Inspection on 19/04/05 for Companion in Care

This inspection was carried out on 19th April 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Companion in Care 25/09/06

Companion in Care 18/09/05

Companion in Care 10/12/04

Companion in Care 29/06/04

Similar services:

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Delrose House Ltd

Clovelly House Residential Home Ltd

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 Companion in Care 24 Borthwick Road Leyton London E15 1UD Lead Inspector Rob Cole Announced Inspection 19th April 2005 at 10:00am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Companion in Care Version 1.10 Page 3 SERVICE INFORMATION Name of service Companion in Care Address 24 Borthwick Road, Leyton, London E15 1UD 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) 020 8519 4135 020 8809 7044 Companion in Care Ltd Mrs Kehinde Ollifunso Ajumobi Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Companion in Care Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 10th December 2004 Brief Description of the Service: Borthwick Road is a three bedroomed house registered to provide care to adults of either gender with a mental disorder. The home was first registered in February 2004. The home is situated in a residential area of Leyton, in the London Borough of Waltham Forest, and is close to shops and other local amenities, and transport networks. The home is indistinguishable from other homes in the area. The home is privately run. Companion in Care Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During the course of the inspection, the inspector spoke with service users, staff at the home and the registered manager. Overall, service users expressed high levels of satisfaction with the home. The inspector was satisfied that it is generally a well run home, providing appropriate support. However, some areas such as health and safety and adult protection require further attention. 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Companion in Care Version 1.10 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 Companion in Care Version 1.10 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) 1,4 and 5 The inspector was satisfied that prospective service users are given sufficient information about the home through trial visits and documentation to help them make an informed choice as to move in or not. However, the home must make sure that it caries out pre admission assessments, to ensure that it can meet service users needs. EVIDENCE: The home has both a Statement of Purpose and Service User Guide in place. Both these documents are written in plain English, and are accessible to all service users. The Statement includes information on the services provided, details of the organisation, and all information required by Schedule 1 of the Care Home Regulations 2001. The Guide has been updated since the last inspection and is now in line with National Minimum Standards. However, as at the last inspection these documents, and others maintained by the home included the CSCI’s logo. This must be removed from the homes documentation. All service users have a written contract/statement of terms and conditions. These are signed by the service user and the homes manager. However, they need amending to include all information required by National Minimum Standard 5, for example they do not include details of the costs of services not covered by fees. The home has an admissions procedure, this states that prospective service users are able to visit the home before making a decision as to move in or not. Companion in Care Version 1.10 Page 8 Service users spoken to confirmed that they did indeed have this opportunity. As there have been no new admissions since the last inspection, the inspector was unable to check Standard 2, that thorough pre admission assessments are carried out on prospective service users, and therefore this requirement remains outstanding. Companion in Care Version 1.10 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 and 10 The inspector was satisfied that service users have control and choice over their daily lives and the running of the home. Care plans and risk assessments were of a good standard. EVIDENCE: All service users have clear care plans in place, these are drawn up with the involvement of the service user. Plans include medical needs, social and leisure needs and mental health needs. Plans are regularly reviewed. All service users are also on the Care Planning Approach programme. The inspector was pleased to note that risk assessments in the home have improved considerably since the last inspection. Risk assessments are now comprehensive, covering risks associated with neglect, violence and aggression, medical conditions and other potential areas of risk. Through observation and discussion there was evidence that service users are able to make decisions and have control over their daily lives. For example, service users are free to get up and go to bed as they choose, mealtimes are flexible, and service users can come and go from the house, and all have front door keys. Service users are routinely involved in the running of the home, for instance the home recently had new floorings fitted, and service users were Companion in Care Version 1.10 Page 10 involved in choosing these. Service user meetings are also held, these include discussions on menus, activities and health and safety in the home. Confidential records are stored securely, and staff and service users can access these as appropriate. Companion in Care Version 1.10 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16 and 17 Service users are able to develop social and independent living skills through access to the community and educational programmes. However, the home must ensure that it is able to meet the social and leisure needs of service users. EVIDENCE: There was evidence that service users have regular access to the community. At present no service users are involved in any formal employment, and service users said they did not currently wish to be. One service has a weekly one to one numeracy and literacy session, and service users are involved in programmes to help promote independence, for example with cooking skills. Service users regularly use local transport networks, such as busses and trains. In the community service users attend local day services, shops and all have their own bank accounts and visit the bank to withdraw their money. Staff are able to support service users with any benefits issues that they have. In house, service users have access to a variety of social and leisure activities, including TV, DVD, music, cards and BBQ’s. In the community service users Companion in Care Version 1.10 Page 12 enjoy going to social clubs, pubs and cinemas. However, at the last inspection service users informed the inspector that they would like the home to organise day trips, yet none have been arranged since that inspection. Service users again informed the inspector at this inspection that they still want day trips organised, the homes manager said they would ensure that this was done. It is a repeat requirement that the home provides appropriate and sufficient community based social and leisure activities in line with service users assessed needs and stated preference. Service users are able to plan their own menus, and are heavily involved in food preparation. Service users were observed to help themselves to drinks and snacks throughout the day. The kitchen was clean and tidy, and food was stored appropriately. Records are kept of fridge/freezer temperatures, these indicated that the fridge was maintained at a safe temperature since the last inspection. Companion in Care Version 1.10 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) The inspector was satisfied that the home takes reasonable steps to safeguard the health of service users. Service users have access to health professionals as appropriate, and clear policies and procedures are in place for the administration of medications. EVIDENCE: All service users are registered with a local GP. There was evidence that service users have access to other health professionals as appropriate, including drug and alcohol counselling, psychiatrists, diabetic nurse, opticians and since the last inspection all service users have had access to dental treatment. Records are maintained of any medical appointments, including any follow up action necessary. The home has a comprehensive medication policy, and all staff receives training in medication before they are able to administer it. Medications were stored securely in a locked cabinet attached to the office wall. Records are maintained of medications entering the home and those returned to the pharmacist. Medical Administration Records are maintained, and the inspector was pleased to note that these have improved since the last inspection, and now appeared to be up to date and accurate. Service users are all able to manage their own personal care, although staff will encourage service users and give advice on appropriate clothing for the weather. Companion in Care Version 1.10 Page 14 Companion in Care Version 1.10 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 standard(s) 22 and 23 The inspector believes that service users are potentially been put at risk from adult protection issues due to lack of staff training and poor polices. EVIDENCE: The home maintains a complaints log, this evidenced that complaints have been appropriately recorded and addressed. The home has a complaints procedure, this was prominently displayed within the home. The procedure included timescales for responding to any complaints, and has been updated since the last inspection and now includes contact details of the CSCI. The home has a copy of the Local Authorities adult protection procedures, and its own policy and procedure on adult protection. However, this was not in line with current legislation, for example, it does not make clear the homes responsibility to notify the Local Authority of any allegations of abuse. Further, the manager informed the inspector that not all staff have received training in adult protection issues, and this must be addressed. Companion in Care Version 1.10 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 standard(s) 24,25,26,27,28 and 30 The inspector was satisfied that the home is suitable to meet its stated purpose. It is well maintained both internally and externally, and is homely and domestic in character. EVIDENCE: The home is situated in a residential area of Leyton, in the London Borough of Waltham Forest. The home is in keeping with other homes in the vicinity, and is close to shops, transport links and other local amenities. All service users have their own bedrooms, these meet National Minimum Standards on size requirements, and have been decorated to service users personal tastes. Bedrooms had appropriate furniture, including table, chair, chest of draws and wardrobes; and bedding, carpet and curtains were well maintained. The inspector was pleased to note that a hand basin has been installed in the downstairs bedroom since the last inspection, and now all bedrooms have hand basins fitted. Communal space consists of a kitchen/dining room, sitting room and a garden. Furniture and fittings around the home were generally well maintained and domestic in character. New floors have recently been purchased, which service Companion in Care Version 1.10 Page 17 users chose. Service users were free to move around communal areas as they wished. The home has one bathroom/toilet, one shower room and one toilet on its own, the inspector believes this to be adequate to meet service users needs. Bathrooms were clean, tidy and free from offensive odour, and all had working locks fitted. Appropriate measures are in place to help control the spread of infection, for example hand washing facilities throughout the home, and protective clothing for staff. Companion in Care Version 1.10 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35 and 36 The inspector believes that the home has staff in sufficient numbers and with sufficient experience to provide appropriate support to service users. However, although staff receive formal supervision and regular training, it is the view of the inspector that they would further benefit from an annual appraisal and review of their performance. EVIDENCE: The home provides 24-hour staff support, including an emergency on-call procedure. All staff are given a copy of their job description, and through observation and discussion their was evidence that staff are suitably qualified and experienced, and were able to demonstrate a good understanding of their roles and responsibilities. The inspector checked several staff employment files, and requirements set at previous inspections around CRB’s and written references appeared to have been met. The manager informed the inspector that service users are involved in the recruitment process for new staff to the home. However, this was not reflected in the homes policy on recruitment and selection, and it is required that the homes policy accurately reflects the actual practice of recruitment and selection. Staff receive a structured induction programme on commencing work at the home, this includes service user issues, the environment and health and Companion in Care Version 1.10 Page 19 safety. Training is on going for staff, and records indicated that staff have recently had training in medication, care planning, fist aid and fire safety. Two staff are currently working towards a relevant NVQ in Care qualification, and the manager informed the inspector that it is the intention of the home for all staff to have the opportunity of taking a relevant qualification. Staff receive regular formal supervision, this is minuted, and staff get a copy of the minutes. Supervision includes discussion on performance, training and service user issues. The home also holds regular staff meetings, and all staff are able to bring items to the agenda. However, at present staff do not undergo an annual appraisal, the manager informed the inspector that appraisals will be introduced for all staff, and this is required. Companion in Care Version 1.10 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 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) 37,38,39,40,41 and 42 Although the inspector believes the manager is sufficiently qualified and experienced to carry out their duties, more attention needs to be paid to health and safety issues. Further, the home would benefit from regular and robust Regulation 26 visits. EVIDENCE: The manager has seven years experience of working with adults with mental health issues, including four years in a managerial capacity. They have successfully completed an NVQ level 4 in Care. On the day of inspection staff were observed to interact with the manager in a relaxed manner, and service users said they found the manager to be accessible and approachable. Record keeping appeared to be kept up to date, and confidential records were stored securely. The home has various systems in place to promote quality assurance, for example service user questionnaires are used to gain feedback. However, Regulation 26 visits are not taking place monthly, further the reports of these visits are not been sent to the CSCI, and the reports seen by the inspector Companion in Care Version 1.10 Page 21 indicated that these inspections were far from comprehensive, and it is a repeat requirement that monthly unannounced Regulation 26 visits are carried out, and a copy of the report forwarded to the CSCI. The home has appropriate policies in health and safety issues, and staff have received health and safety training, including fire safety and first aid. Since the last inspection the home now has a fire risk assessment in place, and hot water temperatures are now checked weekly. However, there were some health and safety issues that must be addressed. The home must ensure that fire alarms are serviced by a qualified engineer at least once every twelve months. The home had a landlords gas safety certificate dated 26/5/04, this indicated that there was a defect that needed remedial action, and this must be addressed. SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 Companion in Care Score 2 x x 3 Standard No 22 23 ENVIRONMENT Version 1.10 Score 3 1 Page 22 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 2 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 2 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 2 2 3 1 x Companion in Care Version 1.10 Page 23 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 YA1 Regulation 4 and 4 Requirement The registered person must ensure that the CSCI logo is not reproduced on any of the homes documentation. (Timescale 31/3/05 not met) The registered person must ensure that thorough pre admission assessments are carried out on all service users before they move into the home. (Timescale 31/3/05 not met) The registered person must ensure that service users contracts/statements of terms and conditions contain all information required by National Minimum Standard 5. (Timescale 31/3/05 not met) The registered person must ensure that service users are given the opportunity to participate in community based social and leisure activities in line with their assessed need and stated preference. (Timescale 31/3/05 not met) The registered person must ensure that comprehensive monthly Regulation 26 visits are carried out, and that a copy of the subsequent report is Version 1.10 Timescale for action 22/8/05 2. YA2 14 22/8/05 3. YA5 5 22/8/05 4. YA14 16 22/8/05 5. YA39 26 22/8/05 Companion in Care Page 24 6. YA42 13 and 23 7. YA23 13 8. YA23 13 9. YA34 18 10. 11. YA36 YA42 19 13 forwarded to the CSCI and a copy retained in the home. (Timescale 31/3/05 not met) The registered person must ensure that the homes fire alarm system and emergency lighting are serviced by a qualified engineer at least once every twelve months. (Timescale 31/3/05 not met) The registered person must ensure that the homes adult protection procedures are in line with current legislation. The registered person must ensure that all staff who work at the home receive training in adult protection issues. The registered person must ensure that the homes policy on recruitment and selection reflects the actual practice of staff recruitment in the home. The registered person must ensure that all staff receive an annual appraisal. The registered person must ensure that all instances highlighted by gas engineers of work requireing remedial action are addressed. 22/8/05 22/8/05 22/8/05 22/8/05 22/8/05 22/8/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Companion in Care Version 1.10 Page 25 Commission for Social Care Inspection 4th Floor, 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 Companion in Care Version 1.10 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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