Inspection on 25/09/06 for Companion in Care

This inspection was carried out on 25th September 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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Companion in Care 18/09/05

Companion in Care 19/04/05

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 Unannounced Inspection 25th September 2006 10:00 Companion in care DS0000043228.V312022.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 Companion in care DS0000043228.V312022.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. Companion in care DS0000043228.V312022.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Companion in care Address 24 Borthwick Road Leyton London E15 1UD 020 8519 4135 020 8809 7044 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) 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 DS0000043228.V312022.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th September 2005 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 DS0000043228.V312022.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 25/9/06 and was unannounced. The inspector had the opportunity of speaking with service users, staff from the home and the homes manager was present for much of the inspection. The inspection also included a tour of the premises and an examination of records and documentations. Overall the inspector was satisfied that this is a well run home, and service users informed the inspector that they were happy with the level of care and support provided. There are some issues that must be addressed, as highlighted within 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 contacting your local CSCI office. Companion in care DS0000043228.V312022.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Companion in care DS0000043228.V312022.R01.S.doc Version 5.2 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 the following standard(s): 1,3,4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The inspector was satisfied that prospective service users are provided with sufficient information about the home to make an informed choice as to move in or not. This information is provided through written documentation and the opportunity of visiting the home. EVIDENCE: The home has a Statement of Purpose and Service User Guide in place. Both documents are written in plain English, and are dated and subject to regular review. The Statement of Purpose includes details of the organisational structure and of the services and facilities provided by the home. The Service User Guide has been updated since the previous inspection, and now includes details of the homes physical environment, and is in line with National Minimum Standards. Service users are given a contract/statement of terms and conditions. These have been signed by service users and the homes manager. Contracts have been updated since the last inspection, and now include details of fees payable. Although there have been no new admissions to the home since the last inspection, the home has an admissions procedure, which covers planned and emergency admissions. The procedure states that service users will be able to Companion in care DS0000043228.V312022.R01.S.doc Version 5.2 Page 8 visit the home before making any decision as to move in or not. Service users spoken to confirmed that they were indeed given this opportunity. Companion in care DS0000043228.V312022.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. It is the inspector’s view that service users are supported to have control over their daily lives, and that they are involved in the day to day running of the home. EVIDENCE: Individual care plans are in place for all service users. These are clear and comprehensive, and of a satisfactory standard. Plans are drawn up with the involvement of the service user, their keyworker and CPN and the homes manager. Plans include needs associated with personal care, mental health issues, accessing the community and daily living skills. Care plans are subject to regular review. Risk assessments are in place for all service users, these too are subject to regular review. Assessments cover risks associated with self harm and substance abuse. The assessments clearly identify risks, and include strategies to manage and reduce these risks. However, the care plan for one service user states that they have a history of violent and aggressive behaviour, yet there were no guidelines in place around managing this. It is required that individual Companion in care DS0000043228.V312022.R01.S.doc Version 5.2 Page 10 guidelines are in place on managing any challenging behaviours that individual service users may exhibit. Through observation and discussion there was evidence that service users have control over their daily lives, for example when to get up and go to bed, when and what to eat etc. Service users are able to come and go from the home as they choose, (in line with their care plans and risk assessments), and all have keys to the front door as well as their bedrooms. Staff informed the inspector that service users are routinely consulted over the running of the home, for example over activities and menus. Bedrooms and some communal areas of the home have recently been decorated, and service users informed the inspector that they had been involved in choosing the new decorations. The home holds regular service user meetings, these are minuted, and evidenced discussions on general issues such as housework and activities. The home has a confidentiality policy in place. This makes clear under what circumstances a confidence may be broken in the health, safety and welfare interests of service users and others. Staff spoken to demonstrated a good understanding of the issues involved around confidentiality. Confidential records were stored securely, and staff and service users can access their records as appropriate. Companion in care DS0000043228.V312022.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): 11,12,13,14,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. It is the inspector judgement that service users are able to live valued and fulfilling lives. Service users have regular access to the community, and food was of a satisfactory standard. EVIDENCE: Although no service users are currently involved in any formal educational opportunities, they are involved in in-house programmes to help develop independent living skills, for example around cooking. Service users informed the inspector that they did not wish to be involved in any formal employment at present. Service users regularly access the local community. One service user attends day services, where they have a meal and play pool, and are able to develop and maintain friendships. Another service user regularly attends a local church. Service users regularly use local shops, markets and banks, and all use public transport. Companion in care DS0000043228.V312022.R01.S.doc Version 5.2 Page 12 For the most part, service users arrange their own social and leisure activities, service users spoken to said this was their preference. Service users visit local pubs, cafes and places of interest. The home will on occasions arrange day trips, recent trips have included the zoo and to a carnival. In house service users have access to a range of leisure activities, including television, videos, music and board games. The home arranges various parties, for example to celebrate birthdays, and recently held a BBQ. Service users are able to maintain contact with family and friends, who are welcome to visit the home at any reasonable time. It is planned that one service user will be visiting a close relative in Dublin later this year, and the inspector was impressed with the effort that has gone into arranging and organising this trip. The service user informed the inspector that they were very much looking forward to this trip. Service users are given their own mail to open, and have access to a telephone, which they can use in private. The home keeps records of menus, these indicated that service users are offered a varied, balanced and nutritious diet. Service users have a large degree of choice over what they eat, and are heavily involved in food preparation, including buying their own food. The kitchen was clean and tidy, and food was stored appropriately. Records are maintained of fridge and freezer temperatures. Companion in care DS0000043228.V312022.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): 18,19,20 and 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The inspector was satisfied that the home is able to meet the health and personal care needs of service users. Medication is stored and administered appropriately, and service users have access to relevant health care professionals. EVIDENCE: All service users manage their own personal care, although staff will encourage and prompt service users with their personal care as appropriate. Service users choose their own cloths to buy and wear, and all were appropriately dressed on the day of inspection. The home has sought the wishes of service users in the event of their death, and these views have been recorded as part of their care plan. All service users are registered with a GP. Records are maintained of medical appointments, including of any follow up action necessary. Records indicated that service users have access to health care professionals as appropriate, including dentists, opticians and CPN’s. The home has a policy on medication, and all staff undertake training before they are able to administer medications. Since the previous inspection the Companion in care DS0000043228.V312022.R01.S.doc Version 5.2 Page 14 inspector was pleased to note that all medications are now stored securely in the home, in a locked cabinet in the office. No service users currently self medicate or are on any controlled drugs. Records are maintained of medications entering the home and of those that are returned to the pharmacist. The home maintains Medication Administration Record (MAR) charts, those examined by the inspector appeared accurate and up to date. Since the last inspection any hand written entries on MAR charts are now signed. Companion in care DS0000043228.V312022.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. It is the view of the inspector that the home has taken reasonable steps to help ensure that service users are free from the risk of abuse, although the home must ensure that all staff undertake training in adult protection issues. EVIDENCE: The home has a complaints log. This evidenced that any complaints received have been appropriately investigated and recorded. The home also has a complaints procedure, this makes appropriate reference to the CSCI, and was on display within the home. Service users spoken to demonstrated a good understanding of whom they could complain to if they so wished. The home has a copy of the Local Authorities adult protection procedures, and also its own policy on adult protection. This appeared to be in line with current legislation. However, not all staff who work at the home have as yet received any training in adult protection issues, the manager said that this would be arranged, and this is required. All service users have their own bank accounts, and only they can withdraw money from these accounts. The home holds money on behalf of one service user, with their agreement. This is held securely, and records are maintained. Records checked by the inspector appeared to be satisfactory. Companion in care DS0000043228.V312022.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): 24,25,26,27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The inspector was satisfied that the home is able to meet its stated purpose in relation to its physical environment. The home was generally well maintained, and service users have access to adequate private and communal space. 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. As stated, bedrooms have been decorated since the previous inspection, and service users were involved in this process. Bedrooms had appropriate furniture, including table, chair, chest of draws and wardrobes; and bedding, carpet and curtains were well maintained. 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 DS0000043228.V312022.R01.S.doc Version 5.2 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 is provided for staff. The home was generally well maintained, both internally and externally. However, a section of the wall in front of the front garden has been knocked down by a car, and this must be repaired. Companion in care DS0000043228.V312022.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): 31,32,33,34,35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The inspector was satisfied that the home is staffed in sufficient numbers to meet service users needs, and that staff are competent to carry out their duties. EVIDENCE: The home provides 24-hour staff support, including an emergency on call procedure. There was a staffing rota on display, and this accurately reflected the staffing situation on the day of inspection. Through observation and discussion there was evidence that staff have a good understanding of service users individual and collective needs. Staff demonstrated a good ability to communicate with service users, and were seen to interact with them in a friendly and professional manner. All staff are given a copy of their job description and of the General Social Care Council codes of conduct. All staff undertake a structured induction programme on commencing work at the home, this includes policies and procedures and service user issues. Staff receive on-going training, recent training includes moving and handling, health and safety, food hygiene and care planning. Of the three care staff employed at the home, only one has a relevant care qualification, although the inspector was informed that a further staff member is currently working towards such a qualification. It is required that at least 50 of the care staff working in the home have an NVQ Level 2 in Care or equivalent qualification. Companion in care DS0000043228.V312022.R01.S.doc Version 5.2 Page 19 All staff receive regular formal supervision. This is minuted, and staff have access to a copy of their supervision records. Supervision covers performance, training needs and service issues. Since the last inspection all staff now have an annual appraisal. The home has policies in place on equal opportunities and recruitment and selection. The inspector checked staff employment files. These were found to contain evidence of satisfactory CRB checks, employment references and proof of ID. However, they did not all contain a full written record of staff’s employment history, including an explanation of any gaps in employment, and this must be addressed. Companion in care DS0000043228.V312022.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): 37,38,39,40,41 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The inspector was satisfied that this is a generally well managed home, with appropriate quality assurance systems in place. EVIDENCE: The homes manager has eight years experience of working with adults with mental health issues, including five years in a managerial capacity. They have an NVQ Level 4 in Care. Staff and service users informed the inspector that they found the manager to be approachable and accessible, and on the day of inspection staff were observed to interact with the manager in a relaxed manner. Record keeping in the home was generally of a good standard, and confidential records were stored securely. The home has policies in place in line with National Minimum Standards, those inspected, including complaints and confidentiality, appeared satisfactory. Companion in care DS0000043228.V312022.R01.S.doc Version 5.2 Page 21 Care plans, service user meetings and staff supervisions all contribute to the quality assurance within the home. Copies of previous inspection reports were available to view in the home. The home issues questionnaires to service users to gain their feedback on the running of the home, those seen by the inspector contained generally positive feedback. The home has various health and safety policies in place, such as on COSHH and fire safety. Staff receive health and safety training, including on food hygiene and manual handling. Fire extinguishers were situated around the home, these were last serviced in June 2006. Fire exits were free from obstruction. The home holds regular fire drills, and the fire alarms are tested weekly. However, the fire alarms have not been serviced since 12/3/05, and it is required that they are serviced at least annually. The home had in date certificates for PAT, gas safety and electrical installation. Hot water and fridge/freezer temperatures are checked and recorded as appropriate. Companion in care DS0000043228.V312022.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 3 2 X 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 2 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 3 3 2 X Companion in care DS0000043228.V312022.R01.S.doc Version 5.2 Page 23 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 YA7 Regulation 13 Requirement The registered person must ensure that guidelines are in place around managing any challenging behaviours that individual service users may exhibit. The registered person must ensure that all staff who work at the home undertake training in adult protection issues. The registered person must ensure that the broken wall outside the front of the homes garden is repaired. The registered person must ensure that at least 50 of the care staff employed at the home have a relevant care qualification. The registered person must ensure that the home has a full written record of staffs employment history, including an explanation of any gaps in employment. The registered person must ensure that the homes fire alarms are serviced at least once every twelve months. Timescale for action 30/11/06 2 YA23 13 31/12/06 3 YA24 23 31/12/06 4 YA32 18 31/12/06 5 YA34 19 30/11/06 6 YA42 13 and 23 30/11/06 Companion in care DS0000043228.V312022.R01.S.doc Version 5.2 Page 24 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 Companion in care DS0000043228.V312022.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection East London Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4ZZ 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. 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