Inspection on 24/05/05 for Drayton Road

This inspection was carried out on 24th May 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 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 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Drayton Road 11/07/06

Drayton Road 06/10/05

Drayton Road 18/11/04

Drayton Road 15/06/04

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 Drayton Road 2 Drayton Road Leytonstone London E11 4AR Lead Inspector Rob Cole Announced Inspection 24th May 2005 10:00am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Drayton Road Version 1.10 Page 3 SERVICE INFORMATION Name of service Drayton Road Address 2 Drayton Road, Leytonstone, London E11 4AR 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 8556 2550 020 8556 2550 tboyle@outward.org.uk Outward Mr Thomas Boyle Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Drayton Road Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 18th November 2004 Brief Description of the Service: Drayton Road is a residential home, registered to provide personal care and support to eight adults with learning difficulties. The home is situated in a residential area of Leytonstone, in the London Borough of Waltham Forest, close to local amenities, and transport networks. The home was purpose built over three floors. The home is privately run and managed by Outward. Drayton Road Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on 24/5/05 and was announced. The inspector had the opportunity of speaking with service users, staff and the homes manager was present throughout the inspection. Overall the inspector was satisfied that the home is suitable to meet its stated purpose and meet the needs of individual service users. Service users spoken to gave positive feedback about the level of support they receive. Staff and management appeared to be sufficiently competent and motivated to carry out their duties. What the service does well: What has improved since the last inspection? What they could do better: The main area of concern that exists with the home is around the physical environment. Although there have been some recent improvements, for instance in service users bedrooms, the home generally is in need of decorating. This is particularly true of the kitchen. Further, the garden needs to be better maintained. Staff would also benefit from more regular supervision and appropriate training. Drayton Road Version 1.10 Page 6 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. Drayton Road 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 Drayton Road 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) 1,3,4 and 5 The inspector was satisfied that prospective service users are provided with sufficient information to enable them to make an informed choice about the home. This information is provided through a combination of written documentation and the opportunity of visiting the home and meeting staff and service users. EVIDENCE: The home has a Statement of Purpose and Service User Guide in place. Both documents are in plain English, the Guide is also in pictorial form, and service users all have their own copy. The Statement is in line with Schedule 1 of the Care Home Regulations 2001, and since the last inspection the Statement has been reviewed. Service users are also given a written contract/statement of terms and conditions. These have been signed by all relevant parties, and service users have their own individual contracts. Contracts include details of fees payable, the rooms to be occupied and the right and obligations of the home and the service user. Although there have been no new admissions to the home since the last inspection, the home has an admissions procedure in place. The manager informed the inspector that prospective service users would be able to visit the home, including for overnight stays, before making any decision as to move in or not. Further, the existing service users would be involved in any decision as Drayton Road Version 1.10 Page 9 to who should move in. The placement would initially be on a trial basis, with a placement review meeting held after three months. From observation and discussion there was evidence that the home is able to meet the collective and individual needs of service users. Staff demonstrated a good ability to communicate with service users, many of whom have complex communication needs. Drayton Road Version 1.10 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9 and 10 The inspector was satisfied that the home is able to meet the individual needs of service users, and that service users have control over their daily lives, and are involved in the day to day running of the home. EVIDENCE: All service users have clear and comprehensive care plans in place. Plans are produced in written form, and are also now produced on audiotape to help service users access them. Plans are drawn up with the involvement of the service user, their keyworker, the homes manager and family where appropriate. Plans were detailed and of a generally high standard, and included information on personal care, social and leisure needs, mobility and medical needs. Daily logs are also maintained, and these are linked to care plans. Clear risk assessments are also in place for service users. Again, these were detailed and of a high standard. Assessments covered risks associated with falling and accessing the community. There was evidence that service users are able to take reasonable risks in line with assessments, for example over the use of knives in food preparation. Through observation and discussion there was evidence that service users have a large measure of control over their daily lives, for example when to get Drayton Road Version 1.10 Page 11 up and go to bed. Where there are restrictions on choice these have been clearly recorded and the reasons why, for instance one service user has restrictions in place on the amount of time they can spend alone with their girlfriend. The service user was involved in this decision, as was their social worker. Service users are regularly consulted on an ad hoc basis, for example on what they want to eat or if they would like to go out. More formal arrangements are also in place to involve service users in the homes decision making process. The home holds regular service user meetings, and there was evidence that decisions taken at these are acted upon. For example at a recent meeting service users had agreed that they would like a new leather sofa for the sitting room, and this was subsequently purchased. The homes manager informed the inspector that two service users are currently doing a training course on staff recruitment, and it is hoped that they will be given the opportunity of been involved in future staff recruitment to the home, and this is recommended. The home has a confidentiality policy in place, which makes clear under what circumstances a confidence may be broken in the health, welfare and safety interests of service users and others. All confidential information is stored securely, and staff and service users can access their records as appropriate. Drayton Road Version 1.10 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16 and 17 The inspector was satisfied that service users have appropriate access to the community, and that their social, leisure and educational needs are been met by the home. Service users are supplied with an appropriate choice of food, although work needs to be done on improving the décor in the kitchen. EVIDENCE: Service users are involved in various educational opportunities. One service user is studying first aid at a local community centre, while another is studying cooking at a college. In house service users are involved in a variety of programmes to promote independence, for instance with cooking and laundry. No service users are currently in employment, although the home is exploring the possibility of a service user having a job which involves food preparation. Service users have links with the local community, three service users attend church, and service users regularly use local shops , banks and hairdressers. Service users use local transport networks, including busses and minicabs, and the home has its own unmarked transportation. Service users are involved in MENCAP groups, and on the day of inspection two service users attended a Drayton Road Version 1.10 Page 13 drama class at a local day services. Service users have access to a variety of social and leisure activities, both in house and in the community. In house service users have access to TV, video, music and board games. The inspector was informed that birthdays are celebrated according to individual choice, and recently this has involved trips to the theatre, restaurants and in house birthday parties. In the community service users go to the cinema and cafes, and one service user went to the pub on the day of inspection. One service user plays in a local football team. All service users are offered an annual holiday as part of their basic contract price, this year some service users are going to Devon, while one service user has said they want to go to Holland. The manager said that this would be arranged. Records are maintained of menus, and these indicated that service users are offered a varied, balanced and nutritious diet. On the day of inspection service users were observed to have a choice over their meals, and mealtimes were seen to be relaxed and unhurried. Service users are involved in food preparation, including buying the food. Fresh fruit was available, and service users were able to help themselves to drinks and snacks throughout the day. Food was stored appropriately, and records are maintained of fridge and freezer temperatures. However, the kitchen was generally in a poor state of repair, for instance damaged flooring and peeling wallpaper. This issue has been identified in several Regulation 26 reports, and must be addressed. Drayton Road Version 1.10 Page 14 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 inspector was generally satisfied that service users personal and healthcare needs are been met. Medications were in good order, and service users are supported to manage their own personal care as much as possible. However, the home must ensure that service users have access to all appropriate health care professionals. EVIDENCE: Clear guidelines on supporting service users with their personal care are in place on individuals care plans, and these indicated that service users are encouraged to do as much for themselves as possible. Service users choose their own clothes, and on the day of inspection all were appropriately dressed. Service users were observed to be involved in the homes daily routines, for example cleaning the kitchen and washing up, and this was in line with care plans. All service users are registered with a GP, and there was evidence of the involvement of other health professionals, including speech and language therapists and psychiatrists. One service users mobility has recently deteriorated, and there was evidence that they have had significant involvement from a physiotherapist with regard to this. However, there was no evidence that all service users have had access to any dental care in the past year, and this must be addressed. Records are maintained of medical Drayton Road Version 1.10 Page 15 appointments. The manager informed the inspector that since the previous inspection service users are now able to see visiting health professionals in private. The home has a detailed medication policy in place, and all staff receive training before they are able to administer medications. Records are kept of medications entering the home and those that are returned to the pharmacist. Medical Administration Record charts are maintained, these appeared to be accurate and up to date. Since the last inspection the medication cabinet has been secured to the wall, and guidelines are in place for the administration of medications prescribed on a PRN basis. Drayton Road Version 1.10 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The inspector was satisfied that sufficient measures and controls are in place to safeguard service users from the risk of abuse. Further, appropriate procedures are in place for anyone wishing to make a complaint. EVIDENCE: The home has a complaints procedure, this was prominently displayed within the home. The procedure included contact details of the CSCI and appropriate timescales for responding to any complaints made. Since the previous inspection the home now has a complaints log in place, although the manager informed the inspector that no complaints have been received in the past year. Service users spoken to demonstrated a good understanding of whom they could complain to if they so wished. The home has a copy of No Secrets, and also a copy of the Local Authorities adult protection procedures. The home has its own adult protection policy, which appeared to be in line with current legislation. All staff have received training in adult protection issues. All service users have their own bank accounts, and they are the only signatories to these accounts. The home holds money in a locked safe on behalf of service users, and this is checked as part of every handover. The inspector checked several service users finances at random, and all appeared to be satisfactory. Records and receipts are kept of financial transactions involving service users monies. Drayton Road Version 1.10 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25,26,27,28,29 and 30 The inspector believes that although the home is suitable to meet its stated purpose, some of the communal areas are in need of decorating. The home has sufficient communal space to meet service users needs, and bedrooms were satisfactory. EVIDENCE: The home is situated in the Leytonstone area of the London Borough of Waltham Forest, close to shops, transport links and other local amenities. The home is purpose built over three floors. Not all of the communal areas are accessible to all service users, due to mobility issues. Corridors are no longer used as storage areas for wheelchairs since the last inspection. The home was generally well maintained externally, although internally there are several incidents of minor maintenance issues which need addressing, such as peeling wallpaper and scuffed paintwork. It is a repeat requirement that all areas of the home are maintained in a good state of repair and reasonably decorated. All service users have their own bedrooms, these have locks fitted and service users have been offered keys to their rooms. Bedrooms have recently been decorated, and service users informed the inspector that they were involved in Drayton Road Version 1.10 Page 18 choosing the new décor. Rooms have been personalised to service users individual tastes, for example with family photographs and televisions. Rooms had appropriate furniture, including table and chairs, wardrobes and chest of draws. Bedding, carpets and curtains were all well maintained, and domestic in character. Bedrooms had adequate natural light and ventilation. Bedrooms meet National Minimum Standards on size requirements. One service user has ensuite facilities in their bedroom, and all other bedrooms have hand basins in them. There is a shower room on the ground floor and a bathroom on the first floor. The ground floor shower room was specifically designed to meet the needs of one of the service users. Grab rails are in place in communal areas, and there are sufficient toilets to meet service users needs. On the day of inspection bathrooms were found to be clean, tidy and free from offensive odours, and all had locks on them. However, the radiator in the downstairs shower room was found to be leaking on the day of inspection, and this must be repaired. The communal areas consist of a kitchen/dining room, a second smaller kitchen, two lounges and a garden. New flooring has been installed in communal areas since the last inspection, and the home has purchased a new three-piece suite, which service users chose. However, the garden was in a state of neglect, and this must be addressed. Drayton Road Version 1.10 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35 and 36 Overall the inspector believes that the home has a dedicated and motivated staff team competent to carry out their duties. However, staff would further benefit from regular supervision, and access to all appropriate training. EVIDENCE: The home provides 24-hour support, including an emergency on-call procedure. The home has a staffing rota, and on the day of inspection this accurately reflected the actual staffing situation in the home. Regular staff meetings are held, which are minuted. All staff are able to put items on the agenda for discussion, minutes seen by the inspector evidenced discussions on service users and health and safety issues. The home has policies in place on equal opportunities and recruitment and selection, and staff are given a copy of their job description on commencing work at the home. The inspector checked several staff employment files, and since the last inspection these now all appeared to be satisfactory, with evidence of references, CRB checks and suitable proof of identification. All staff are involved in a structured induction programme on commencing work in the home, this includes the environment and service user issues. Since the previous inspection records are now maintained of all staff training. These evidenced that staff have recently had training in manual handling, epilepsy, Drayton Road Version 1.10 Page 20 challenging behaviour and adult protection. One of the current service users has been diagnosed as having dementia, and it is required that staff receive training in working with people with dementia. Of the six care staff employed at the home, five either have or are currently working towards a relevant NVQ qualification. Staff supervision arrangements are shared between the manager and the deputy manager, minutes are taken, and staff receive a copy of the minutes. Supervision covers training, performance and service user issues. However, formal supervision of some staff has been infrequent, and it is required that staff receive formal supervision at least six times a year. All staff have an annual appraisal. Drayton Road Version 1.10 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,40,41,42 and 43 The inspector was satisfied that the home is well run, and that the manager is competent to carry out their roles and responsibilities. EVIDENCE: The homes manager is currently working towards the Registered Managers Award, and is a registered nurse for people with learning difficulties. The manager has extensive experience of working with adults with learning disabilities, including in a managerial role. The home also employs a deputy manager. The manager presented as promoting an open and inclusive atmosphere, staff were observed to interact with the manager in a relaxed manner. Staff and service users spoken to said that they found the manager to be approachable. Confidential records were all stored securely, and staff and service users can access them as appropriate. The home appears to have all written policies in place in line with National Minimum Standards. The inspector checked several Drayton Road Version 1.10 Page 22 at random, including adult protection and equal opportunities, and all appeared to be satisfactory. Staff meetings, service user meetings and care plan reviews all contribute to the quality assurance within the home. There was evidence of monthly Regulation 26 visits, and copies of previous inspection reports were available within the home. Questionnaires are issued to service users to help gain feedback, those seen by the inspector were generally positive. The home has various health and safety policies in place, and staff undertake health and safety training, including first aid and food hygiene. Fire fighting equipment was situated throughout the home, and regular fire drills are held. Alarms and extinguishers are serviced by an engineer. Since the last inspection the home has had a satisfactory electrical installation safety check, and hot water temperatures are regularly checked and found to be at safe levels. 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 3 x 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 Standard No 24 Score 2 Drayton Road Version 1.10 Page 23 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score 25 26 27 28 29 30 STAFFING 3 3 2 2 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 2 Standard No 31 32 33 34 35 36 Score 3 3 3 3 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 Drayton Road Version 1.10 Page 24 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 YA24 and YA17 Regulation 23 Requirement The registered person must ensure that all parts of the home are kept in a good state of repair and must be kept reasonably decorated and furnished. (timescale 31/3/05 not met) The registered person must ensure that service users have access to all appropriate health care, including dental care. The registered person must ensure that the leaking radiator in the downstairs shower room is repaired. The registered person must ensure that the homes garden is well maintained. The registered person must ensure that staff working in the home receive appropriate training on working with people with dementia. The registered person must ensure that all staff receive regular formal supervision, at least six times a year. Timescale for action 5/9/05 2. YA19 13 5/9/05 3. YA27 23 5/9/05 4. 5. YA28 YA35 23 18 5/9/05 5/9/05 6. YA36 18 5/9/05 Drayton Road Version 1.10 Page 25 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 YA8 Good Practice Recommendations It is recommended that service users who live at the home are given the opportunity to be involved in the recruitment of all staff to the home. Drayton Road Version 1.10 Page 26 Commission for Social Care Inspection 4th Floor, Gredley House 1-11 Broadway, Stratford London E15 4BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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