Inspection on 21/02/06 for Endymion Road, 2

This inspection was carried out on 21st February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Endymion Road, 2 02/10/08

Endymion Road, 2 14/11/07

Endymion Road, 2 01/08/06

Endymion Road, 2 07/06/05

Endymion Road, 2 25/01/05

Endymion Road, 2 22/07/04

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 Endymion Road, 2 2 Endymion Road London N4 1EE Lead Inspector Caroline Mitchell Unannounced Inspection 11:00 21 February 2006 st Endymion Road, 2 DS0000060622.V265602.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 Endymion Road, 2 DS0000060622.V265602.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. Endymion Road, 2 DS0000060622.V265602.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Endymion Road, 2 Address 2 Endymion Road London N4 1EE 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) 020 8693 6088 020 8299 4818 bowoffice@care4free.net Choice Support Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Endymion Road, 2 DS0000060622.V265602.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th June 2005 Brief Description of the Service: 2 Endymion Road is a large converted terraced house situated in the Finsbury Park area of North London. The home is registered to provide personal care for up to six service users of either sex and over the age of 18 who have a learning disability. The stated aim of the home is to provide a supportive environment where service users can live their lives according to their individual wishes and needs with the assistance of staff. There are three floors and all service users have single rooms. There are six single bedrooms and one sleep in room for staff; none of the rooms are en -suite. There are three bathrooms, and four toilets, a kitchen and a lounge. The accommodation is not suitable for service users with physical mobility problems. Choice Support, a large organisation that provides residential services for people with learning disabilities nationally, operates the home. The housing management is provided by London and Quadrant. Endymion Road, 2 DS0000060622.V265602.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on an unannounced basis and took around three hours to complete. The inspector toured the building and reviewed a number of the records kept in the home. The inspector also had the opportunity to speak with three staff members and took the opportunity to spend some time sitting in the lounge with one service user. The service users have learning disabilities and various levels of autism. Due to the nature of their disability, and their communication difficulties it is difficult to gain service users’ opinions about life in the home. However, the service users that the inspector observed were relaxed and comfortable in the company of the staff. One service user used written communication to tell the inspector that they were happy in the home. What the service does well: What has improved since the last inspection? What they could do better: At this inspection an immediate requirement was issued about repairing a light fitting in one of the bathrooms, and this was completed within the given timescale. Choice support are introducing a new, person centred planning process in order to ensure that service users are as involved as possible in the care planning process. However, no real progress has been made with this over the last two inspections and it is an area that the registered person needs to address ad a matter of priority. The arrangements for storage and day-today access of written material in the home need to be reviewed. In addition the practice of propping open bedroom doors could leave service users at risk in the event of a fire. The manager needs to apply to go through the registration process with the Commission. Endymion Road, 2 DS0000060622.V265602.R01.S.doc Version 5.0 Page 6 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. Endymion Road, 2 DS0000060622.V265602.R01.S.doc Version 5.0 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 Endymion Road, 2 DS0000060622.V265602.R01.S.doc Version 5.0 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 the following standard(s): These standards were not inspected on this occasion. EVIDENCE: Endymion Road, 2 DS0000060622.V265602.R01.S.doc Version 5.0 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 the following standard(s): 6, & 9 A new Person Centered Planning format is being introduced. However, this is taking a long time to get off of the ground, and both the plans and the risk assessments are in need of review for most service users. This issue needs to be addressed as a matter of priority. EVIDENCE: The inspector saw the written records for four service users. Each had an individual plan in place. These were identified as needing review at the previous inspection and the inspector noted that very little progress has been made. Choice Support is introducing a new way of planning for service users’ needs, which is called person centred planning (PCP). The manager has undertaken the training as a facilitator in order to begin the process of involving the key workers in reviewing each service user’s plan in the new format. However, only one of the other staff in the team has undertaken the training and the staff spoken to concurred that they would feel more confident in to undertake the task if they had been given training. Meanwhile, the old care plans remain in place. The inspector did see one completed PCP for one service user and this was of a good standard. However, it was evident that the service user’s day service Endymion Road, 2 DS0000060622.V265602.R01.S.doc Version 5.0 Page 10 had taken the lead in co-ordinating this PCP, rather than staff in the home. In addition, there was no evidence of progress being monitored in terms of the goals and tasks that had been agreed as part of the plan. A requirement in respect of review of service users’ plans is restated as part of this report. At the previous inspection the registered persons were required to ensure that service users risk assessments were reviewed and updated. One staff member assured the inspector that the risk assessments had been reviewed since the previous inspection and showed the inspector evidence of this for one service user. However, the inspector could not find evidence that risk assessments had been reviewed for the other service users, and the previous requirement is restated as part of this inspection. Endymion Road, 2 DS0000060622.V265602.R01.S.doc Version 5.0 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 the following standard(s): 11, 13, 14, & 17 The home provides opportunities for personal development and takes service users’ cultural needs and preferences into account. Service users do take part in a good range of social and leisure activities, both in the home and in their local community. EVIDENCE: Two service users were at home at the time of the inspection and four were attending the specialist day service for people with learning disabilities, which they attend regularly. There is evidence in the day-to-day records that the service users are assisted and supported to develop on a personal level. Each service users’ written records include an ethnic minority cultural needs assessment. These are of a good standard and provide guidance for staff in respect of their cultural and religious needs and preferences. Specific plans and strategies are in place and staff work with service users to ensure they develop to their full potential. Records reflect that service users take part in various activities including going shopping, for walks in the park and attending a specialist day centre for people with learning disabilities and taking part in a variety of activities there. Endymion Road, 2 DS0000060622.V265602.R01.S.doc Version 5.0 Page 12 Service users are assisted to take part in the life of the local community. They have freedom passes for public transport and the home has it’s own transport. Supporting service users to access community activities and local facilities is given a high priority. The inspector observed that there was plenty of fresh food in the home, especially fruit. One service user was being encouraged to help themselves to fruit and staff were trying different choices of lunch with another service user, until they reached a preference. Endymion Road, 2 DS0000060622.V265602.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 20 Service users are assisted and supported to access appropriate health care. The arrangements that are in place in the home for the storage and administration of medication were acceptable and safeguard service users interests. Service users can be confident that their ageing, illness or death would be handled sensitively and appropriately in the home. EVIDENCE: Evidence was seen on service users plans that they are assisted and supported to access appropriate health care facilities and each one is registered with a General Practitioner. The service users are supported to attend the surgery, and outpatient hospital appointments when necessary. Some service users’ records included health care assesments, the format of which was devised by the learning disabilities partnership. This assessment is quite thorough and helps to ensure that service users’ health care needs are properly considered. However, not all service users have one completed, and a recommendation is made in respect of this. The inspector reviewed the arrangements that are in place in the home for the storage and administration of medication and these were acceptable. The home uses the Boots system, which provides medication in colour coded blister packs and Boots had provided staff with the appropriate training, in the use of the system. Endymion Road, 2 DS0000060622.V265602.R01.S.doc Version 5.0 Page 14 Endymion Road, 2 DS0000060622.V265602.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Service users and their representatives can feel their views are listened to and will be acted on, and that service users are protected from abuse, neglect and self-harm. There are written procedures for handling complaints a policy on adult protection and whistle blowing exists that is in line local adult protection procedures. EVIDENCE: The inspector saw a copy of the guidance for service users about how to make a complaint. It is written in accessible language and includes “widget” pictures to help service users to understand the process. No complaints had been recorded in the home since the previous inspection. Choice Support has developed an adult protection policy to comply with the Department of Health guidance “No Secrets” and this is available in the home along with a whistle blowing policy for staff. There have been no adult protection issues since the previous inspection. Endymion Road, 2 DS0000060622.V265602.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, & 28 The home provides an environment that service users can regard as their home and their bedrooms are personalised to reflect this. The standard of the repair and décor has been improved and is a more comfortable environment for service users to live in, although there are still some minor issues that need to be addressed and some service user’s bedrooms are sill in need of redecoration. EVIDENCE: Endymion Road, 2 DS0000060622.V265602.R01.S.doc Version 5.0 Page 17 There has been improvement in the decorative state of the home since the last inspection. At the previous inspection a number of requirements were restated in respect of the state of the environment and the inspector was pleased to note that the majority of these had been addressed. It is evident that effort has been put into ensuring that service users’ bedrooms are decorated and equipped to reflect the personalities and interests of each occupant. However, the decoration remains quite tired in some of the bedrooms, and there is a need to re-decorate. A requirement is restated in relation to this. The vanity units in most service users’ bedrooms had suffered water damage and these had been refurbished. There are sufficient bathrooms and some separate toilets in the home. At the previous inspection, it was noted that the toilets and bathrooms needed to be redecorated and the floor covering needed to be replaced. The pedestals of two wash hand basins were cracked. At this inspection the inspector was pleased to note that all of these repairs had been done. A light fitting on the ceiling in the bathroom on the first floor was not secured to the ceiling and was hanging down from it’s attachment. The connecting wires were exposed and were a health and safety hazard to both staff and service users. An immediate requirement was issued for the registered person to ensure that the light fitting is secured and made safe by a suitably qualified person and this was addressed within the given timescale. There is one lounge and a large sensory room and the inspector was pleased to note that both rooms have been improved decoratively, and new curtains have been provided along with some new furniture. The kitchen also had been redecorated and the carpet had been replaced on the stairs and landings. The inspector was also pleased to note that service users’ artwork is displayed in the home. During the tour of the home the inspector noted that there were a number of minor issues that need to be addressed. These included repair of the edging strip on the floor covering in the lounge, replacement of the sealant around the work surface in the kitchen and cleaning of the covers on the light fittings in the kitchen. Requirements are made in respect of these issues. Endymion Road, 2 DS0000060622.V265602.R01.S.doc Version 5.0 Page 18 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 The home is adequately staffed in terms of the hours provided. The needs of the service users in the home were seen to be met by the numbers, competence and skills of the staff employed, although staff have a need for training regarding the new service user planning process. EVIDENCE: There was evidence that staff have the skills, competencies and experience to meet the assessed needs of service users. Interactions between staff and service users were observed to be appropriate, professional and relaxed. It was apparent that the staff team are committed to working with individual service users to enable them to live as they wish and to fulfil their individual goals and aspirations. The inspector was provided with a copy of the staff rota for the period in which the inspection was undertaken and noted that this indicated that there was sufficient numbers of staff rota’d on duty to ensure that all shifts were covered. There have recently been a number of new staff recruited, in order to ensure that there are sufficient numbers of staff to support service users’ assessed needs at all times, and to ensure continuity of care on a day by day basis. Staff do have access to a good range of training through Choice Support. However, as mentioned under standard 6 of this report, during discussion it became evident that there is a need to ensure that staff receive training Endymion Road, 2 DS0000060622.V265602.R01.S.doc Version 5.0 Page 19 regarding the new service user planning process (PCP) that is being introduced. A recommendation is made in respect of this training. Endymion Road, 2 DS0000060622.V265602.R01.S.doc Version 5.0 Page 20 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, 41 & 42 The manager must apply to be registered by the Commission. The record keeping in the home needs to be reviewed in order to safeguard the service users’ best interests. The home protects peoples’ physical safety through a reasonably proactive approach to health and safety, although the practice of propping open bedroom doors could leave service users at risk in the event of a fire and health and safety walk rounds need to be undertaken regularly. EVIDENCE: A manager has been appointed to run the home. He was on annual leave at the time of the inspection. However, he did make time to telephone the inspector to seek feedback from the inspection. An application for him to be registered with the Commission has not yet been received and a requirement is made in respect of this. The written records seen by the inspector in the office were on quite high shelves, and liable to fall on peoples’ heads when they tried to take then down. In addition the quantity of written records being kept in the kitchen have increased to a point where they were becoming obtrusive and this also raises Endymion Road, 2 DS0000060622.V265602.R01.S.doc Version 5.0 Page 21 issues regarding confidentiality. The inspector also noted that a number of these records were out of date and in need of rationalisation and review, as some provided conflicting or confusing information. A recommendation is made in respect of these issues. The staff meeting minutes were examined and reflected that these meetings are both regular and comprehensive. In general the policy, procedures and processes that are in place protect the health and safety of service users and staff. However, the health and safety walk round audit has not recently been conducted very regularly and a requirement is made in respect of this. A number of the doors in the home are fitted with magnetic closures that are linked to the fire alarm system and close automatically in the event of a fire. However, the service users’ bedroom doors are not linked to this system and are being propped open regularly, in order to help air the rooms. As stated in the home’s own fire risk assessment, fire doors must not be wedged open in this way. As at the previous inspection, it is recommended that the service users’ bedroom doors are fitted with magnetic closures of the same type that are currently in place in the rest of the house. Endymion Road, 2 DS0000060622.V265602.R01.S.doc Version 5.0 Page 22 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 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X 2 2 2 X X LIFESTYLES Standard No Score 11 3 12 X 13 3 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 3 2 3 X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Endymion Road, 2 Score X 2 3 X Standard No 37 38 39 40 41 42 43 Score 2 X X X 2 X X DS0000060622.V265602.R01.S.doc Version 5.0 Page 23 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 YA6 Regulation 15 Requirement The manager must ensure that all service users plans are completed in the new PCP format. The previous timescale of 31/08/05 was not met. 2. YA9 13 (4) The registered provider must ensure that the service users risk assessments are reviewed and updated. The previous timescale of 31/08/05 was not met. 3 YA27 23 [2] [c] The registered provider must ensure that the light fitting in the bathroom on the first floor is repaired or replaced. The previous timescale of 12/09/04 not met. Issued as an Immediate Requirement. 4 YA27 23 (2) (d) The registered provider must ensure that the covers on the light fittings in the kitchen are cleaned. DS0000060622.V265602.R01.S.doc Timescale for action 30/06/06 30/04/06 27/02/06 30/03/06 Endymion Road, 2 Version 5.0 Page 24 5 YA27 23 [2] [b] The registered provider must ensure that the sealant around the work surface in the kitchen is replaced. 30/03/06 6 YA28 23 [2] [b] The registered provider must ensure that the edging strip on the floor covering in the lounge is replaced and repaired as necessary. 30/04/06 7 YA26 23 (2) (d) The registered provider must ensure that the service users bedrooms are re-decorated as necessary. The previous timescale of 30/05/05 not met. 30/06/06 8 YA42 13 (4) The registered person must ensure that the health and safety walk round audit is conducted on a regular basis. 30/03/06 9 YA42 23 (4) The registered person must ensure that fire doors are not wedged open. 30/03/06 10 YA37 8 The registered persons must ensure that the manager applies to be registered by the Commission. 30/06/06 Endymion Road, 2 DS0000060622.V265602.R01.S.doc Version 5.0 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 YA19 Good Practice Recommendations It is recommended that the learning disabilities partnership health care assessment be completed for each service user. 2 YA32 It is recommended that key workers are provided with training regarding the new service user planning process (PCP) in order to 3 YA42 It is recommended that the service users bedroom doors are fitted with magnetic closures of the same type that are currently in place in the rest of the house. 4 YA41 It is recommended that the registered person review and rationalise the storage of written records in the office and the kitchen, to ensure that ordinary life principals are adhered to, whilst staff have appropriate access. 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