Inspection on 06/10/05 for Drayton Road

This inspection was carried out on 6th October 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 24/05/05

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 Unannounced Inspection 6th October 2005 10:00 Drayton Road DS0000007262.V257150.R01.S.doc Version 5.0 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 Drayton Road DS0000007262.V257150.R01.S.doc Version 5.0 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. Drayton Road DS0000007262.V257150.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Drayton Road Address 2 Drayton Road Leytonstone London E11 4AR 020 8556 2550 020 8556 2550 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) Outward Mr Thomas Boyle Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Drayton Road DS0000007262.V257150.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th May 2005 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 DS0000007262.V257150.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 6/10/05 and was unannounced. The inspector had the opportunity of speaking with service users and staff at the home. Overall, the inspector believes that this is a well run home, service users informed the inspector that they are happy with the care and support provided. There are some areas that must be addressed, as highlighted within the report. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Drayton Road DS0000007262.V257150.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Drayton Road DS0000007262.V257150.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None The standards in this section were not tested as part of this inspection, but will be tested as part of the next inspection. EVIDENCE: The standards in this section were not tested as part of this inspection, but will be tested as part of the next inspection. Drayton Road DS0000007262.V257150.R01.S.doc Version 5.0 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 and 10 It is the view of the inspector that service users are able to have a large measure of control over their daily lives. Care plans and risk assessments were of a good standard, and tailored to the individual. Mechanisms are in place to ensure that service users views are taken into account in the day-to-day running of the home. EVIDENCE: All service users have individual care plans in place. Plans are drawn up with the involvement of service users, their family, keyworker and the homes manager. Plans were of a good standard, clear and comprehensive, and included information on personal care needs, mobility, cultural needs, community involvement and development needs. The plans have been produced in plain English, and also in an audio version to help make them more accessible to service users. Daily logs are maintained for service users, and these are linked to their care plans. Each service user also has a detailed risk assessment in place. Risks are clearly set out, and assessments include information and strategies on how the risks can be managed and reduced. Assessments include risks associated with falling, epilepsy and accessing the community. The home has a missing persons procedure, and individual missing persons profiles for each service user. Drayton Road DS0000007262.V257150.R01.S.doc Version 5.0 Page 9 Through observation and discussion there was evidence that service users have control over their daily lives. Service users are able to get up and go to bed as they choose and are able to chose when and what they eat, for example service users were observed to be given a choice as to what they had for breakfasts, for instance some service users wanted cereal, some toast and jam and other a cooked breakfast, all of which were available. Where restrictions on choice do apply, these are clearly recorded. For example, the home keeps cigarettes on behalf of one service user, who is given one cigarette every hour. The reasons for this are clearly recorded, and the service user confirmed to the inspector that he had been involved in this decision, and was satisfied with the arrangement. Staff informed the inspector that service users are involved in the day to day running of the home, for example the home has recently had new floor coverings fitted in communal areas, and service users were involved in choosing these. The home holds regular service user meetings, these are minuted, and include discussions on menus, holidays and activities. The home has a confidentiality policy in place, which makes clear under what circumstances a confidence may be broken in the health, safety and welfare 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 DS0000007262.V257150.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None The standards in this section were not tested as part of this inspection, but will be tested as part of the next inspection. EVIDENCE: The standards in this section were not tested as part of this inspection, but will be tested as part of the next inspection. Drayton Road DS0000007262.V257150.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 It is the judgement of the inspector that the home is able to meet the personal and healthcare needs of service users. Service users have access to health care professionals as appropriate, and are able to manage their own personal care as much as possible. However, the home must ensure that there is appropriate recording of medications. 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. There was evidence that service users have access to appropriate health professionals, for example on the day of the inspection one service user had an appointment with a dietician and another had an appointment with a physiotherapist. Records are maintained of medical appointments, and these evidenced that since the last inspection service users now have access to regular dental care. The home makes use of Drayton Road DS0000007262.V257150.R01.S.doc Version 5.0 Page 12 the Continence Advisory Service who supply advice and continence products. Used continence products are disposed of appropriately. The home has a comprehensive medication policy in place, and all staff receive training before they are able to administer medications. Medications are stored in a locked cabinet within the office. No service users currently self medicate or are on any controlled drugs. Medication Administration Record charts are maintained, those examined by the inspector appeared to be up to date and accurate. Records are kept of medications that enter the home, but there was no evidence that the home keeps records of any medications that are returned to the pharmacist. Further, there was no evidence of any guidelines in place on the administration of medications prescribed on a PRN basis. Both of these issues must be addressed. Drayton Road DS0000007262.V257150.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 It is the view of the inspector that the home has adequate polices and procedures in place around complaints and adult protection. However, to further ensure that service users are protected from abuse, it is required that all staff receive training in adult protection issues. EVIDENCE: The home maintains a complaints log, although staff informed the inspector that no complaints have been received in the past twelve months. There was also a complaints procedure. This was prominently displayed within the home, and included timescales for responding to complaints, and made appropriate reference to the CSCI. The complaints procedure has also been produced in video format to help make it more accessible to service users. Service users spoken to demonstrated a good understanding of whom they could complain to if they so wished. The home has a copy of the Local Authorities adult protection procedures, and also its own adult protection policy. This appeared to be in line with current legislation. The inspector discussed adult protection issues with a member of the staff team, who demonstrated only a limited understanding of their roles and responsibilities with regard to adult protection. This staff member confirmed to the inspector that they had not received any training in adult protection since they started working at the home, and it is required that all staff employed at the home receive appropriate training in adult protection issues. Drayton Road DS0000007262.V257150.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29 and 30 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 and private space to meet service users needs. 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. 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. In particular, the kitchen is in a poor state of repair, staff informed the inspector that the home is scheduled to have a new kitchen fitted in the near future. It is a repeat requirement that all areas of the home are maintained in a good state of repair and reasonably decorated. The outside window on the first floor landing was very dirty, to the point that it restricted the flow of natural light into the home, and this must be cleaned. 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 DS0000007262.V257150.R01.S.doc Version 5.0 Page 15 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 fitted to them. The radiator in the downstairs shower room has been repaired since the last inspection. The home’s garden was well maintained, and much improved since the previous inspection. The home has various means in place to help prevent the spread of infection, including an infection control policy. Staff are provided with protective clothing, such as aprons and gloves. The laundry facilities are adequate to meet service users needs, and hand washing facilities are situated throughout the home. Drayton Road DS0000007262.V257150.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35 and 36 It is the belief of the inspector that the staff are sufficiently competent and experienced to carry out their duties, and that they have a good understanding of service users needs. However, current staffing levels mean that the home is not always able to meet the assessed needs of service users, and this must be addressed. EVIDENCE: The home provides 24-hour staffing, including an emergency on-call procedure. The home had a staffing rota on display, this accurately reflected the actual staffing situation on the day of inspection. However, the inspector has serious concerns about the staffing levels at the home. On the day of inspection, there were only two staff on duty between the hours of 8am and 2pm, to support all eight service users. The rota indicated that it was routine for the home to operate with just two members of staff on duty. The two staff had responsibility for providing all necessary personal care, cooking, cleaning, laundry, dealing with phone calls, completing any necessary paperwork, administering medications and dealing with any visitors to the home. (On the day of inspection there was a planned visit by two builders and one by the dietician along with the unannounced inspection visit), and supporting service users to access the community. One service user was supported by staff to attend a physiotherapist appointment, this left just one staff member in the home to provide support to the seven remaining service users. This meant that staff had very little time to spend interacting with service users, and that Drayton Road DS0000007262.V257150.R01.S.doc Version 5.0 Page 17 service users opportunities for accessing the community were severely limited. Staff at the home informed the inspector that they believed current staffing levels were not adequate to meet the needs of service users. Further, the inspector believes that such low staffing levels potentially puts service users at risk. For instance, when the inspector first arrived at the home, they were let in by a service user who did not ask why the inspector was there, not did they ask for any identification. The inspector was left alone with service users for approximately two minutes before any staff arrived, staff informed the inspector that they were both too busy with personal care to be able to come to the door. The home must review its staffing levels to determine how it can meet the assessed needs of service users at all times. The home has policies in place on recruitment and selection and equal opportunities. Staff informed the inspector that service users at the home are currently undertaking training in staff recruitment, and it is planned that once they have completed this course they will be involved in the recruitment of staff to the home, and this is recommended. Staff employment files are stored securely, only the homes manager has access to them. As the manager was not present during the inspection, these were not checked on this occasion, but will be checked as part of the next inspection. On commencing work at the home all staff are provided with a copy of their job description and a copy of the General Social Care Council codes of conduct. Through observation and discussion staff demonstrated a good understanding of their roles and responsibilities, including a good ability to communicate with service users, some of whom have complex communication needs. All staff receive a structured induction programme. This includes service user issues and policies and procedures. Staff training is on-going, and records are maintained of training. These indicated that staff have recently received training in medication, manual handling, and since the last inspection staff have been trained in issues around dementia. However, not all staff have received training in fire safety or food hygiene, even though these staff are responsible for food preparation. It is required that all staff receive all necessary statutory health and safety training, including fire safety and food hygiene. Staff informed the inspector that of the six care staff currently employed at the home, three either have or are presently working towards a relevant NVQ qualification. Further, the inspector was informed that it was the homes intention that all staff will be given the opportunity of completing a relevant qualification in time. All staff receive regular formal supervision from the homes manager or deputy manager. Records are kept, and staff receive a copy of the minutes. Supervision includes service user issues, training and performance. Drayton Road DS0000007262.V257150.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,41,42 and 43 The inspector was satisfied that Drayton Road is a well run home. Record keeping is of a generally good standard, and appropriate controls are in place to help ensure the health and safety of service users and others. 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. Staff and service users spoken to said that they found the manager to be approachable. Care plan reviews, service user meetings, staff meeting and staff supervisions all contribute to the quality assurance within the home. Copies of previous inspection reports were available, and there was evidence of monthly unannounced Regulation 26 visits taking place. Questionnaires are issued to service users to gain their feedback on the home, those seen by the inspector Drayton Road DS0000007262.V257150.R01.S.doc Version 5.0 Page 19 were generally positive. 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 at random, including medication and equal opportunities, and all appeared to be satisfactory. The home has various health and safety policies in place, including infection control and fire safety. Fire fighting equipment was situated throughout the home, and was last serviced in March 2005. Fire exits were free from obstruction on the day of inspection. Regular fire drills are held, and the home tests fire alarms weekly. These were last serviced by an engineer on the 4/8/05. The home had in date certificates for PAT testing and electrical installation and gas safety. COSHH products were stored securely, and the home tests and records fridge/freezer and hot water temperatures. The home has appropriate employers liability insurance cover. Drayton Road DS0000007262.V257150.R01.S.doc Version 5.0 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 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score 3 3 2 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Drayton Road Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 DS0000007262.V257150.R01.S.doc Version 5.0 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 YA24 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 5/9/05 not met) The registered person must ensure that the home maintains a record of all medications returned to the pharmacist. The registered person must ensure that the home has clear guidelines in place on the administration of all medications prescribed on a PRN basis. The registered person must ensure that all staff working at the home receive appropriate training in adult protection issues. The registered person must ensure that all the home’s windows are kept clean. The registered person must ensure that the home carries out a review of staffing levels to determine how it can meet the assessed needs of service users at all times. The registered person must DS0000007262.V257150.R01.S.doc Timescale for action 31/01/06 2 YA20 13 31/01/06 3 YA20 13 31/01/06 4 YA23 13 31/01/06 5 6 YA24 YA33 23 18 31/01/06 31/01/06 7 YA35 13 and 18 31/01/06 Page 22 Drayton Road Version 5.0 ensure that all staff receive appropriate statutory health and safety training, including fire safety and food hygiene. 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 DS0000007262.V257150.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection East London Area Office 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. Extracts may not be used or reproduced without the express permission of CSCI Drayton Road DS0000007262.V257150.R01.S.doc Version 5.0 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. 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