Inspection on 04/07/06 for Essex Park 49

This inspection was carried out on 4th July 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 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Essex Park 49 30/09/09

Essex Park 49 21/10/08

Essex Park 49 26/10/07

Essex Park 49 02/11/05

Essex Park 49 17/05/05

Essex Park 49 02/11/04

Essex Park 49 03/06/04

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Edenvale

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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 Essex Park 49 Finchley London N3 1ND Lead Inspector Mr Teferi Degeneh Key Unannounced Inspection 4th July 2006 09:00 Essex Park 49 DS0000010437.V298120.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Essex Park 49 DS0000010437.V298120.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Essex Park 49 DS0000010437.V298120.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Essex Park 49 Address Finchley London N3 1ND 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 8346 3860 020 8346 3860 Walsingham Community Homes Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Essex Park 49 DS0000010437.V298120.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd November 2005 Brief Description of the Service: Essex Park is a home for six adults with learning disabilities. The home is owned and managed by Walsingham Community Homes; an organisation, which provides special needs housing in other parts of the U.K. The home is a detached, two storey building, located in a pleasant residential area of Finchley in North London. It is close to shops and many other amenities. Service users bedrooms are located on the ground and first floor. The communal lounge, dining rooms and kitchen are located on the ground floor. There is a large attractive garden at the rear of the property which is accessible to service users. A car is provided for the purpose of taking service users out on various shopping trips and excursions. Information about the home including service users’ guide and the CSCI inspection reports are available from the home by contacting the provider. The weekly fees of the home depend on the assessed needs of service users but currently range from £1104.35 to £1161.83. Essex Park 49 DS0000010437.V298120.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection is based on information obtained from the observation of the people who use the service and discussions with them about their experiences of living at the home. The files relating to care plans and risk assessments of the service users were inspected as part of the inspection. Other documents examined included the menus, the rotas, and records relating to service users’ finances, visitors’ book and the home’s diary. A group discussion was held with three care staff. The acting manager, Ms Sally Smith, was present during most part of the inspection. What the service does well: What has improved since the last inspection? What they could do better: The methods of recording and handling service users’ finances must be improved. The current practices are below service users’ expectations. The registered person must ensure that medication is appropriately administered and recorded. All the staff need to undergo adult protection training. There is a need to redecorate the home and to ensure that the carpets are cleaned or replaced. The registered person must reassess the window restrictors and ensure that they are appropriately fitted. Currently there is no registered manager, and this needs to be addressed. The registered person must confirm in writing that all the staff at the home are appropriately recruited and that the necessary information about them has been obtained before they started work. Finally, the registered person must implement a quality assurance system by, among other things, gathering feedback from service users and visitors to the home. Essex Park 49 DS0000010437.V298120.R01.S.doc Version 5.2 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. Essex Park 49 DS0000010437.V298120.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Essex Park 49 DS0000010437.V298120.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New service users are confident that their admission to the home is dependent on the outcome of their needs assessment and the ability of the home to meet their needs. EVIDENCE: Four service users’ files, which were assessed, showed that service users have been assessed before admission. Currently there is one vacancy at the home. The manager said three referrals have been made to the home but none was successful. She said that the home’s assessment of these new referrals indicated that their needs could not be met by the available services and facilities. She explained that the home admits new service users on the basis of their needs assessments. There is an admission’s procedure which explains that the needs of new service users are assessed and their care plans are developed before they are admitted. Essex Park 49 DS0000010437.V298120.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live at the home have benefited from the home’s processes of care plans and risk assessments. EVIDENCE: All the four assessed service users’ files contained evidence of care plans. The care plans are detailed and reflect the assessed needs of service users. The care plans cover issues such as communication, mobility, health and behavioural problems. The plans highlight what service users have difficulties with and what actions can be taken to overcome these difficulties. The responsible person said she updates the care plans. Each person has a risk assessment in their files. Discussions with the staff and the people who use the service showed that the service users take part in various activities in the home. It was mentioned that service users help with setting the tables and washing up before and after meals. All the people who live at the home have access to communal areas. Essex Park 49 DS0000010437.V298120.R01.S.doc Version 5.2 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): 12, 13, 15, 16, and 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are adequately engaged and the meals provided meet service users’ needs. However, the process of managing service users’ finances can be improved with the implementation of proper recording and accounting of all transactions. EVIDENCE: All people who live at the home have day activities either at a day centre or at a college. From discussions with the responsible person and the staff it was clear that service users are supported to attend cultural shows and places of worship. Service users are consulted about the food. They said that the food provided at the home is good. From records and discussions it was evident that service users go to shops, cafés and bowling. Some service users were observed making hot drinks. The home manages service users’ finances. The cash tins and the records of finances were checked. Two matters of concerns were revealed: money taken out by staff for shopping for some service users was not appropriately recorded and it was difficult to make a proper accounting. For example, the balance of financial records for a service user did not match the actual cash in the tin. It was also noted that staff use tip-ex to Essex Park 49 DS0000010437.V298120.R01.S.doc Version 5.2 Page 11 make corrections of financial records. Discussions with the responsible person and service users indicated that the home consults service users about the meals. Service users said the meals provided were good. On the day of the inspection one person had their meal at a café meal while the others had their meals in the garden at the back of the home. The lunch provided at the home reflected the menu for the day. All food in the fridge is labelled. The staff who prepare meals have undergone training in basic food hygiene. Care plans and discussions with the staff showed that the home caters for people with special dietary needs. Essex Park 49 DS0000010437.V298120.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, and 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Despite good practices in meeting service users’ needs in respect of their personal care and health needs, risks to service users’ have not been eliminated. This is evidenced by the medication administration process whereby staff wrongly signed for medicines they have not administered. EVIDENCE: Service users who were spoken to said they are happy with the way the staff support them. Three care staff provided satisfactory descriptions of how they ensure privacy, dignity, rights and choice of service users while supporting them with their personal care. The files of the people who live at the home contain information about health care needs. Discussions with the responsible person and the inspection of the documents showed that service users are registered with their own general practitioners and that they have been supported to access appropriate health care. It was evident from discussions with the responsible person and the home’s records that referrals have been made to a specialist health professional in order to address the health needs of a service user. Written evidence was available to confirm that the people who live at the home have seen a dentist and an optician. The home has supported people to access a community nurse input and a diabetic clinic service. A consultant psychiatrist regularly sees service users and reviews medication. Essex Park 49 DS0000010437.V298120.R01.S.doc Version 5.2 Page 13 Medicines are kept in a locked cabinet in the office. The responsible person confirmed that two staff, one of which is a witness, administer medicines. An examination of the medication administration record sheets (MARS) and the medicines showed that on one occasion (14/07/06) staff wrongly signed for the tablets they did not administer. Essex Park 49 DS0000010437.V298120.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, and 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The people who use the services are reassured by the home’s complaints procedure. Despite the last requirement about the need for the staff to undergo adult protection training, the registered person has yet to arrange this training for the staff. EVIDENCE: The responsible person confirmed that there have been no complaints. The home has a procedure on complaints and there is a whistle blowing policy. At the last inspection the registered person was required to ensure that all staff receive training on adult protection. This is yet to be complied with. From discussions with the staff and the responsible person it was evident that the staff are aware of the home’s policy on the protection of vulnerable adults from abuse. The home has obtained a copy of the placing authority’s adult protection policy and procedures. Essex Park 49 DS0000010437.V298120.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, and 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The decorations and fittings of the home can be improved to make the home a comfortable and safe place to live. Loose window restrictors put service users health and safety at risk. EVIDENCE: At the last inspection the registered person was required to ensure that the extractor fan in the ground floor shower room is cleaned regularly to prevent a build up of dust. During the guided tour of the premises it was observed that these have been complied with. However, the requirement regarding the decoration of parts of the home is yet to be complied with. Indeed, the decorations of some walls in communal areas and bedrooms have stains and are not attractive to look at. The carpets by the entrance hall and the stairs are also in need of repair or replacement. The acting manager said there is a plan to redecorate the walls and to clean or replace the carpets. The inspection of the rooms showed that a number of window restrictors are loose. The home was clean and tidy on the day of the inspection. There were no offensive odours. Essex Park 49 DS0000010437.V298120.R01.S.doc Version 5.2 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): 32, 34, and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have benefited from trained and experienced staff provided by the home. EVIDENCE: The responsible person confirmed that three care staff have embarked on a care training to achieve NVQ level 2 qualification. She said that a care member of staff has already achieved a care qualification equivalent to NVQ level 2. Three care staff spoken to gave satisfactory descriptions of how they ensure the welfare and safety of service users in a care home. They confirmed that they have read the home’s policies and procedures. The home has developed a training programme and it was evident from discussions with the registered person and the documents that the staff have attended training programmes such as basic food hygiene, health and safety, first aid, fire safety, diversity and medication. However, as mentioned earlier the staff are yet to attend training on adult protection. The manager confirmed that the staff are recruited centrally. She said that the recruitment and staff selection processes include advertisements, short listing, interviewing and offering jobs to successful candidates. She said the interviews take place either at the head office or at the home. The responsible person said CRB’s and references of all staff are kept at the head office. Essex Park 49 DS0000010437.V298120.R01.S.doc Version 5.2 Page 17 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, 39, and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Even though encouraging efforts are being made to ensure that the services and facilities provided meet the needs of service users, the benefits to the service users can be further enhanced by reviewing the style of leadership and by actively seeking the views of service users regarding the quality of the services and by taking an action to improve the services. EVIDENCE: The acting manager has been a manager at a different home owned by the company that runs this home. She said she has moved to manage this home following the resignation of a previous registered manager. The acting manager has NVQ level 4 (Manager) qualification and is currently undertaking training to complete the registered manager’s award. She has also NVQ assessors’ qualification. The acting manager said she is currently in the process of making an application to the CSCI to become a registered manager. The acting manager explained that the home is currently recruiting an assistant Essex Park 49 DS0000010437.V298120.R01.S.doc Version 5.2 Page 18 manager. She said that she often finds the job difficult due to lack of sufficient support from the staff. She said: “I do all things by myself”. Two incidents/accidents have been recorded and dealt with since the last inspection. The home has taken precautionary measures in respect of health and safety of service users. The temperatures of the water and the area where the medicines are kept are measured and recorded regularly. Records are available to show that the gas boiler and all portable electrical appliances are tested and safe to use. The home has yet to develop a tool for gathering feedback from service users and visitors regarding the quality of the services and facilities provided. The responsible person said an independent agency comes to the home to undertake health and safety audit. It was also mentioned that senior staff from the head office visit the home to undertake audit of the services. Reports of these visits are compiled and copies are sent to the CSCI local office as part of Regulation 26 of Care Homes Regulations 2001. Essex Park 49 DS0000010437.V298120.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 2 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 2 X X 3 X Essex Park 49 DS0000010437.V298120.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? YES 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 YA12 Regulation 17(1)(2); 20(1) (2)(3) Requirement The registered person must ensure that there are proper and reliable recording and accounting procedures for service users’ finances. Tip-ex must not be used to correct financial recording errors. The registered person must put in place appropriate medication administration procedures. The registered person must investigate the medication administration incident of 14/07/06 and take appropriate actions. A copy of the report into the investigation of this incident must be forwarded to the CSCI Inspector. The registered person must ensure that all staff receive adult protection training and are familiar with The London Borough Of Barnet Adult Protection manual. (Time scale of 30/01/06 not met) The registered person must ensure that all parts of the home are appropriately decorated and that the DS0000010437.V298120.R01.S.doc Timescale for action 15/08/06 2 YA20 13(2); 17 31/08/06 3. YA23 18(1)(c) (i) 30/09/06 4 YA24 23(1)(2) 30/09/06 Essex Park 49 Version 5.2 Page 21 5 YA24 6 YA34 7 YA37 8 YA39 carpets in the halls and the stairs are cleaned or replaced. 23(1)(2) The registered person must ensure that the window restrictors are adjusted and appropriately fitted to meet the needs of the service users. Where there are no restrictors, the registered person must reassess all windows and ensure that they are fitted with restrictors. 19(1)(2)(3) The registered person must (4)(5)(6) confirm in writing to the CSCI inspector that satisfactory information and documents (as listed under Sch. 2 of Care Homes Regulations 2001) in respect of all persons working at the home have been received as part of the recruitment process. 9(1)(2) The registered person must ensure that the home is run by a registered manager. An application for registration must be submitted to the CSCI by the acting manager. 24(1)(a)(b)(3) The registered person must put in place effective quality assurance and quality monitoring systems, which seek the views of service users, visitors and professionals. The outcome of the surveys must be published and made available to all parties including the CSCI. 31/08/06 31/08/06 30/09/06 30/09/06 Essex Park 49 DS0000010437.V298120.R01.S.doc Version 5.2 Page 22 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 YA37 Good Practice Recommendations The registered person should employ an assistant manger. Work should be appropriately delegated to ease the pressure on the management. Essex Park 49 DS0000010437.V298120.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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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