Inspection on 06/09/06 for Evering Road (41)

This inspection was carried out on 6th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Evering Road (41) 04/12/08

Evering Road (41) 19/08/08

Evering Road (41) 03/09/07

Evering Road (41) 19/01/06

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 6th September 2006 12:00 Evering Road (41) DS0000010268.V310382.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 Evering Road (41) DS0000010268.V310382.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. Evering Road (41) DS0000010268.V310382.R01.S.doc Version 5.2 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.V310382.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th January 2006 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; here is a garden to the rear, The home can cater for service users who have significant physical disabilities. Evering Road (41) DS0000010268.V310382.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection of Evering Road took placed on September 6th 2006 for the duration of five hours. The purpose of the inspection was to assess the service against key National Minimum Standards and gauge the home’s success in addressing outstanding requirements made at the previous inspection. Assisting the inspector with the inspection was the acting senior support worker as the home’s registered manager was away on maternity leave and the (interim) manager was absent for the day. The inspection process included the review of two service user files, the interview of three staff members on shift at the time, a tour of the home’s premises and review of key policies and relevant documentation. As a result of the inspection findings ten requirements and no recommendations were made. The inspector would like to thank all service users and staff who co-operated and contributed to the inspection. What the service does well: What has improved since the last inspection? Of significant improvement were the home’s attempts to effectively engage with service users to more actively involve them in the decision making process. The development of person centred approach has done much to Evering Road (41) DS0000010268.V310382.R01.S.doc Version 5.2 Page 6 identify and address the individual ability and preferences of service users that can be more systematically gauged. There had been a marked improvement in the range of recreational activities offered to service users, which were now more consistent and varied. Activities offered were clearly in accordance to service users indicated preferences. The inspector was encouraged to learn that overall the dynamic and hence the cohesiveness of the staff group had also improved. All staff that spoke with the inspector indicated that the efforts and leadership of the interim manager and subsequent changes to the home’s staffing structure had proved effective. It was the inspector’s view that this continuing development of the staff group had a direct positive effect on the home’s overall service provision. 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.V310382.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 Evering Road (41) DS0000010268.V310382.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): No new service users had been admitted to the home since the last inspection, therefore no standards under this heading were assessed on this occasion. EVIDENCE: Evering Road (41) DS0000010268.V310382.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 & 9 Quality in this outcome area is good. This judgment had been made using available evidence including a visit to this service. EVIDENCE: Of the two service user files reviewed, one evidenced a updated assessment of need, co-ordinated by the local authority, while the second service user file reviewed had very recently participated in a review meeting of his care needs. Relevant documentation was yet to be supplied by the local authority. The senior staff member informed the inspector that a third service user had also had his needs re-assessed due to a number of recent falls. Documented care plans reviewed by the inspector were comprehensive and holistically explored service user needs. The senior staff member described how the service’s development of person centred planning systematically encouraged staff to gauge and better understand the individual ability and preferences of service users. The senior staff member illustrated the tools used by staff on a daily basis that provided good information about the level of service user independence and preferred activities/tasks. So for example where any given activity is offered to service users and refused, alternatives are offered and service user responses are gauged. Consistent choices and decision were made in relation to recreational Evering Road (41) DS0000010268.V310382.R01.S.doc Version 5.2 Page 10 activities, meal choices, personal care tasks, etc. Where necessary, pictorial cues/objects of reference are used by staff to enhance effective communication with service users. The inspector was satisfied that documented risk assessments were available on service user files. The senior member of staff gave good verbal illustration of recent risk assessments put in place to address the changing needs of service users, for example new risk assessments were in place for the service user whose mobility appeared to be deteriorating. Evering Road (41) DS0000010268.V310382.R01.S.doc Version 5.2 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): 12,13,15,16 & 17 Quality in this outcome area is good. This judgment had been made using available evidence including a visit to this service. EVIDENCE: As mentioned elsewhere in this report, the range of activities offered by the service had significantly improved since the last inspection. The inspector was informed and saw supporting documented evidence of a wide range of recreational activities being offered to service users. For example, in recent months service users had been on a river cruise, attended a carnival in a neighbouring borough, enjoyed trips the seaside and London based tourist sights, attended discos and enjoyed meals out. The staff of HILT’s Evering Road is commended for developments in this area of their work. The service also ensured that service users enjoyed good access to the local community and so for example, service users also enjoyed walks in the local park, shopping trips, attendance at places of worship etc. The increase in service users’ participation in leisure activities had indirectly led to the development of new relationships for some service users; opportunities were available for service users to attend social functions based at other HILT Evering Road (41) DS0000010268.V310382.R01.S.doc Version 5.2 Page 12 services and widen service users’ social networks. Family members of most service users were in frequent contact with residents of Evering Road. With regard to menu planning, the senior staff member explained that service users were actively encouraged to make decisions about meal choices. Pictorial cues were consistently used to facilitate choice; in addition to the preparation of two evening meals, service users are prompted to indicate their preference. The senior member of staff commented that staff also offered a range of traditional Nigerian meals to the service user who had indicated this as a preference. His family had been active in identifying the service users favourite traditional Nigerian recipes. Evering Road (41) DS0000010268.V310382.R01.S.doc Version 5.2 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): 18,19 & 20 Quality in this outcome area is good. This judgment had been made using available evidence including a visit to this service. EVIDENCE: The senior staff member commented that she felt the development of person centred planning had enhanced the staff’s understanding of the importance of providing personal care in accordance to service users’ wishes. Staff demonstrated good working knowledge of some of these preferences, including the challenges posed by service users limited use of speech. Staff clearly had good working knowledge of the likes and dislikes of service users and how such preferences were communicated. Files reviewed by the inspector contained comprehensive information about the physical and mental health needs of service users. Needs assessments highlighted known healthcare issues and service user records evidenced well how these needs were addressed by the service. The inspector saw detailed documentation related to the developing mobility needs of one service user and the increase in the number of epileptic seizures experienced. Documentation (reviewed via the home’s accident/incident book) and guidance to staff on file was clear and consistent; liaison with relevant health professionals was appropriate and effective. Evering Road (41) DS0000010268.V310382.R01.S.doc Version 5.2 Page 14 The inspector reviewed the medication information for one service user in detail and was satisfied that the home’s administration of service user medication was sound and in accordance with previously reviewed HILT medication policies. Evering Road (41) DS0000010268.V310382.R01.S.doc Version 5.2 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 Quality in this outcome area is adequate. This judgment had been made using available evidence including a visit to this service. EVIDENCE: The previous inspection had highlighted the need for the service to amend slightly information regarding the service’s complaints procedure. The inspector was satisfied that this had been completed satisfactorily. The previous inspection had also highlighted the need for full and completed records to be maintained in relation to all complaints and allegations. The inspector asked to review documented information for a previously reviewed complaint/allegation, but no such information was made available. A brief telephone conversation was held between the inspector and the interim manager during the inspection. The inspector was informed that no information was held on site of the documented allegation reviewed at the previous inspection. The interim manager suggested that it was likely that service managers at the organisation’s head office maintained relevant information. Subsequent to the inspection, despite requests, no information confirming the conduct of an investigation of the allegation was produced. The service must ensure that documented evidence of all allegations/investigations are maintained and made available for the purpose of CSCI inspections. Evering Road (41) DS0000010268.V310382.R01.S.doc Version 5.2 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, 25, 27 & 30 Quality in this outcome area is poor. This judgment had been made using available evidence including a visit to this service. EVIDENCE: The previous inspection had highlighted the need for the home to provide draft proofing in one service user bedroom, ensure the periodical service of the home’s mobile hoist, ensure the ground floor shower was repaired, kept clean and the door lock repaired. The inspector was satisfied that these issues had been appropriately resolved. Still outstanding however, was the repair to damaged walls, particularly those in service users bedrooms on the ground floor. Identified walls were in need of re-plastering and re-painting. The senior member of staff commented that she was aware that the home’s landlords, Mosaic Housing, had been alerted to this issue, but thus far, the re-decoration of the premises remained outstanding. The requirement is therefore repeated. During the inspection the inspector participated in an accompanied tour of the premises. The inspector observed a broken toilet seat in the first floor toilet that needed to be replaced. The inspector also observed in the bedroom of one service user that electric fans were being used to dry sections of the carpet. The inspector was informed that earlier in the morning the carpet had been stained with urine. Staff explained that the incontinence/toileting habits Evering Road (41) DS0000010268.V310382.R01.S.doc Version 5.2 Page 17 of the service user in question were cause for growing concern. Staff indicated that they had suggested to HILT managers that the carpet be removed and placed with hard flooring to prevent constant soaking of carpeting and to assist eliminate the offensive odour which was very evident on the day of the inspection. The inspector would support and recommend the staffs’ suggestion be promptly acted upon to enhance the comfort and pleasantness of the service user’s immediate environment and that of the overall home. The inspector also concerned for the safe use of the home’s ground floor bathroom. The erected grab rails were not sufficiently secured to the wall rendering the rails hazardous for service user and staff use. The inspector also noted the poor condition (difficulty in manoeuvring) two bath chairs, which were equally hazardous for use. The service must ensure that adapted equipment is maintained in good working order or is replaced to ensure the safety of both service users and staff. Evering Road (41) DS0000010268.V310382.R01.S.doc Version 5.2 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): 32, 34 ,35 & 36 Quality in this outcome area is adequate. This judgment had been made using available evidence including a visit to this service. EVIDENCE: The previous inspection had highlighted the need for the service to evidence full staff information as outlined in schedule 2 of the Care Homes Regulation. The senior member of staff commented that she did not have access to staff personnel files and so Standard 34 was not assessed on this occasion and the requirement is repeated. In reviewing service user files and discussion with a number of staff during the inspection, the inspector was satisfied that staff were competent and qualified to perform assigned duties. Since the last inspection some staff had pursued relevant training opportunities; two team members were in the process of completing NVQ training, while another had enrolled on a social work degree course. Staff indicated that felt well supported by line managers however formal 1:1 supervision and its consistent documentation was in need of improvement. Evering Road (41) DS0000010268.V310382.R01.S.doc Version 5.2 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): 37, 38,39 &42 Quality in this outcome area is adequate. This judgment had been made using available evidence including a visit to this service. EVIDENCE: It was the inspector’s view that recent changes to the structure of the staff group had proved effective in the overall improvement of services offered by the home. Staff appeared far more relaxed and worked cohesively as a staff group than was evident previously. It was clear that the strong leadership of the interim manager had contributed to the effectiveness of the staff’s performance and ultimately, the quality of service users’ lives. It was the inspector’s view that the promotion of service users’ health, safety and well-being was compromised by environmental issues, highlighted elsewhere in this report. There is a need for consistent self-monitoring of Evering Road by HILT managers and a proactive effort to address issues with Mosaic Housing, the building landlords. The inspector saw no evidence of the required monthly monitoring visits, which would assist and promote improvement in service provision. Evering Road (41) DS0000010268.V310382.R01.S.doc Version 5.2 Page 20 Evering Road (41) DS0000010268.V310382.R01.S.doc Version 5.2 Page 21 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 3 23 2 ENVIRONMENT Standard No Score 24 2 25 2 26 X 27 2 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 2 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 4 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 2 X X 2 X Evering Road (41) DS0000010268.V310382.R01.S.doc Version 5.2 Page 22 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 YA23 Regulation 13(3) Requirement 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 of all adult protection investigations (Previous timescale of 28/02/06 not met) The registered person must repair/redecorate areas of the home - noticeably bedroom and first floor corridor walls that have been damaged. (Previous timescale of 30/04/06 not met) The registered person must ensure that the broken toilet seat in the first floor toilet is replaced The registered person must ensure that service user’s bedrooms have appropriate flooring that adequately meets service user needs. The registered person must ensure that existing bath chairs are repaired or replaced to ensure the safety of service users and staff DS0000010268.V310382.R01.S.doc Timescale for action 31/12/06 2. YA24 23(2)(b) 31/12/06 3. YA24 23(2)(c) 31/10/06 4. YA25 12 31/12/06 5. YA27 23(2)(c) 30/11/06 Evering Road (41) Version 5.2 Page 23 6. YA27 23(2)(c) 7. YA30 23 (2)(d) 8. YA34 19 9. YA36 18(2) 10. YA39 26 The registered person must ensure that the grab rails in the ground floor shower room is securely fixed to the wall The registered person must ensure that the home’s premises is kept hygienic and is free from offensive odours 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 & 28/02/06 not met) The registered person must ensure that all staff receive regular supervision that is documented (Previous timescale of 01/10/05 not met) The registered person must ensure that the required unannounced monitoring visits are consistently conducted and that subsequent reports are made available on site to staff and for the purpose of inspection. 30/11/06 31/10/06 31/10/06 31/10/06 31/10/06 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.V310382.R01.S.doc Version 5.2 Page 24 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.V310382.R01.S.doc Version 5.2 Page 25 - 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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