Inspection on 19/01/06 for Evering Road (41)

This inspection was carried out on 19th January 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 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Evering Road (41) 04/12/08

Evering Road (41) 19/08/08

Evering Road (41) 03/09/07

Evering Road (41) 06/09/06

Evering Road (41) 18/07/05

Evering Road (41) 29/03/05

Evering Road (41) 19/10/04

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 Evering Road (41) 41 Evering Road Stoke Newington London N16 7PU Lead Inspector Sandra Jacobs-Walls Unannounced Inspection 19th January 2006 10:00 Evering Road (41) DS0000010268.V280121.R01.S.doc Version 5.1 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 Evering Road (41) DS0000010268.V280121.R01.S.doc Version 5.1 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. Evering Road (41) DS0000010268.V280121.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Evering Road (41) Address 41 Evering Road Stoke Newington London N16 7PU 020 7241 2145 020 7241 2145 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Hackney Independent Living Team Ms Sheilagh Hindmarsh Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Evering Road (41) DS0000010268.V280121.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th July 2005 Brief Description of the Service: Hackney Independent Living Team (HILT) Evering Road project is a residential home offering services to a maximum of 6 residents who have learning disabilities. HILT, a private sector organisation, manages the home. The home is situated in a residential area of Stoke Newington in the London Borough of Hackney. It is within easy access to local shopping and transport facilities. The ground floor is wheelchair accessible. At the time of the inspection four service users were accommodated. One service user lives on the first floor in a self contained flat, the remaining service users are accommodated on the ground and first floor. There is a garden to the rear. The building is homely in appearance and can cater for service users who have significant physical disabilities. Evering Road (41) DS0000010268.V280121.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on the morning of January 19th 2006 for 4.5 hours. At the time of the inspection the home’s registered manager was away on maternity leave; the management of the home had been temporarily assigned to the manager of another HILT registered home. This manager was present throughout the inspection. The inspection process included discussion with one of the service users, interviews with staff on shift at the time, discussion with the manager, a tour of the home’s premises and review of two service user files and the review of three staff files. The inspector would like to thank all service users and staff who co-operated and contributed to the inspection. As a result of the inspection findings nine requirements and no recommendations were made. What the service does well: What has improved since the last inspection? Since the last inspection (conducted in July 2005) a number of staff changes had occurred. Previously it had been noted that the staff group for a number of differing reasons was not as cohesive and working together effectively as it had been in the past. The inspector was pleased to note that with the change in the staff group the dynamics of the team appeared far more positive, which was clearly to the benefit of service users. The inspector also noted that information held on file was current, relevant and comprehensive. The previous inspection had highlighted the need for improvement in case recording on service users files. Evering Road (41) DS0000010268.V280121.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Evering Road (41) DS0000010268.V280121.R01.S.doc Version 5.1 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 Evering Road (41) DS0000010268.V280121.R01.S.doc Version 5.1 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): All four service users had lived at the home for a number of years therefore no standards under this heading was assessed. EVIDENCE: Evering Road (41) DS0000010268.V280121.R01.S.doc Version 5.1 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): 6,7,8,9 & 10 Service users assessed and changing needs are reflected in their individual plans and they are encouraged to make decisions about their lives. Service users are consulted on and participate in all aspects of life in the home and are supported to take risks as part of an independent lifestyle. Their information is maintained confidentially. EVIDENCE: The inspector reviewed the individual files for two service users. Both files evidenced current placement reviews and subsequent care plans. These were very individualised. Service users are encouraged to make decision about their lives, for example one service user who spoke with the inspector indicated that staff generally accepted his refusal to accept assistance from them. Service users are encouraged to make decisions about a range of issues including choice of clothes, menu plans, activities etc; this was evident in case recording reviewed. Files also contained current risk assessments that addressed issues such as personal security, being out in the community, use of a vehicle and holidaying for example. The manager produced a newly developed confidentiality policy, which had not been in place at the time of the last inspection. Evering Road (41) DS0000010268.V280121.R01.S.doc Version 5.1 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): 11,12,13,14,15,16 & 17 Service users have opportunities for personal development and are able to participate in appropriate activities. Service users readily access the local community and engage in appropriate leisure activities. They are encouraged to maintain and develop appropriate relationships and their rights are well respected. Service users are offered a healthy diet and enjoy meals provided by the home. EVIDENCE: The development of person centred planning at the home has increased opportunities for the personal development of service users. For example staff appear to have an increased awareness of the abilities of service users and in one instance, staff are assisting the service user to identify a college course. The home offers a fair range of activities for service users consideration, although the inspector felt that creative options needed to be further facilitated. The manager commented that staff were currently working with OT services to identify more challenging activities for service users. Currently service users often access the local community for shopping and other recreational activities; service users have the opportunity to participate in bowling and swimming activities and the inspector was informed that all service users took a holiday last summer. Evering Road (41) DS0000010268.V280121.R01.S.doc Version 5.1 Page 11 Most of the service users have good relationships with their families and the manager commented that plans are being made for friendships to develop between service users living at the home and those living in other HILT projects. A fair degree of consideration has been given to meals offered at the home. The manager commented that due to recent changes, a wide range of meals is now offered to service users. This includes African meals for one service user who is Nigerian in origin. The manager told the inspector that staff had requested recipes of traditional African dishes from relatives that staff could prepare at the home. The inspector reviewed menu plans for the current and past weeks; service users largely determine menus for the forthcoming week via the weekly residents meeting. Evering Road (41) DS0000010268.V280121.R01.S.doc Version 5.1 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): 18,19,20 & 21 Service users receive personal support in accordance to preferences and their physical and emotional health needs are well met. The home’s management of service user medication is sound as are policies that address the ageing, illness and death of service users. EVIDENCE: Service user files reviewed evidenced that staff were well informed of the manner in which service users preferred personal care tasks performed. One file seen had very clear written guidance to staff outlining the importance of using aromatherapy oils while bathing the service user to enhance sensory impact since the service user had both hearing and sight impairments. Files also contained good documentation of staff monitoring and efforts to address the physical and mental health needs of service users. Files contained a dedicated section that highlighted medical and mental health support needs. There was evidence of good liaison between staff and other health specialists such as GP’s, dental services and CPNs. The inspector reviewed in detail medication information for one service user. The inspector was satisfied that medication practices were sound and appropriately administered by staff. The medication information reviewed was very comprehensive; detailing what individual medication was used for, how it was to be taken, the identification of possible side effects and information Evering Road (41) DS0000010268.V280121.R01.S.doc Version 5.1 Page 13 about any special instruction. Staff had very useful information to support their management of service user medication. The manager also informed the inspector that staff understood the necessity to accept the consistent refusal of one service user to comply with his prescribed medication regime. In this instance, mental health professionals were involved in managing the situation. Evering Road (41) DS0000010268.V280121.R01.S.doc Version 5.1 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 & 23 Service users feel their views are listened to however minor amendment is needed to information available about the home’s complaints procedure. Service users are protected from abuse, neglect and self-harm however improvements are needed in evidencing outcomes of subsequent adult abuse investigations. EVIDENCE: The inspector reviewed the home’s complaints log that appropriately detailed complaints made against the home and how these were resolved. The previous inspection had highlighted the need for the home’s complaints information to include the contact details of the appropriate CSCI office. This amendment was yet to have been made, so the requirement is repeated. The previous inspection had also highlighted the need for staff to appropriately document all actual/suspected instances of adult abuse and the outcomes of any subsequent investigation. At the previous inspection the inspector had been concerned for the lack of documentation surrounded a complaint made by one member of staff with regard to care practices towards a particular service user. The inspector had considered the complaint to be one of a adult protection nature and in need of investigation. At this inspection the inspector asked to review documentation of any investigation and subsequent outcomes. However, no information was produced. This is unsatisfactory as all instances of an adult protection nature must be appropriately recorded and information made available for the purposes of inspections. Evering Road (41) DS0000010268.V280121.R01.S.doc Version 5.1 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): Service users do not all live in homely, comfortable, safe environments. Service users bedrooms promote independence and generally suit service user needs, although some minor work was noted for some rooms. Shared spaces complement service users’ individual rooms; repair to one shower room was required. The home was clean and hygienic and service users have access to specialist equipment in the home. EVIDENCE: The inspector participated in an accompanied tour of the home’s premises. Staff had expressed significant concern for the environment that the service user who occupied the semi-independent flat chose to live in. The inspector met with this service user who did not permit the inspector access to the flat in acknowledgement of “the state it was in”. He admitted that the environment was not clean and hygienic, but expressed some resistance to staff assisting him address issues of cleanliness. He did tentatively agree to accept staff assistance. The inspector acknowledged that staff were actively promoting the service users right to make decisions about his living space and felt that in this instance the offer of staff assistance was appropriate. The inspector saw three service user bedrooms, one of which was equipped with a mobile hoist for use with the service user. The inspector noted however Evering Road (41) DS0000010268.V280121.R01.S.doc Version 5.1 Page 16 that the annual service of the hoist was overdue. Bedrooms seen were generally very personalised, adequately furnished and decorated. The manager informed the inspector that one of the bedrooms was draughty and in need of draft proofing. Other areas of the home there was in need for general re-decoration and repair; this was particularly the case for the halls throughout the home. At the time of the inspection, one of the shower rooms was not in use and had a broken door lock. The shower room walls were also in need of cleaning. The manager commented that the building owners were aware of these issues and optimistic that repairs would be conducted shortly. Evering Road (41) DS0000010268.V280121.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35 & 36 Service users benefit from the clarity of staff roles and responsibilities and are supported by competent and qualified staff. The staff group has improved upon its effectiveness. The home’s recruitment practices need further improvement; staff training opportunities are adequate. The frequency of staff supervision remains cause for concern. EVIDENCE: The inspector noted on this inspection significant improvement in the working relationship between the staff team. Previous staff relationships and subsequently the work environment were strained. The positive work environment was contributed to a number of effective staff changes and the strong leadership of the new temporary manager. Staff who spoke with the inspector confirmed this view. The inspector reviewed the staff personnel information held on site for three members of staff and noted that for one member of staff, required information i.e. written references and CRB check was not evidenced. The manager commented that that it was likely that full staff information was maintained at HILT head office and that there had been a delay in transferring information to the home. The inspector was clear that if it was the home’s practice to keep required staff information on site, then full information must be evidenced. The previous inspection had highlighted the lack of formal staff supervision as being problematic and contributory to the then staff difficulties. The manager acknowledged that the frequency of staff supervision remained poor, but that Evering Road (41) DS0000010268.V280121.R01.S.doc Version 5.1 Page 18 other informal channels of support is available to staff. Team members who spoke with the inspector confirmed this to be the case. The requirement is therefore repeated. Evering Road (41) DS0000010268.V280121.R01.S.doc Version 5.1 Page 19 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): Service users benefit from a adequately well run home, currently with strong leadership and management of the service. Self-monitoring systems are in place and service users’ rights and best interests are safeguarded by the home’s policies and procedures; these however are not always supported by documentation. The health, safety and welfare of service users are generally promoted and service users benefit from accountable management of the service. EVIDENCE: The service is adequately well run; this, the inspector feels is due to improvement working relationships amongst the staff group and the strong leadership skills of the current manager. Staff must however ensure that essential documentation such as details of complaints or adult protection enquires are well evidenced. There was good information to suggest that the staff team were attempting to work with the service user who had a longstanding history of refusing services from staff, documentation evidenced good liaison with the care manager responsible for coordinating the service users placement options. Evering Road (41) DS0000010268.V280121.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 1 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 2 28 3 29 3 30 2 STAFFING Standard No Score 31 3 32 3 33 3 34 2 35 3 36 1 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 3 2 3 3 Evering Road (41) DS0000010268.V280121.R01.S.doc Version 5.1 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 YA22 Regulation 22 Requirement The registered person must ensure that the home’s complaints policy is further revised to include the contact details of the relevant CSCI office The registered person must ensure that the home’s adult protection procedures are complied with fully, in every instance. This includes evidence of complete documentation (Previous timescale of 01/09/05 not met) The registered person must ensure the identified service user bedroom in need of draft proofing is completed. The registered person must ensure that servicing of the home’s mobile hoist is conducted annually The registered person must repair/redecorate areas of the home – noticeable walls that have been damaged The registered person must ensure that the home’s ground floor shower is repaired The registered person must DS0000010268.V280121.R01.S.doc Timescale for action 28/02/06 2 YA23YA41 13(3) 28/02/06 3 YA24 23(2)(p) 30/04/06 4 YA24 23(2)(c) 28/02/06 5 YA24 26(2)(b) 30/04/06 5 6 YA27 YA27 23(2)(j) 23(2)(e) 28/02/06 28/02/06 Page 22 Evering Road (41) Version 5.1 7 8 YA30 YA34 23(2()d) 19 9 YA36 18(2) ensure that the lock to the ground floor shower room is repaired The registered person must ensure that the shower room walls are kept clean The registered manager must ensure that staff files evidence all information as specified in Schedule 2 of the Care Homes Regulations (Previous Timescale of 01/10/05 not met) The registered person must ensure that all staff receive regular supervision that is documented (Previous timescale of 01/10/05 not met) 28/02/06 28/02/06 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Evering Road (41) DS0000010268.V280121.R01.S.doc Version 5.1 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 Evering Road (41) DS0000010268.V280121.R01.S.doc Version 5.1 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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