Inspection on 19/12/06 for Downs Park Road (93)

This inspection was carried out on 19th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Downs Park Road (93) 08/07/07

Downs Park Road (93) 30/11/05

Downs Park Road (93) 19/04/05

Downs Park Road (93) 28/10/04

Downs Park Road (93) 13/05/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

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 Downs Park Road (93) 93 Downs Park Road Hackney London E5 8JE Lead Inspector Sandra Jacobs-Walls Unannounced Inspection 19th December 2006 11:30 Downs Park Road (93) DS0000010267.V323148.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 Downs Park Road (93) DS0000010267.V323148.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. Downs Park Road (93) DS0000010267.V323148.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Downs Park Road (93) Address 93 Downs Park Road Hackney London E5 8JE 020 8533 5340 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) Hackney Independent Living Team Ms Ellen Georgiou Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Downs Park Road (93) DS0000010267.V323148.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. House not to be left unattended when any tenant is in the house. A worker will always be available by radio pager when house is empty 30th November 2005 Date of last inspection Brief Description of the Service: 93 Downs Park Road is a care home offering support, personal care and accommodation to a maximum of four service users who have learning difficulties. The home offers support 24 hours a day. The home is a large three-storey terraced house situated in a residential area of Clapton, in the London Borough of Hackney. The home has good bus links and is within walking distance of local shops, and amenities. Hackney Independent Living Team, (HILT) manages the home, which is a voluntary sector provider of care services. At the time of the inspection, four service users were accommodated. Downs Park Road (93) DS0000010267.V323148.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection of 93 Downs Park Road took place on December 19 2006 for the duration of four hours. On the day of the inspection the home’s registered manager was off sick and had been so for a significant length of time. The interim manager was on site at another HILT registered home and so two support workers who were employed by HILT as ‘bank’ staff assisted with the inspection. On this occasion the inspector did not have the opportunity to speak with any service users as all four service users were out for the duration of the inspection. The purpose of the inspection was to assess the home against key National Minimum Standards and gauge its success at addressing requirements made at the previous inspection conducted in November 2005. The inspector would like to thank all staff that co-operated and contributed to the inspection. As a result of the inspection findings six requirements and no recommendations were made. What the service does well: What has improved since the last inspection? The inspector was of the opinion that the standard of care was similar to that observed at the previous inspection. In the absence of a manger to assist with the inspection the inspector was reliant upon bank staff’s knowledge of the service, which the inspector felt somewhat hampered the outcomes of the inspection. Downs Park Road (93) DS0000010267.V323148.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Downs Park Road (93) DS0000010267.V323148.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Downs Park Road (93) DS0000010267.V323148.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): No new service users had been admitted to the home since the last inspection and so no standards under this heading were assessed on this occasion. EVIDENCE: Downs Park Road (93) DS0000010267.V323148.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As part of the inspection process, the inspector reviewed the individual case files for two of the home’s current service users. Review of the files revealed that one service user’s care had recently been reviewed and that an updated care plan was evident. However, the second file appeared not to evidence an updated care plan, the most recent care plan on file was dated April 2005. The service must ensure that all service users’ care is reviewed and documented care plans are kept current. Members of staff assisting with the inspection gave examples of service users participating in the decision making process. So for example, one service user in particular immensely enjoyed spending time alone in the garden and when he decides to do so, staff encouraged this activity. All service users are encouraged to participate in meal planning on a weekly basis and are encouraged to assist with the weekly food shop. Service users negotiate amongst themselves television channels they wish to watch and are Downs Park Road (93) DS0000010267.V323148.R01.S.doc Version 5.2 Page 10 encouraged to respect each other’s choices. Another service user habitually changed into her nightclothes upon entry to the home after spending the day at the local day centre. The service users choice of afternoon clothing is well known to other service users and staff and her desire to dress in this manner is respected by all. Another service users, who is largely non verbal, prefers to spend much of his spare time in his room alone playing cards, he also is keen to be seated at the table first at meal times. Staff who spoke with the inspector commented that staff and other members of the household respected both these choices/decisions. In reviewing two service users a file, the inspector was satisfied that risk assessments were in place in both cases. Issues of risk explored included poor traffic awareness, anxiety around being out in the community, fear of loud noises, personal injury, falls, scalding and the risk of electric shock. Documented risk assessments included the potential risk, the likelihood of occurrence and risk reduction strategies. Downs Park Road (93) DS0000010267.V323148.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff informed the inspector that all service users attended local day centres during the week. Day centre activities provided service users with good opportunities for recreational activities. Additionally, one service user enjoyed playing keyboards, which he owned and was kept in his bedroom. Three other service users regularly accessed the community via HILT’s occupational therapy service. Another service user enjoyed shopping at East London markets with her sister. Service users regularly enjoyed going to the local park, shopping trips, visit to friends at other HILT projects, to parties, for walks and to eat out. Staff commented that service users had good contact with family members; one service user spent weekends with his parents; another enjoyed fortnightly Downs Park Road (93) DS0000010267.V323148.R01.S.doc Version 5.2 Page 12 visits to her sister and the third service user regularly visited the family home on weekends. The fourth service user occasionally visited his family. Staff interviewed commented that they felt service users’ rights were respected and that their responsibilities were recognised in their daily lives. Somewhat vague examples were given such as ensuring service users enjoyed privacy when they so wished, choice with regard to waking and retiring times and staff encouragement of the completion of household chores. Weekly residents meetings were convened, where service users were encouraged to share ideas about service provision. The weekly residents meetings were also the forum for the weekly meals to be decided upon and planned. Staff made use of pictorial food cards to ensure that actual choices could be made. The inspector reviewed the menu planner for the week of the inspection and was satisfied that meals offered were healthy, varied and nutritiously balanced. Downs Park Road (93) DS0000010267.V323148.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The members of staff assisting with the inspection commented that in general service users, with the exception of one, were able to attend to their own personal care needs and that staff were available to supervise and prompt only. For the service users who needed greater input in completing personal care tasks, staff would talk through what they were about to do and ask whether this was what the service user wanted. Files reviewed contained good documentation that highlighted the abilities of service users to perform personal care tasks and noted those areas that service users needed staff assistance. The staff member demonstrated fair knowledge of some of the medical needs of service users, she informed the inspector of care taken with regard to the service user who had a history of suffering ‘fits’, although no episode had occurred in recent years. The inspector was informed that the day prior to the inspection, one of the service users had been accompanied to the dentist and the outcome and next scheduled appointment was documented in his file. Another service user for whom there are concerns about his weight gain was his weight recorded on file. Downs Park Road (93) DS0000010267.V323148.R01.S.doc Version 5.2 Page 14 In reviewing two service users individual case files, the inspector noted consistent documentation of healthcare issues, medical appointment and any necessary treatment required. Risk assessments seen also in some cases highlighted risks posed as a result of service users healthcare issues. With regard to medication practices, the home’s medication policies had been reviewed previously and were considered satisfactory. The staff member explained that she had received medication training via her former agency and was yet to receive training via HILT; however, she was aware that medication training was being offered to HILT staff an she was awaiting confirmation of her training date. The inspector was informed that the new interim manager had recently changed the medication practices of the home. The worker indicated that the interim manager had felt that systems in place at his project had proved more effective to manage. Medication files and information had been simplified and documentation had been made clearer. Service users’ medication came in prepacked blister packets prepared by the pharmacist to avoid medication error and each service user had a dedicated section of the medication cabinet to store individual medication. The inspector reviewed the medication chart and medication information for one service user in detail and was satisfied that the home’s medication practices were safe and in accordance to the organisation’s medication policies. Downs Park Road (93) DS0000010267.V323148.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The previous inspection had highlighted the need for the home to revise its complaints procedure to include the contact details of the local CSCI office. During the inspection, the inspector asked to see the complaints procedure, which was not produced. Similarly, the homes log of documented complaints would not be located either. The home must evidence the appropriate revision of the home’s complaints procedure and the home’s complaints log must be produced for the purpose of inspections. The home’s adult protection policies had been reviewed during a previous inspection and were considered satisfactory. The member of staff commented that there had been no instances of an adult protection nature; review of the home’s incidents book supported this view. Downs Park Road (93) DS0000010267.V323148.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The previous inspection had highlighted the need for the home’s upstairs toilet and ground floor bathroom to be re-decorated. The inspector was satisfied that both areas had been re-decorated however, the quality of this decoration (e.g. the bath sealant seen in the ground floor bathroom) appears to be of poor quality. The inspector reviewed all service users bedrooms, some of which had been nicely redecorated since the last inspection. The crack in one service user’s bedroom wall seen previously had been repaired. On the day of the inspection the home was very clean and hygienic in appearance. Downs Park Road (93) DS0000010267.V323148.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): In the absence of permanent staff or senior staff during the inspection, the inspector did not have access to staff personnel records, which may have included information with regard to staff training and supervision. Therefore related standards under this heading were not assessed on this occasion. EVIDENCE: Downs Park Road (93) DS0000010267.V323148.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 & 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In the absence of senior staff or service users during the inspection it was difficult to form conclusive judgement in relation to the management of the service currently, this was also compounded by the change in the home’s management arrangements in recent months. Nonetheless, staff that spoke with the inspector indicated that despite this staffing changes, staff worked well together to meet the needs of service users. The registered manger is yet to complete required management training. In light of recent management arrangements the inspector continues to request that copies of the monthly monitoring visits to the home be consistently shared with CSCI .In general it was the inspector’s view that the health, safety and welfare of service users were being adequately promoted and protected by the service. Downs Park Road (93) DS0000010267.V323148.R01.S.doc Version 5.2 Page 19 Downs Park Road (93) DS0000010267.V323148.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 2 X X 3 X Downs Park Road (93) DS0000010267.V323148.R01.S.doc Version 5.2 Page 21 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 &5 Requirement The registered person must ensure that the homes Statement of Purpose and Service User Guide is revised to include the contact details of the local CSCI office on information about the home’s complaints procedure. The registered person must ensure that all service users’ care plans are reviewed and updated on at least an annual basis. The registered person must ensure that the homes complaints procedure is updated to include the contact details of the local CSCI office and that the home’s complaints log is made available for the purpose of CSCI inspections. The registered person must ensure that individual staff supervision sessions are consistently conducted and documented on file. (Previous timescale of 31/05/05 not met) The registered manager must complete the level 4 NVQ qualification. DS0000010267.V323148.R01.S.doc Timescale for action 28/02/07 2. YA6 15(2)(b) 28/02/07 3. YA22 22(2) 28/02/07 4. YA36 18(2) 31/03/07 5. YA37 9(2)(i) 30/06/07 Downs Park Road (93) Version 5.2 Page 22 6. YA39 26 The registered person must ensure that monthly monitoring visit reports are promptly forwarded to the Commission for review. (Previous timescale of 31/05/05 not met) 18/02/07 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 Downs Park Road (93) DS0000010267.V323148.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection East London Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Downs Park Road (93) DS0000010267.V323148.R01.S.doc Version 5.2 Page 24 - 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!