Inspection on 07/04/05 for Cranbrook Road (477-481)

This inspection was carried out on 7th 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 but made no statutory requirements on the home.

Other inspections for this house

Cranbrook Road (477-481) 14/09/07

Cranbrook Road (477-481) 08/01/07

Cranbrook Road (477-481) 03/04/06

Cranbrook Road (477-481) 19/10/05

Cranbrook Road (477-481) 19/07/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

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Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Cranbrook Road (477-481) 477-481 Cranbrook Road Ilford Essex IG2 6ER Lead Inspector Gwen Lording Unannounced 07 April 2005 2.00. p.m. 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. Cranbrook Road (477-481) Version 1.10 Page 3 SERVICE INFORMATION Name of service Cranbrook Road (477-481) Address 477-481 Cranbrook Road, Ilford, essex IG2 6ER 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 8586 7781 Sahara Homes Ltd Current manager not yet registered Care Home 19 Category(ies) of Learning disability (19) registration, with number of places Cranbrook Road (477-481) Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: There are no conditions of registration. Date of last inspection 13/01/05 Brief Description of the Service: 477 Cranbrook Road is a care home providing accommodation and support for service users with a learning disability/ physical disability and associated challenging behaviours. The registered providers are Sahara Homes Limited. The home is registered to accommodate 19 service users in two seperate units of 10 and 9. House One is wheelchair accessible and has a passenger lift. House Two is more suitable for service users who are independently mobile. The home is situated in a busy residential area of Gants Hill in the London Borough of Redbridge. The area is well served by public transport and there are many easily accessible facilities and amenities within the local area. The home has its own transport. There is a large rear garden, which is wheelchair accessible. The home aims to integrate the service users into community life and supports them to access and participate in mainstream as well as specialist resources in the community in which they live, within their individual capabilities. Cranbrook Road (477-481) Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and started at 2.00 p.m. It took place over four hours during the afternoon and early evening. The inspector spoke to one service user and was able to communicate with five other service users with the assistance of staff. The registered provider, manager and three other members of staff were also spoken to. The inspector took the opportunity to speak to a District Nurse who visited the home during the evening. A partial tour of both Houses took place and staff and care records were inspected. An additional unannounced visit was made in January this year (2005) following concerns around the management and administration of medication and the use of restraint without staff having received proper training in such methods. There has been a change of manager since the last inspection. What the service does well: What has improved since the last inspection? A new manager has just been appointed and she has a good understanding of the areas in which the home needs to improve and further develop. She has set out how these improvements will be planned and managed. Since the last inspection the management of medication has improved and all staff have received training in medication awareness and administration. Cranbrook Road (477-481) Version 1.10 Page 6 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. Cranbrook Road (477-481) Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Cranbrook Road (477-481) Version 1.10 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 standard(s) 2 and 3 The assessments completed by the home and the information and reports received from other health professionals means that staff have detailed information to enable them to determine whether or not the home can meet a prospective service user’s needs. EVIDENCE: Each service user has a completed Care and Support Assessment form, which is undertaken prior to admission to the home. There was a care needs assessment on the files of those service users sampled. One service user recently admitted to the home from hospital had a detailed Transition Programme, which had been drawn up with the involvement of the home. This was a structured programme, which covered an eight-week period with regular reviews by the hospital multi-disciplinary team involving the service user and care staff in the home. The programme set out how to meet his needs through positive planned interventions. This will ensure that the service user’s admission to the home is well planned and any difficulties he has in settling into the home will be addressed and understood by staff in the home. Cranbrook Road (477-481) 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 and 9. Not all the care plans are detailed enough to provide staff with sufficient information about how to meet service users’ personal and health care needs. The absence of risk assessments for the use of cot sides and lap belts may result in the unsafe use and practice of such restraint methods. Staff are very active in helping service users to access local independent advocacy services to support them in the right to take risks and assist with making informed decisions. EVIDENCE: Information in some of the care plans examined was not being regularly reviewed or updated to reflect changing needs. The standard of care planning was not consistent for all service users. The level of disability of the current service users in the home severely limits the degree to which they can be involved in the development of plan of care. However, staff in the home had developed a plan of care for one recently admitted service user that is in a simple graphic format that he can understand. The key worker has also developed a book for him with pictures of Cranbrook Road (477-481) Version 1.10 Page 10 staff, his bedroom and other places in the home that acts as a reference point for him whilst getting to know the staff and the home. There were no risk assessments for the use of equipment used as physical methods of restraint such as cot sides and lap belts. Permission had also not been sought for its use through discussion with relatives or representatives of the service user. Cranbrook Road (477-481) 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) 13, 14 and 16 Opportunities for social and leisure pursuits and personal development are actively promoted and supported by staff for all service users to enable them to participate in the wider community in which they live. EVIDENCE: Each service has an individual planned activity programme, which takes account of the service user’s preferences, interests, experiences, age and capabilities related to their disability. The duty rota is planned to ensure that the numbers and skills of staff needed each day are sufficient so that planned programmes of activities are carried out. The home has its own transport – a minibus and designated driver. Some service users attend specialist day centres and others participate in leisure activities in the community including swimming, shopping and eating out. Cranbrook Road (477-481) Version 1.10 Page 12 One service user spoken to had just returned from day services. She said she was happy that staff were always there at the end of the day to pick her up and bring her home. Staff showed a keen and genuine interest in hearing how she had spent her day. Cranbrook Road (477-481) 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) 18, 19 and 20 The service users’ physical and emotional health care needs are closely monitored and this ensures that service users’ needs are recognised and met. The medication policies and procedures are clear and all staff have received training. There is some isolated inconsistent recording resulting in unsafe practices. EVIDENCE: All of the care plans examined recorded referrals to specialist health care professionals and that appointments were being kept. Two service users who are insulin dependant diabetics receive visits by the District Nursing Service twice a day. The District Nurse visiting the home during the evening of the inspection was spoken to and she was very positive about the home’s management of these two service users’ health care needs. There is an effective level of communication between herself and the home. There is only one female service user currently living in the home and female care staff always provides her personal care needs. The intimate personal care needs of male service users are provided by male care staff. Cranbrook Road (477-481) Version 1.10 Page 14 There are policies and procedures for the handling and recording of medicines in the home. The majority of staff have received medication training from a local pharmacist. Staff are not allowed to administer medication unless they have undertaken this training and been deemed competent. Written protocols are in place for the use of PRN (when required) medication. There were a number of isolated omissions on the recording of medication on the Medication Administration Records (MAR) charts. It was not clear whether the medication had been refused by the service user or it had not been administered as prescribed by staff. Staff must ensure that if medication is not administered the reason why must be clearly recorded on the MAR chart. Cranbrook Road (477-481) 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) 23 Staff have received accredited training in the use of physical restraint that protects the rights and interests of the service user and is the minimum consistent with safety and dignity. There has been no progress in all staff working in the home to receive training in adult protection issues/ abuse awareness to ensure a proper response for reporting any suspected or witnessed abuse. EVIDENCE: There is a written policy and procedure for the protection of vulnerable adults and some staff have received training in ‘Alerters of Abuse’. A requirement was made at the last inspection for all staff working in the home to receive training in Adult Protection/ Abuse Awareness and this has not yet been progressed. However, staff spoken to were generally aware of their responsibilities regarding allegations of abuse or witnessed abuse. The home’s policies and procedures on the handling of service users’ money must reinforce the need for two signatures to be recorded for all financial transactions, to safeguard both staff and service users. The majority of staff have received training in the use of restraint, ‘Safe and Therapeutic Management of Aggression and Violence’. This is a five day accredited training course, which is competency based and involves a final written exam. Staff spoken to commented that the training had helped them understand physical and verbal aggression and made them feel more confident when dealing with such situations. Cranbrook Road (477-481) 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 and 30 The décor, furnishings and fittings in the home are of a very good standard and provide a comfortable and homely place for service users to live. EVIDENCE: The home was first registered in May last year (2004) and it is furnished and equipped to a high standard. All the bedrooms are single, have en suite facilities and are furnished and decorated to suit individual’s preferences and particular needs. House One is fully accessible for wheelchair users including the garden. The home is clean with no offensive odours throughout. There is a wellequipped laundry, which some service users are able to use with the support of staff. Cranbrook Road (477-481) Version 1.10 Page 17 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) 33, 34 and 35 Staffing levels are satisfactory and there is sufficient staff on duty to meet the individual needs of the service users. The procedures for the recruitment of staff are robust and provide safeguards for people living in the home. EVIDENCE: Staffing levels are regularly reviewed to respond to service users’ changing needs. The duty rota is very flexible and staff are rostered to work at peak activity periods during the day. This ensures that service users are able to follow their individual activity programmes and have one to one time with staff. In discussion with staff it was evident that they understand and fully support the main aims and values of the home. The staff files examined of three staff members employed since the last inspection indicated that the home is undertaking all the necessary recruitment checks to ensure the protection of service users. All staff are provided with a copy of the General Social Care Council (GSCC) standards and code of conduct. Cranbrook Road (477-481) Version 1.10 Page 18 The home has a training and development plan and the manager is pro active in determining and identifying training needs for staff according to service users’ individual needs. Cranbrook Road (477-481) Version 1.10 Page 19 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 and 42 The home is managed well and provides a safe environment for the service users in the home. EVIDENCE: The current manager has been in post only a few weeks and there have been two previous managers since the home opened last year. The current manager is in the process of submitting an application to be registered with the Commission. She was previously registered as the manager in a similar but smaller home, within the provider organisation. She has a good understanding of the areas in which the home needs to improve and further develop. The home is well maintained and provides a safe environment for service users and staff. Inspection of records indicated that regular tests to emergency lights and fire alarms had been carried out. Regulation 26 visits are undertaken by the registered providers but a copy of the report is not always sent to the Commission. Cranbrook Road (477-481) Version 1.10 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. 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 5 Score x 3 3 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 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 x x x 3 Standard No Cranbrook Road (477-481) Standard No 31 32 Version 1.10 Score x x Page 21 11 12 13 14 15 16 17 x x 3 3 x 3 x 33 34 35 36 3 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 2 x 2 x x 3 x Cranbrook Road (477-481) Version 1.10 Page 22 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 6 Regulation 14 Requirement The manager must ensure that each service user has an individual written plan of care which details how current and anticipated specialist requirements will be met (Timescale of 30/09/04 not met) It is a requirement that all staff in the home receive training in adult protection issues/ abuse awareness (Timescale of 31/10/04 not met) It is a requirement that the duty rota records the full name of each member of staff and their designation for example, senior carer, support worker (Timescale of 31/08/04 not met) Risk assessments must be undertaken for the use of cot sides and wheelchair lap belts. Written permission must also be sought for their use through discussion with relatives or representatives of the service user. Staff must ensure that if a prescribed item of medication is not administered , the reason why must be clearly recorded on the Medication Administration Version 1.10 Timescale for action 31/05/05 2. 23 13 30/06/05 3. 33 17 7/04/05 4. 9 13 30/05/05 5. 20 13 7/04/05 Cranbrook Road (477-481) Page 23 Record (MAR) chart. 6. 23 13 The homes policy on the handling of service users money must reinforce the need for two signatures to be recorded for all financial transactions, to safeguard both staff and service users. The manager must submit an application for registration as the manager of the home with the Commission. Visits under Regulation 26 of the Care Homes Regulations 2001 must be undertaken and a copy of the report provided to the Commission. 30/04/05 7. 37 8 31/05/05 8. 39 26 31/05/05 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 Cranbrook Road (477-481) Version 1.10 Page 24 Commission for Social Care Inspection Ferguson House 113 Cranbrook Road Ilford Essex IG1 4PU 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 Cranbrook Road (477-481) Version 1.10 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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