Inspection on 19/05/05 for Fouracres Care Services

This inspection was carried out on 19th May 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Fouracres Care Services 04/04/07

Fouracres Care Services 04/05/06

Fouracres Care Services 16/01/06

Fouracres Care Services 14/02/05

Fouracres Care Services 26/07/04

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 Fouracres care service 47 Fouracres Enfield Middlesex EN3 5DR Lead Inspector Tony Brennan Announced 19 May 2005 10:00 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 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 Stationary 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. Fouracres care service Version 1.10 Page 3 SERVICE INFORMATION Name of service Fouracres Care Service Address 47 Fouracres, Enfield, Middlesex EN3 5DR Telephone number Fax number Email 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 8292 4823 020 8216 1306 Mrs Philomena Okoron-Kwo Mr Kwaku Apeaning Ampofo PC Care Home Only 4 Category(ies) of LD Learning Disability registration, with number of places Fouracres care service Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1 The home must not admit anyone with a physical disability who is unable to descend the stairs without assistance in the event of an emergency. 2 The home is not suitable for wheelchair users. 3 Service users should not be allowed in the office in the loft room. 4 The registered persons must ensure that an appropriate balance of female and male staff is maintained to reflect the gender of the service users. Date of last inspection 14 February 2005 Brief Description of the Service: Fouracres is a small home registered to provide a service to four service users who have a learning disability. The service is owned by Ms Philomena Chickwendu Okoron-Kwo. There is a registered manager Mr Kwaku Apeaning Ampofo. The service is an end of terrace house with three floors. The ground floor consists of a kitchen, lounge/dining area and one bedroom. On the first floor there are three further bedrooms and an office/sleep-in room. On the top floor in a loft conversion there is an office area. The home is located in a quiet residential area of Enfield and is a short distance from local shops and public transport. The stated aims of the home are to provide support to people with special needs in a safe and secure environment. Fouracres care service Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was undertaken as part of the annual inspection process. The inspector also sought to confirm that the fifteen areas for improvement found at the last inspection were addressed. The inspection took place over one day. The registered manager, Mr Kwaku Apeaning Ampofo, assisted the inspector. The inspector spoke with the person currently living at the home and two staff. The inspector toured the building and examined a range of records relating to the care and management of the home. What the service does well: What has improved since the last inspection? What they could do better: There are ten issues that the home needs to address in order to improve the life of the person living in the home. Any restriction on the person who lives at the home must be recorded and agreed. The person living at the home said that he has not been able to use his mobile phone, as he can’t renew his calling credit. Staff need to have training in how to give medicines, first aid, food hygiene, mental health and care skills to be able to care for the person living in the home. The home needs to ensure that all new staff are checked to ensure that they have not committed any criminal offence. The information on the home provided for anyone living at the home needs to be in a format accessible to service users. Notes on support given to staff to do their job need to be given to them. Fouracres care service Version 1.10 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Fouracres care service Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Fouracres care service Version 1.10 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 standard(s) 1 2 3 4 5 Service users and prospective service users are not able to access information on the service. Service users needs are assessed prior to admission to the home. The home meets the assessed needs of the one service user currently accommodated in the home. Service users are supported to make a positive choice to live at the home. Service users are provided with details of their rights and obligations. EVIDENCE: A service user spoken to understood the service that the home provided. The statement of purpose and service users guide contained all the required information. The service user spoken to said that he could not read. The service users guide and statement of purpose needs to be put into accessible formats. For example, tape or symbols. This was discussed with the registered manager who agreed to follow this up. The service user explained that staff had consulted him regarding the support that he required. The inspector found that there were detailed assessments of the service user’s needs. The assessment had been used as the basis to develop care plans. The service user said that staff understood him and knew how to meet his needs. Staff spoken to could explain how the needs of the service user were met. The inspector observed interaction between staff and the service user and found that this was supportive and appropriate to the needs of the service user. The service user said that before coming into the home he had been able to visit and spend time with the staff. The service Fouracres care service Version 1.10 Page 9 user’s file was found to contain a contract that had all the required information. This had been amended since the last inspection. Fouracres care service Version 1.10 Page 10 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 standard(s) 6 7 9 The Care Plan provided detailed information on how the needs of the one service user currently cared for would be met. The service user was not aware of the restriction being placed on him. Risks to the service user were assessed. EVIDENCE: The service user said that staff understood his needs and had explained the care plan to him. The care plan identified the actions required to meet the needs of the service user. The staff spoken to understood the needs of the service user. The inspector found that the requirement to record and agree restriction on the service user had not been agreed and put in place. The service user was aware of certain restrictions but these had not been discussed with him or the other relevant professionals. Since the last inspection, detailed risk assessments had been put in place. These detailed the risks for the service user and how they could be alleviated. The risk assessments were cross-referenced to the care plans and were discussed in the daily notes. Fouracres care service Version 1.10 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 standard(s) 13 15 16 17 The service user is supported to develop and maintain community links. The service user needs to be able to use his mobile phone in order to enhance his quality of life and promote his independence. The service user is able to determine his own daily routine. The service user is provided with a choice of varied and balanced meals so as to make sure his health is promoted. EVIDENCE: The service user confirmed that the home’s staff have been assisting him to become more integrated into the local community. The service user said that staff had assisted him so that he was able to use public transport on his own in getting to know the local area. The service user said that he had a place at college and the inspector saw a letter confirming this. The service user explained that he visits relatives regularly and the staff had helped him to do this. These visits were referred to in the service users care plan, risk assessments and daily notes. The service user said that he was happy with these arrangements. The service user said that top up for his mobile phone still needs to be organised with his relative. This had been a requirement of the last inspection report and is restated in this report. Fouracres care service Version 1.10 Page 12 The service user said that he was able to determine his daily routine. The care plan outlined the service user’s routine and any support needed. The service user confirmed that he had been consulted about his daily routine. Daily notes showed that intervention had taken place when staff noticed changes in daily patterns or behaviour. The inspector observed that staff involved the service user in the daily routines of the home. The service user explained that he had chosen the food and was involved in the purchase of the food. The service user explained that he felt that he was offered a varied diet. The menu showed that nutritionally balanced meals were offered. The inspector observed that the service user was fully involved in the preparation of the meal and the health and nutritional benefits of food choices were discussed in a way that was relevant to the service user. A daily record is now being maintained of the meals eaten by the service user. Fouracres care service Version 1.10 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 standard(s) 18 19 20 The service user receives the support he needs. The service user has access to the medical care he needs. Staff need to be trained in the safe administration of medication so as to make sure the service user’s health needs are fully met. EVIDENCE: The service user explained that he does not need direct assistance from staff with his personal care needs, but he felt they encouraged and supported him to maintain his independence. Since the last inspection the service user said that he has had an eye test and new glasses. The inspector saw that the service user’s health needs were recorded in the care plan and action had been taken to address these. Records of medicines administered and returned were complete. There was no system in place to record medicines returned to the pharmacist. The policy on medicines administration was complete. At the last inspection it was required that staff receive training on the administration of medication. The inspector found that this still needs to happen. Fouracres care service Version 1.10 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 standard(s) 22 23 The service user is confident that his complaints will be listened to, taken seriously and acted upon. The service user is protected from abuse by the systems in place in the home. EVIDENCE: The service user said that he felt confident in making his concerns known to staff. The complaints policy explained how to make a complaint and how it would be dealt with. The complaints record showed actions taken to resolve complaints. The service user said that he felt safe and could approach staff if he had any concerns regarding how he was treated. There were comprehensive policies on handling abuse and protection. The home does not have a copy of the Enfield procedure on adult protection. The registered manager agreed to obtain this. The inspector found that training was still needed on adult protection. The inspector found that a record still needs to be put in place on how the service user’s monies will be managed. Fouracres care service Version 1.10 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 standard(s) 24 30 Service users live in a homely and safe environment. The home is clean and hygienic. This provides a comfortable and pleasant place for anyone living in the home. EVIDENCE: The service user was happy with the homely environment provided by the home. The home is well furnished and is fully equipped. The inspector found that the home was clean and hygienic. Staff spoken to understood how to prevent cross infection and equipment was provided for this purpose. Fouracres care service Version 1.10 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 32 33 34 35 36 Staff have clearly defined roles that ensure the needs of service users are met. Staff do not have all the skills to meet the needs of the one service user. There are sufficient staff to meet the needs of the service user. The service user is not protected by the home’s recruitment procedures. EVIDENCE: Staff are appropriately supervised. The manager needs to give staff copies of notes of their supervision sessions. The inspector found that the job descriptions outlined the tasks required to meet the needs of the service user. Staff spoken to were aware of their role and responsibilities. Staff were observed working with the service user and were seen to be offering appropriate and sensitive support. The service user said that staff were supportive and helpful. The inspector saw that training records showed that the home still needs to achieve the target of 50 of staff having NVQ in care. The service user said that he felt that there were sufficient staff to meet his needs. The rota showed that the staffing level of one member of staff at all times was maintained. The registered manager explained that before new service users were admitted the necessary staffing would be in place. The inspector examined four staff files and found that they did not contain all the required documentation relating to the recruitment of staff. CRB checks had not been obtained. The inspector saw records that confirmed that staff had gone through an appropriate induction. The inspector saw records which Fouracres care service Version 1.10 Page 17 confirmed that since the last inspection all staff had undergone induction training. Records showed that staff still needed to receive training in first aid and food hygiene. Staff had not been given access to the Learning Disabilities Award Framework. There still needs to be training on understanding mental illness. Staff spoken to confirmed they were being supervised every two weeks. The manager explained that staff are not given a copy of the notes of their supervision. The inspector explained this would be a recommendation of this report. Fouracres care service Version 1.10 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 40 41 42 All the necessary policies and procedures are in place to protect service users. Records are maintained to ensure the safety of service users. Service users and staff health and safety is promoted. EVIDENCE: Policies were in place to cover all the required areas. These were clearly written and accessible. The service user said that staff had explained the policies to him. The inspector found that all the records examined were clearly written and contained the necessary information. The service user confirmed that staff had explained the contents of records. The inspector saw that the appropriate checks and drills were taking place to prevent fire. The inspector saw that the first aid box contained all the required items. The required certificates for gas and electrical safety were in place. Fouracres care service Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 Fouracres care service x x 3 x 2 Standard No 31 32 33 34 35 36 Score 3 2 3 2 2 3 Version 1.10 Page 20 16 17 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x 3 3 3 x Fouracres care service Version 1.10 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 9 Regulation 12(1) Requirement The registered persons must ensure that all restrictions are recorded and that there is a record that these have all been agreed with other professionals involved with the service user. (This requirement was not met and is restated in this report). The registered persons must ensure the arrangements for the service user to access the phone are recorded and the service user is supported to keep his mobile phone credit topped up. (This requirement was not met and is restated in this report). The registered persons must ensure that staff receive training on the administration of medication. (This requirement was not met and is restated in this report). The registered persons must ensure that 50 of staff achieve NVQ in care at level 2. The registered persons must ensure that all staff appionted have a POVA first and CRB check before they commence work in the home. The registered persons must Version 1.10 Timescale for action 01/09/05 2. 15 12(1) 01/09/05 3. 20 13(2) 18(2a) 01/09/05 4. 5. 32 34 18(2a) 19(1) 01/10/05 01/09/05 6. 35 18(2a) 01/09/05 Page 22 Fouracres care service 7. 35 18(2a) 8. 35 18(2a) ensure that all staff receive training on food hygiene and first aid. The registered persons must 01/10/05 ensure that staff are given access to the Learning Disabilities Award Framework. The registered persons must 01/09/05 ensure that all the staff are trained on understanding mental illness. (This requirement was not met and is restated in this report). 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. 2. Refer to Standard 1 36 Good Practice Recommendations The registered persons should ensure that the statement of purpose and service users guide are available in formats that are accessible to service users. The registered persons should ensure that staff are given copies of their supervision record. Fouracres care service Version 1.10 Page 23 Commission for Social Care Inspection 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. Extracts may not be used or reproduced without the express permission of CSCI Fouracres care service Version 1.10 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. 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