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Inspection on 28/06/05 for Dagenham Road

Also see our care home review for Dagenham Road for more information

This inspection was carried out on 28th June 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is part of the Outlook Care Group, it offers as independent a lifestyle to service users as is possible around their assessed needs and risk assessments. The organisation is very well structured and the staff benefit from support of the whole management team and the organisations training structure. The home is very comfortable and homely and is undergoing some refurbishment at the moment with the purchase of new soft furnishings in the communal lounges, the choice of which has involved the service users. It is always a pleasure to visit the home and the staff team and service users are always welcoming of visitors to their home.

What has improved since the last inspection?

Work has been undertaken to improve the bathrooms within the house, there have been requirements made within previous reports and the manager has ensured that these have been met. The three bathrooms have been redecorated and tiling replaced where required , also new flooring has been laid and fixtures and fittings replaced. Major work is about to be undertaken to completely re-fit the shower room.

What the care home could do better:

The home offers a very high quality service to the service users living there, whereby the staff are very committed to the service users and maintaining their independence and choices as far is practicably possible. The service users when spoken to are all very complimentary of the staff as were the family/representatives spoken to. There is always room for improvement in any service, but at present there is nothing obvious that could be recommended.

CARE HOME ADULTS 18-65 Dagenham Road 357a-359 Dagenham Road Romford Essex RM7 0XX Lead Inspector Kim OConnell Unannounced Inspection 28th June 2005 9.30 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. Dagenham Road G55_S0000027897_Dagenham Road_V233924_200605_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Dagenham Road Address 357a-359 Dagenham Road, Romford, Essex RM7 0XX 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 8595 5336 020 8984 8989 Outlook Care Pauline Dora Dean CRH Care Home 8 Category(ies) of MD Mental disorder registration, with number of places Dagenham Road G55_S0000027897_Dagenham Road_V233924_200605_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 10 March 2005 Brief Description of the Service: The home is situated in Dagenham Road, with easy access, by bus to Romford town centre or Dagenham Heathway. The home has two units of four beds each. In March 2003 the home changed from having three units to two residential care home units and one supported living unit. There is now a registered manager in post and support workers who staff the home, two support workers have worked at the home since it opened. There are places for 8 service users with mental health support needs, a new registration certificate has been issued to reflect these changes. The service user group at the time of inspection were semi-independent, needing prompting reassurance and support from staff. The staff team work hard to ensure the service users independence is maintained, and liaise with other professionals to regulate service users health and wellbeing. The home is staffed 24 hrs a day with a waking member of staff at night. Outlook Care provides the support whilst East Thames Housing Group are the landlord. Dagenham Road G55_S0000027897_Dagenham Road_V233924_200605_Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection took place on 28th June 2005 and was unannounced, the inspector would like to thank the service users, manager and staff for the warm welcome extended to her and for the input from all at Dagenham Road towards the inspection process. The inspector checked documentation, spoke with staff and service users and had a tour of the home. This inspection is very close to the previous report and therefore not all standards have been assessed on this occasion, there had been some requirements made in that report which were inspected during this inspection, all core standards will be assessed throughout the inspection year during future inspections. The home as always was found to be tidy, clean and homely, the staff and service users were seated in the kitchen area having coffee and a chat, planning their day, the inspector was invited to join them and was made welcome. What the service does well: What has improved since the last inspection? Work has been undertaken to improve the bathrooms within the house, there have been requirements made within previous reports and the manager has ensured that these have been met. The three bathrooms have been redecorated and tiling replaced where required , also new flooring has been laid and fixtures and fittings replaced. Major work is about to be undertaken to completely re-fit the shower room. Dagenham Road G55_S0000027897_Dagenham Road_V233924_200605_Stage 4.doc Version 1.30 Page 6 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. Dagenham Road G55_S0000027897_Dagenham Road_V233924_200605_Stage 4.doc Version 1.30 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 Dagenham Road G55_S0000027897_Dagenham Road_V233924_200605_Stage 4.doc Version 1.30 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) 0 Under this heading no standards were tested on this occasion, there have been no new service users admitted to the home since the last inspection. All core standards will be tested during future inspections in the coming inspection year. EVIDENCE: Dagenham Road G55_S0000027897_Dagenham Road_V233924_200605_Stage 4.doc Version 1.30 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 & 10 By the use of person centred planning, comprehensive care plans and risk assessments the home are able to ensure that service users are able to live individually appropriate lifestyles. EVIDENCE: Individual records are kept for each service user and the inspection of three service user files showed appropriate recordings within care plans, The standard of the care plans within the home, using the person centred planning system is very comprehensive, service users individual goals are documented and link directly to their care plans. Care plans are reviewed regularly and documented accordingly, risk assessments are carried out to reflect any changes in assessed needs of service users and to support service users to maintain a safe independent lifestyle. Regular service user meetings take place within the home and are documented, there is a notice board within the home informing all service users of any forthcoming events within the service and the local community. Dagenham Road G55_S0000027897_Dagenham Road_V233924_200605_Stage 4.doc Version 1.30 Page 10 The service users spend time together within the home on an informal, family type basis discussing events and possible participation in them. Service users records are held securely within the home, and all service users are aware of their right to access the information held on them. Dagenham Road G55_S0000027897_Dagenham Road_V233924_200605_Stage 4.doc Version 1.30 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 user has an individual planned activity programme, which takes account of the service user’s preferences, interests, experiences, age and capabilities related to their assessed needs. 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. Some service users attend specialist day centres and others participate in leisure activities in the community including shopping and eating out. Dagenham Road G55_S0000027897_Dagenham Road_V233924_200605_Stage 4.doc Version 1.30 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 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, ensuring the safety of service users. EVIDENCE: All of the care plans examined recorded referrals to specialist health care and emotional care professionals where required and recorded that appointments were being kept. The service users living at the home require very minimal assistance with personal care, one service users requires a degree of assistance and she receives this personal care from female staff. There are policies and procedures for the handling and recording of medicines in the home. At present there are no service users who self medicate. The majority of staff have received medication training from a local pharmacist. Staff are not authorised to administer medication unless they have undertaken this training and been deemed competent. Dagenham Road G55_S0000027897_Dagenham Road_V233924_200605_Stage 4.doc Version 1.30 Page 13 The inspector discussed with the manager the possibility of arranging a visit from the Commissions specialist pharmacy inspector, not because of any concerns but as a source of advice and as a more in depth inspection of the homes practice and procedures around the administration of medications. Since this inspection was undertaken, the Commissions pharmacy inspector has visited the home and no requirements were made in his report, a copy of which is available from the Commissions office. Dagenham Road G55_S0000027897_Dagenham Road_V233924_200605_Stage 4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 0 The standards under this heading were not tested on this occasion, there are no outstanding requirements and the home have received no complaints since the last inspection. These standards will be tested during future inspections of the home. EVIDENCE: Dagenham Road G55_S0000027897_Dagenham Road_V233924_200605_Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,27 and 30 The décor, furnishings and fittings in the home are of a very good standard and provide a comfortable and homely environment for service users to live. EVIDENCE: The home has recently undergone some re decoration in areas throughout the home, including the lounge areas. New soft furnishings have been purchased and these were chosen by the service users living at the home. The bathrooms have been re decorated and tiling replaced, also flooring replaced in all bathrooms, the addition of new pictures, and accessories have made the bathrooms very individual. The downstairs shower room, has had requirements made previously around ensuring the accessibility of the shower room for the service user with reduced mobility. The work has been agreed by the North Thames Housing Association who manage the property, an assessment of the work required has been carried out and funding is in place, worksheets were seen at the time of this inspection evidencing that this major work is imminent. Dagenham Road G55_S0000027897_Dagenham Road_V233924_200605_Stage 4.doc Version 1.30 Page 16 The home is clean with no offensive odours throughout. There is a well equipped laundry, which service users are able to use with minimal support from staff. Dagenham Road G55_S0000027897_Dagenham Road_V233924_200605_Stage 4.doc Version 1.30 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. Staff files examined of staff members indicate that the home is undertaking all the necessary recruitment checks to ensure the protection of service users including taking up two written references and a CRB check. All staff are provided with a copy of the General Social Care Council (GSCC) standards and code of conduct. Dagenham Road G55_S0000027897_Dagenham Road_V233924_200605_Stage 4.doc Version 1.30 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. Dagenham Road G55_S0000027897_Dagenham Road_V233924_200605_Stage 4.doc Version 1.30 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 The home is managed well and provides a safe environment for the service users in the home. EVIDENCE: The current manager has been at the home for some years and has recently been confirmed in post, although she was registered as the manager by the Commission in 2004. The home is well maintained and provides a safe environment for service users and staff. Regulation 26 visits are undertaken by the organisations area manager and copies forwarded to the Commission on a monthly basis. Dagenham Road G55_S0000027897_Dagenham Road_V233924_200605_Stage 4.doc Version 1.30 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 ENVIRONMENT Score x x 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 x x 3 Standard No 11 12 13 14 15 16 17 x x 3 3 x 3 x Standard No 31 32 33 34 35 36 Score x x 3 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Dagenham Road Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x x x x x x G55_S0000027897_Dagenham Road_V233924_200605_Stage 4.doc Version 1.30 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 Regulation NONE Requirement Timescale for action 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 NONE Good Practice Recommendations Dagenham Road G55_S0000027897_Dagenham Road_V233924_200605_Stage 4.doc Version 1.30 Page 22 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 Dagenham Road G55_S0000027897_Dagenham Road_V233924_200605_Stage 4.doc Version 1.30 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!