Inspection on 01/12/05 for Community Resettlement Project

This inspection was carried out on 1st December 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Community Resettlement Project 04/04/08

Community Resettlement Project 10/08/07

Community Resettlement Project 10/07/06

Community Resettlement Project 02/04/05

Community Resettlement Project 01/11/04

Community Resettlement Project 15/04/04

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Tudor Lodge

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Abbey Road [53]

Cherry Tree House

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

CARE HOME ADULTS 18-65 Community Resettlement Project 24-28 Argyle Street Kings Cross London WC1H 8EN Lead Inspector Ms Pippa Treadwell-Smith Unannounced Inspection 1st December 2005 10:00 Community Resettlement Project DS0000010342.V268732.R01.S.doc Version 5.0 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 Community Resettlement Project DS0000010342.V268732.R01.S.doc Version 5.0 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. Community Resettlement Project DS0000010342.V268732.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Community Resettlement Project Address 24-28 Argyle Street Kings Cross London WC1H 8EN 020 7278 3629 0207 813 9776 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) Community Housing Association Mr Neil Whitelam Care Home 18 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (18) of places Community Resettlement Project DS0000010342.V268732.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd April 2005 Brief Description of the Service: The Community Resettlement Project (CRP) is managed by Community Housing Association. This organisation has considerable experience in the housing sector and provide a wide range of care and support services. The home itself provides care and support to adults with mental health needs. It is situated in a residential/commercial street very close to Kings Cross Station. The property is three adjoining houses. House number 24 is registered to accommodate five women; house number 26 is the office-cum-staff area and house number 28 is registered to accommodate thirteen male service users. The houses are interconnected. Accommodation for service users is provided in single rooms, each is furnished with a fridge and a wash hand basin. Communal facilities include toilets, bathrooms, kitchens and lounges. There are two gardens to the rear of the premises. The houses are not suitable for service users with mobility problems and as they are listed buildings, alterations and adaptations are unlikely. The focus of the CRP is on rehabilitation and resettlement. Residents are to be motivated to be able to cook and undertake cleaning and laundry or improve these skills. An average stay is twenty-two months although residents can be there for longer. Prospective service users must have the ability or at least be motivated with regard to social skills, shopping and budgeting, self-catering, domestic cleaning, laundry, personal care and self-medication. Community Resettlement Project DS0000010342.V268732.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day and lasted about four and a half hours. The new manager was interviewed and assisted with the inspection. The inspector was able to discuss general issues with service users and staff. A variety of records were looked at including care plans, training records and health and safety documents. Several comments were returned from service users, relatives and health care professionals. These comments have been incorporated in to the report. 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 Community Resettlement Project DS0000010342.V268732.R01.S.doc Version 5.0 Page 6 contacting your local CSCI office. Community Resettlement Project DS0000010342.V268732.R01.S.doc Version 5.0 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 Community Resettlement Project DS0000010342.V268732.R01.S.doc Version 5.0 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): This standard was not assessed. EVIDENCE: Community Resettlement Project DS0000010342.V268732.R01.S.doc Version 5.0 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): These standards were not assessed EVIDENCE: Community Resettlement Project DS0000010342.V268732.R01.S.doc Version 5.0 Page 10 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): Standard 12, 15 & 17 There is a system in place to address the social inclusion needs of the service users and the involvement of relatives. More recording is required to ensure that the dietary needs of the service users are being addressed. EVIDENCE: Social inclusion and participation and involvement are areas addressed as part of the support plan. These are reviewed as part of the key working meetings. Records show that service users are engaged in activities both within the home and externally. Two of the service users returned comment cards and said that the home provides suitable activities. It is an area that the staff are addressing although they find it difficult sometimes to motivate the service users. The home has a visitor’s policy, which is based on the need for security, fire safety and respecting the privacy of other service users. Discussion with the service users and care records show a clear regard for contact with family members however this is determined by the wishes of the service users. As part of the admission process service users are asked to complete a family contact questionnaire. This empowers the service user to have a say in how much information can be shared with family members. Two relatives returned Community Resettlement Project DS0000010342.V268732.R01.S.doc Version 5.0 Page 11 comment cards both confirmed that important matters affecting their relative are discussed with them. In both cases this is in keeping with the family contact questionnaire. One relative commented “The feedback is at all times very good, which is important to me and his family”. Service users are expected to shop and cook independently therefore it is not feasible to maintain a record of food provided for individual service users. However the home needs to be able to demonstrate that the dietary needs of the service users are being monitored and there needs to be a system in place to do this. Discussions with the manager and staff highlighted that dietary needs must be a set agenda item for monthly key working meetings and the minutes must reflect the details of the discussion. There needs to more written evidence that cultural needs are being addressed. A tour of the home identified issues with the kitchen in House Number 28, which are discussed later in the main body of the report. Community Resettlement Project DS0000010342.V268732.R01.S.doc Version 5.0 Page 12 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): Standard 20 The system for the administration of medication in the home is safe however further work in required in respect of the medication policy. EVIDENCE: The home has a medication policy. The one, which was looked at on the day of the inspection did not cover the areas of non-compliance with the procedure, the seven-day hold rule and the management of controlled drugs. Staff were knowledgeable about both these areas as they four of them have done a distance learning course. Medication profiles are available. The home operates a monitored dosage system. Lists are maintained identifying which service users self medicate and which do not. Selfmedication is the result of a risk management system. Service users sign agreements giving consent for staff to hand out medication and agreeing to come to the office to take it. Facilities are available for service users to retain their own medication in their rooms safely. The bedroom door is lockable and there in also a lockable drawer. Community Resettlement Project DS0000010342.V268732.R01.S.doc Version 5.0 Page 13 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): Standard 23 Service users are protected by the home’s practices although the policy and procedure needs to be updated. EVIDENCE: The home has a whistle blowing policy which is familiar to staff. Service users also confirmed that they felt comfortable about approaching staff if they had concerns. The home’s policy on the protection of vulnerable adults was inspected. This became effective from 10th March 2004. It makes reference to out of date legislation ie “The Registered Homes Act 1984”. The policy reflects that services will be subject to local multi-agency adult protection policies however the home needs to ensure that their procedure dovetails with the Camden Adult Protection Procedure. The manager has acknowledged the need for adult protection training and this has been arranged although the inspector would require confirmation of the date. Community Resettlement Project DS0000010342.V268732.R01.S.doc Version 5.0 Page 14 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): Standard 24 & 30 Overall the home provides a pleasant and comfortable place for service users to live however some repair work is required to communal areas. A satisfactory standard of cleanliness is being maintained. EVIDENCE: Community Resettlement Project DS0000010342.V268732.R01.S.doc Version 5.0 Page 15 The houses are in keeping with the local community. A tour of the home showed that a reasonable standard of hygiene is being maintained in the home. The statement of purpose clearly sets out where the premises meet or does not meet the national minimum environment standards; this includes that it is not suitable for people with mobility problems. The home has an integrated fire alarm system and complies with fire safety regulations. The home functions on a hostel, rather than care home basis. Each service user has their own room and share kitchens, lounges one of which is non-smoking, toilets and bathrooms/showers. The home is situated in Kings Cross and security is given a high priority, with CCTV cameras on all front entrances. Given its’ location, there is good access to local amenities and local transport. A tour of the home showed that overall the home is meeting the service users needs in a homely and comfortable way however repairs are required in some areas. The following items require attention:House 28 In the downstairs kitchen there are two broken panes of glass and a cracked pane; the extractor is missing from this kitchen; there are 3 control knobs from the cooker; 3 of the storage cupboards cannot be secured for storing service users’ foodstuffs. In the laundry room, the washing machine requires replacement. This means for several months the male service users have had to be escorted to the laundry room on the female side in order to do any washing. This is tying up staff and resources. Boiler is faulty. Service users are complaining that they do not have access to hot water on the third floor. Toilet opposite Room 6 has no toilet seat. There is a lack of privacy in the kitchens as they are overlooked and there are no curtains or blinds. Bathroom on the third floor has no frosted glass and only a net curtain. House 26 The blind in the ground floor kitchen is broken The house is cold and below the comfortable temperature of 21C The toilet adjacent to Rooms 4 and 5 is without a toilet seat Community Resettlement Project DS0000010342.V268732.R01.S.doc Version 5.0 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 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): Standards 32, 34 & 35 Staff have the skills and training to meet the needs of the service users. Service users are protected by the home’s recruitment and selection process. EVIDENCE: The staffing rota identified that staff work alone at specific times of the day, usually late evening, sleeping in cover and early morning. The home has a lone working policy. Discussion with the manager and staff confirm that preadmission assessments are thorough to determine that service users meet certain criteria, so as to be compatible with lone working situations. The shift pattern includes an overlap so that both a male and female member of staff are on duty. Two of the support workers have completed their NVQ Level 3, training, a third member of staff has nearly completed the same course and a fourth is in the midst of the training. The manager confirmed that he is in the process of identifying training needs for staff. This process will form part of a regular and structured supervision sessions. The manager is new in post and has confirmed that supervision sessions are being planned and will be diarised. These sessions will include personal development, problem solving and training needs. There is a plan to record training. The manager confirmed that he will be involved in the recruitment and selection of staff. The home has an established recruitment and selection Community Resettlement Project DS0000010342.V268732.R01.S.doc Version 5.0 Page 17 policy, which is underpinned by equal opportunities. The procedure includes all the relevant checks such as references, CRB and POVA. Community Resettlement Project DS0000010342.V268732.R01.S.doc Version 5.0 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 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): Standards 37, 39 & 42 There are systems in place to ensure that the home is being effectively managed. Service users are consulted but not always published. EVIDENCE: Since the previous inspection a new manager is now in post. He has the background experience and skills to be eligible to apply for registration. There has been written confirmation from the provider that registration will be applied for. Discussions with the manager highlighted that he is aware of the need to do the NVQ 4 in Care and Management. Service user’s views are sought in a variety of ways. The Care Management System allows for a quality review electronically. Service users are able to have an input through the key working meetings and reviews of their care plans. The person in charge visits incorporates discussions with the service Community Resettlement Project DS0000010342.V268732.R01.S.doc Version 5.0 Page 19 users. There are weekly resident’s meetings. Previously the provider has undertaken an annual satisfaction survey undertaken. A wide range of records were checked during the inspection including servicing documents, employers liability insurance and accident reporting. Health and safety inspections are carried out internally. The Employers Liability Insurance certificate is on display and current. Areas such as legionella and gas safety are addressed. There is a planned date to test the fixed electrical wiring and portable electrical items. Community Resettlement Project DS0000010342.V268732.R01.S.doc Version 5.0 Page 20 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 X X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 1 X X X X X 3 LIFESTYLES Standard No Score 11 3 12 X 13 X 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Community Resettlement Project Score X X 2 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 X DS0000010342.V268732.R01.S.doc Version 5.0 Page 21 No 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 YA17 Regulation 16(2)(i) Requirement Nutrition must be a standard item for discussion at the monthly key working meetings. Key workers must record the outcome of those discussions. The policy relating medication needs to be reviewed and updated in line with the guidelines from the Royal Pharmaceutical Society of Great Britain and the requirements of the Misuse of Drugs Act 1971 The items listed for repair and attention must be actioned to ensure a safe environment for service users Timescale for action 31/12/05 2. YA20 13(2) 30/01/06 3. YA24 23(2)(b) 30/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Community Resettlement Project DS0000010342.V268732.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Camden Local Office Centro 4 20-23 Mandela Street London NW1 0DU 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 Community Resettlement Project DS0000010342.V268732.R01.S.doc Version 5.0 Page 23 - 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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