Inspection on 10/10/05 for Gardiner Close

This inspection was carried out on 10th October 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Gardiner Close 22/05/07

Gardiner Close 10/05/05

Gardiner Close 14/06/04

Gardiner Close 19/02/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Gardiner Close 2 Gardiners Close Dagenham Essex RM8 2XG Lead Inspector Helen Fontaine Unannounced Inspection 10 October 2005 15:00 Gardiner Close DS0000027900.V257369.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Gardiner Close DS0000027900.V257369.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Gardiner Close DS0000027900.V257369.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Gardiner Close Address 2 Gardiners Close Dagenham Essex RM8 2XG 0208 592 3616 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) Outlook Care Mrs Julie Michelle Wilson Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Gardiner Close DS0000027900.V257369.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th May 2005 Brief Description of the Service: Gardiner’s Close is a registered care home providing care and support to up to seven people who have a learning disability. It is operated by Outlook Care, a not for profit organisation who operate a range of support services for vulnerable adults in North East London and Essex. The home was purpose built in 1996, and is on a generous plot at the end of a cul de sac. All residents have their own bedrooms, and share spacious and well-maintained communal rooms. The building is owned by London and Quadrant housing trust, which are responsible for maintaining the property. Five of the residents moved in together when the home opened in March 1996, having lived together in an older style home that was being closed. The age range is 51 to 66 years. One person moved in December 2002 and quickly became established as a member of this settled household group. The seventh person joined the group in February 2004. Gardiner Close DS0000027900.V257369.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place in accordance with the annual inspection programme for this home. The previous inspection took place in May 2005 and was an unannounced inspection, there where no Requirements from that inspection. A tour of the home was undertaken where a number of the Service Users were seen and communicated with. A number of documents were seen and one member of staff was spoken to. The Manager were present and added valuable information about the home. What the service does well: What has improved since the last inspection? What they could do better: There is one Service User currently being assessed by the Learning Disabilities team for Dementia. The home have four other Service Users the Manager feels are also likely to have a diagnosis of Dementia in the near future. Gardiner Close DS0000027900.V257369.R01.S.doc Version 5.0 Page 6 The home will need to inform the Commission for Social Care Inspection, if any of the Service Users have a diagnosis of Dementia. The home has a number of Service Users wandering at night and therefore does need to be a waking night staff to meet this need. 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. Gardiner Close DS0000027900.V257369.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Gardiner Close DS0000027900.V257369.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Prospective Service Users’ do have their individual aspirations and needs fully assessed. EVIDENCE: During the inspection an ‘assessment folder’ of the most recent resident was looked at. This contained a good range of information, including a care plan and profile, and an additional assessment and tracking notes done by the homes staff. The assessment was done with pictures and with pictures that were individually chosen for the Service User. The assessment covered: personal details, emergency contact, professionals’ involved and previous accommodation, the support needs, social, emotional and personal care and other areas covering nursing, psychiatric, GP/Consultant. This assessment gave the Service User the opportunity to express their view, in a way that that allowed them to, as well as others who were relevant. Gardiner Close DS0000027900.V257369.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 8 Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. Service Users do make decisions about their lives with assistance and are consulted on and participate in all aspects of life in the home. EVIDENCE: During the inspection two Service Users personal files were looked at, which included the Person Centred Plan, Health Care and daily diaries. The Person Centred Plan fully involved the Service Users in planning their support and how they spend their time. There was a My Life Plan written and with pictures that was meaningful and with language indicating that the Service Users were involved. One area had “My sister died, this was very sad”, another areas was about ‘Things that I am good at’. The issue of death and dying was covered clearly by the Service Users own wishes- “My Dad has said that he would like for me to be cremated and laid to rest with him”. There was nothing in the PCP that could have been improved and there were no areas important to the Service User that was left out. Each PCP was different reflecting the individual issues important to the Service Users and from this PCP came the care plan and risk assessments. Gardiner Close DS0000027900.V257369.R01.S.doc Version 5.0 Page 10 The home do have Residents meetings, the home do not have regular once a month meetings but tend to wait for a particular issue that needs their involvement. The Manager said that the next Residents meeting would be about choosing another budgerigar, as the previous one had died. However there is an Advocates meeting once a month, which raises any concerns or complaints. Both the Residents meeting and the minutes of the Advocates meetings were looked at. Gardiner Close DS0000027900.V257369.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 17 Service Users are able to take part in age, peer and culturally appropriate activities and are offered a healthy diet and enjoy their meals. EVIDENCE: During the inspection a number of records were looked at and covered weekly activities. The PCP had a section on how I like to spend my week and a table that showed that Service Users have regular scheduled programmes. These activities were both in the home and out at either day centres or in the community. The table covered all the areas that were on the PCP, giving the number of times the activity had taken place during the month. These tables were filled in each month and kept for the review of activities. The staff member spoken to during the inspection and the Manager said that the Service Users really enjoy their food. The Service Users that were spoken to during the inspection indicated when asked that they liked the food and mealtimes. The Fridge and freezers looked at during the inspection were well stocked and had a variety of foods. Gardiner Close DS0000027900.V257369.R01.S.doc Version 5.0 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 21 Service Users receive personal support in the way they prefer and require, their physical, emotional and health needs are being met. The ageing process and death of a Service User are handled with respect and as the individual would wish. EVIDENCE: During the inspection documents around the separate need to know file gives a good pen picture profiles on each Service User. This includes the level of support that each Resident needs to maintain their personal care. This is also covered in the PCP, with one Service Users PCP saying “I am a diabetic, staff check my blood sugar levels every day and I have a nurse that comes in twice a day”. The PCP then goes on to say “I can have a hypo if my diabetes is not controlled properly, if this happens I need to have a sugary drink to bring my levels of up again”. Another PCP it was written, “I am good at dressing and undressing”, giving a good indication of the personal support is given in the way the Service Users prefer and require. The Manager said that the Learning Disabilities team is assessing one of the Service Users for Dementia; the home must inform the Commission for Social Care Inspection if the Service User is diagnosed with Dementia. There is a section in the PCP around the area of Death and Dying and this is an area the home does really very well. It is not an easy subject but it was clear Gardiner Close DS0000027900.V257369.R01.S.doc Version 5.0 Page 13 that every effort had been made, to make absolutely sure that the Service Users wishes were reflected. It was documented on the PCP in a way that was individual and with pictures; this also reflected the wishes of carers and family. Gardiner Close DS0000027900.V257369.R01.S.doc Version 5.0 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 Service Users views are listened to and acted on, the homes policies and procedures and staff training protects them from abuse, neglect and self-harm. EVIDENCE: There are good policies and procedures in the home for complaints with simple and clear notices posted in the hall. There is also a pictorial version and there is a video available in the home on how to complain. The complaints log looked at during the inspection and there were no complaints since 2002. The Manager said that they go through the pictorial sheet on complaints with the Service Users, regularly. The staff member talked to during the inspection was very clear that any complaints or concerns by either Service Users or staff would be dealt with straight away. Staff member talked to was aware of the policies and procedures for the dealing with abuse. The Advocates meeting each month also covered areas of both complaints and reporting abuse, neglect or self-harm. Gardiner Close DS0000027900.V257369.R01.S.doc Version 5.0 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, 28 and 30 Service Users live in a homely, comfortable and safe environment with adequate shared spaces that complement and supplements Service Users’ individual rooms. The home is clean and hygienic and pleasantly decorated. EVIDENCE: During the inspection a tour of the home was undertaken, the home was very clean and hygienic and very nicely decorated. The most outstanding impression was that of space and light, with areas that the Service Users could either enjoy company or have space for some quiet time. One Service User was seen sitting comfortably in the garden, when other Service Users returned to the home then enjoyed sitting and joining in with conversations with other Residents. The garden was very pleasant and the Manager said that the staff and themselves undertake the gardening. A new area of decking in the garden is being developed, which will allow Service Users to sit in the garden when the grass is wet. Gardiner Close DS0000027900.V257369.R01.S.doc Version 5.0 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, 33 and 36 Service Users are supported by competent and qualified staff and are protected by the home’s recruitment policies and practices. The staff team is well supported, which benefits the Service Users. However, the home must deploy waking night staff, in order to protect service users who are wandering. EVIDENCE: During the inspection staff files of the two newest members of staff were looked at. Both members of staff had CRB’s and two references, along with statement of terms and conditions. The staff development files were looked at, with the 1st week, 2nd week and 1st month with areas covering the homes policies and procedures. Staff training for another member of staff was looked at and had Fire training, Medication, NVQ level 2, Health & Safety, Manual handling, Food hygiene, First aid, Aspects of aging. A member of staff spoken to said that the home is very good and offers the Service Users exceptional care. The staff supervision was seen during the inspection of the staff files and all staff are receiving regular supervision, covering areas of training, Service Users, staff and Health & Safety. A member of staff spoken to said that there are a number of Service Users wandering during the night, the home does need to review the staff rota to have waking night staff to meet this need. Gardiner Close DS0000027900.V257369.R01.S.doc Version 5.0 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 Service Users benefit from a well run home. EVIDENCE: The conclusion at the end of the inspection is that the home is very well run; the records kept are appropriately kept. The PCP and care plan with risk assessments are available for staff, other confidential information and staff records are kept locked in the Office. All the procedures for recruitment of staff is carefully followed, all the issues around PCP’s, Care plans and risk assessments are done in full according to the homes policies and procedures. The only issue which is something that the member of staff spoken to raised, was the Service Users over time not being able to use the stairs. This member of staff felt was a shame, as it meant that they had to be moved to a home that could meet that need. Another issue, which has been raised in another part of this report, was the need for waking night staff. The member of staff spoken to said that sleep-in Gardiner Close DS0000027900.V257369.R01.S.doc Version 5.0 Page 18 staff are increasingly being woken due to Service Users’ wandering. The home does need to make sure that the right staff ratio is working to meet the needs of the Service Users. Gardiner Close DS0000027900.V257369.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X 3 X 3 LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 2 3 X 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Gardiner Close Score 3 3 X 3 Standard No 37 38 39 40 41 42 43 Score 3 X X X X X X DS0000027900.V257369.R01.S.doc Version 5.0 Page 20 NO 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 YA33 Regulation 18(1)(a) Timescale for action The Registered person must 30/11/05 ensure that waking night staff are deployed to protect service users who wander at night. Requirement 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 Gardiner Close DS0000027900.V257369.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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 Gardiner Close DS0000027900.V257369.R01.S.doc Version 5.0 Page 22 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!