protection Policy that seeks to protect and safeguard service users. The home’s Policy was last reviewed in 2003 and procedures are appropriately followed in event of incidence. The Manager was advised to obtain the finalised copy of Islington’s Adult Protection Policy EVIDENCE: There has been a recent allegation regarding money missing from a service user’s account. The financial policy and procedures for the home were inspected. Money is kept in a locked safe and record keeping concerning money and valuables was found to be appropriately, signed, dated and contents checked twice daily at staff handover. The breach of security was found in the accessibility of service users Bank Pin details, this breach was suitably responded to by the adherence to Adult Protection procedures. The allegation was duly investigated and appropriate action was taken to ensure the protection of service users. Additionally, lockable cabinets have been purchased and placed in each service user’s room. However, the financial issues raised by this recent incident has, particularly in light of the new ‘Direct Payment scheme’ emphasised the need for the review and development of the home’s financial policy. This revised Financial Policy will be checked at the next Inspection. The home’s Adult Protection Policy was last reviewed in 2003. The Manager was advised to obtain a copy of Islington’s Adult Protection Policy Cloudesley Road G58 s20971 Cloudesley v182594 050706 Stage 2.doc Version 1.40 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, 30 Service Users benefit from living in a comfortable home in a well-maintained area of Islington. The overall standard of the décor of the home is good providing the service users with an attractive and homely place to live. EVIDENCE: The home offers the opportunity for independent and communal living without being too institutional. It is reflects a homely environment offering smoking and non smoking lounges with a kitchen accessible to all at all times during the day. Furnishing to a good and clean standard though one lounge the curtain rail will need to be changed in order to reflect an appropriately dressed window. The overall décor and cleanliness is of a good standard though the home was in need of the daily clean. The inspector was informed that the Cleaner was absent due to ill health. Cloudesley Road G58 s20971 Cloudesley v182594 050706 Stage 2.doc Version 1.40 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) 34 The home’s recruitment policy and practice was not inspected on this occasion as personnel files are held centrally. The previous requirement states that this standard will be checked at an announced Inspection. This matter will be followed up with the provider EVIDENCE: Cloudesley Road G58 s20971 Cloudesley v182594 050706 Stage 2.doc Version 1.40 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 40 The Home’s Policy and Procedures in the main been have been appropriately reviewed, though one Policy remains in need of appraisal. A Recommendation will be made for this Policy to be reviewed accordingly. EVIDENCE: The home’s Policies and Procedure have been reviewed and finalised as stated by the Requirement. In general Policies have been reviewed and dated between 2003 – 2005, however, the Policy concerning Volunteers was dated 1996, this will need to be reviewed. Cloudesley Road G58 s20971 Cloudesley v182594 050706 Stage 2.doc Version 1.40 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. 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 1 x x x Standard No 22 23 ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 1 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x x Standard No 11 12 13 14 15 16 17 x 2 3 3 3 3 x Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cloudesley Road Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x x 2 x x x G58 s20971 Cloudesley v182594 050706 Stage 2.doc Version 1.40 Page 19 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 2 Regulation 14(1)(b) Requirement The Registered Manager must ensure that Service Users Assessments are kept on file and that these are regularly updated to reflect their changing needs. The Registered manager must ensure that: Service usersCare Plans are kept up to date and reviewed regularly and that such plans reflect input from service users There is a consistent system for the presentation of Care Plans ensuring that forms that are no longer in use are discarded. The Registered Person must ensure that the home, in participation with the service users, produce individual daily activity plans for each Service User The Registered person must submit to the Commussiion a robust policy and procedure for the safe handling and security of service users monies and valuables. . Timescale for action 05/09/200 5 2. 6,7,8 & 9 12, 15 &17(3)(a) 05/09/200 5 3. 12 16(2) (m) 05/09/200 5 4. 23 16 (2)(L) 05/09/200 5 5. Cloudesley Road G58 s20971 Cloudesley v182594 050706 Stage 2.doc Version 1.40 Page 20 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 40 23 Good Practice Recommendations The registered person should ensure that the Policy in regards to Volunteers is appropriately updated The Registered Manager should obtain the finalised copy of Islingtons Adult Protection Policy Cloudesley Road G58 s20971 Cloudesley v182594 050706 Stage 2.doc Version 1.40 Page 21 Commission for Social Care Inspection Centro 4 20-23 Mandela Street Camden Town London NW1 0DW 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 Cloudesley Road G58 s20971 Cloudesley v182594 050706 Stage 2.doc Version 1.40 Page 22 - 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. 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