Inspection on 09/05/06 for Glen Pat Homes

This inspection was carried out on 9th May 2006.

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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Glen Pat Homes 22/11/07

Glen Pat Homes 09/02/06

Glen Pat Homes 29/09/05

Glen Pat Homes 14/10/04

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

CARE HOME ADULTS 18-65 Glen Pat Homes 10 Elm Park Road Winchmore Hill London N21 2HN Lead Inspector Tony Brennan Key Unannounced Inspection 9th May 2006 10:00 Glen Pat Homes DS0000050726.V289743.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 Glen Pat Homes DS0000050726.V289743.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. Glen Pat Homes DS0000050726.V289743.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Glen Pat Homes Address 10 Elm Park Road Winchmore Hill London N21 2HN 020 8805 9371 020 8805 9371 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) Mr Michael Glen Woodstock Ms Esther Adebambo Amachree Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Glen Pat Homes DS0000050726.V289743.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. No emergency admissions can be made. Admissions can be made only in line with the agreed Statement of Purpose. 9th February 2006 Date of last inspection Brief Description of the Service: Mr & Mrs Woodstock own Glen Pat Home. Mr Michael Woodstock is the responsible person for the home. The home consists of a large house in a quiet street in Winchmore Hill. The home is close to shops and public transport links. There are seven large single bedrooms, a dining and a sitting room. The home is appropriately furnished and there is a garden to the rear of the house. The home’s stated aim is to support people with learning disabilities to live in the community. The home also aims to provide care and support service users who may have challenging behaviour, and to support service users tailored to their individual needs. The fees are between £550 and £750 a week. This report is available through the internet. Copies may also be obtained from the provider of this service. Glen Pat Homes DS0000050726.V289743.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken as part of the annual inspection programme. The inspector also sought to confirm that the five areas for improvement identified at the last inspection were addressed. The inspection took place over one day. The registered manager, Esther Amachree, assisted the inspector with the inspection. The inspector spoke with four people who live at Glen Pat Home and three staff. The inspector observed care practice and interaction between service users and staff. The inspector toured the building and examined a number of records relating to the care, health and safety and management of the home. Since the last inspection there has been an adult protection investigation. This concerned the support needed by people living at the home who have challenging behaviour. All issues resulting from this have been addressed. There is currently one complaint that is being investigated by the registered manager. The inspector would like to thank the registered manager and staff who assisted him by answering questions about the running of the home. The inspector would also like to thank those people who live at the home who discussed their views of the service they receive. What the service does well: People who live at Glen Pat Home commented that the home was “good” and felt that staff “helped”. The inspector observed staff interaction with those who use the service and found that this was supportive and demonstrated that staff understood their needs. A person living at the home was observed talking with a member of staff who explained what meal options were available. The member of staff responded by encouraging them to participate in preparing the meal. A person who lives at Glen Pat home said “I go to art group and yoga”. They also confirmed “staff take me to church”. The registered manager explained and was able to provide written evidence that a person who uses the service had applied to do a cookery course at a local college. A person who lives at the home confirmed that they “like to visit my family”. The support needed was recorded in the person’s care plan and risk assessment. People who live at the home commented that the food was “nice”, and that they “got things they like” in the meals provided. People who live at the home were observed preparing the evening meal. People who live at Glen Pat home commented that they “liked” their bedrooms. Service users commented that staff were “alright” and “OK”. Staff were observed throughout the inspection and demonstrated understanding of the needs of people living at the home. The registered manager has completed training on person centred care and has now arranged for all staff to undergo this training. This will be used to Glen Pat Homes DS0000050726.V289743.R01.S.doc Version 5.1 Page 6 further develop the service through the introduction of person centred care and care planning. The registered manager explained that she has been developing the activities programme in consultation with people living at the home and has ensured that sufficient staff are available. What has improved since the last inspection? 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. Glen Pat Homes DS0000050726.V289743.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 Glen Pat Homes DS0000050726.V289743.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): 2 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users needs are assessed prior to admission to the home to ensure they receive the care and support they require. EVIDENCE: A service user commented that the home was “good” and another service user felt that staff “helped”. The inspector observed staff interaction with those who use the service and found this demonstrated that staff understood the needs of service users. When service users returned from their day centres the inspector observed that they were greeted and offered a drink. Service users have been assessed prior to admission and assessment from other professionals was seen. The needs identified at assessments were addressed in the care plans. Staff spoken to understood the needs of service users. Appropriate professional support had been obtained to ensure the needs of service users could be met. There were assessments detailing behavioural needs relating to service users learning disabilities. Glen Pat Homes DS0000050726.V289743.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): 679 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Care plans provided detailed information on how the needs of service users would be met. Service users are supported to make decisions about their lives. Risks to service users are assessed to ensure their safety. EVIDENCE: A service user was observed talking with a member of staff who explained what meal options were available. The member of staff responded to the service user and encouraged them to participate in preparing the meal. Care plans seen detailed the kind and level of support required by service users. Since the last inspection care plans on positively supporting service users behaviour had been further developed. These provided a specific programme and guidance for the individual service users and how to handle their behaviour. There was also guidance on when it was appropriate to administer ‘when required’ medications. A service user said that they could “choose what to do”. Care plans recorded the preferences of service users. This included service users cultural and religious needs. Risk assessments outlined the actions to be taken to prevent risks. The risk assessments were cross referenced to the care plans and reviewed regularly. Staff were observed Glen Pat Homes DS0000050726.V289743.R01.S.doc Version 5.1 Page 10 preparing to escort service users out and risk factors to individual service users were considered as part of this preparation. Glen Pat Homes DS0000050726.V289743.R01.S.doc Version 5.1 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 judgement has been made from evidence gathered both during and before the visit to this service. Service users are supported to engage in a range of appropriate activities and community contact. Service users are supported to maintain appropriate personal relationships. Service users are supported to determine their own routines and can choose to live the way they wish. The service user is provided with a choice of varied and balanced meals. EVIDENCE: All but one of the service users attend day centres throughout the week. The inspector found that since the last inspection a detailed programme of activities had been drawn up for the one service user not attending a day centre. The service user returned home from a shopping trip in the late afternoon of the day of the inspection. The inspector spoke with this service user who said that “I go to art group and yoga”. The service user also confirmed “staff take me to church”. The registered manager explained and was able to provide written evidence that the service user had applied to do a cookery course at a local college. The registered manager also explained that service users had participated in a local event celebrating African cultures. Glen Pat Homes DS0000050726.V289743.R01.S.doc Version 5.1 Page 12 The inspector found that all service users have access to a programme of activities that met their needs and supported them to be part of their local community. The daily notes of a service user who is Hindu recorded weekly visits to the Hindu temple and community group. Care plans and risk assessments outlined the support service users needed to maintain personal relationships. One service user spoken to confirmed that they “like to visit my family”. The support needed was recorded in the service user’s care plan and risk assessment. The inspector observed service users on their return from the day centre. They were supported and offered a choice of activities prior to their evening meal. Some spent the time talking with staff in the sitting room or helping in the kitchen. Daily notes referred to a range of activities that service users had chosen to participate in. A service user commented that the food was “nice”. Another service user commented that they “got things they like” in the meals provided. Service users and staff were observed preparing the evening meal. The registered person explained that the menu is prepared with service users involvement each week. The inspector saw that the dietary requirements of service users were recorded and reflected in the menu. Professional support had been followed where service users had special dietary needs due to health issues. The cultural diversity of service users was reflected in the meals provided. The inspector saw that one service user who is Hindu has a vegetarian menu. Glen Pat Homes DS0000050726.V289743.R01.S.doc Version 5.1 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 judgement has been made from evidence gathered both during and before the visit to this service. Service usesr are supported with their personal care needs to ensure they are as independent as is possible. Service users have access to the medical care they need. Service users are not protected by safe procedures for handling medication. EVIDENCE: Staff spoken to understood the support that service users needed with their personal care. The support needed was recorded in the service users care plan. This included information on same sex care where this was appropriate. The behavioural support needs of service users was assessed and planed for. Interest and social care needs were also identified in the service users plans. A service user commented that staff had “helped me to go to the hospital”. Service users were supported to access medical services that meet their needs. Records seen showed that service users were receiving the medical care that they needed. Care plans outline the medical needs of service users and the support they required. The medicines record for receiving, administering and return of medicines to the pharmacist were found to be complete. Medication profiles are up to date and recorded when medication had been reviewed. Most staff have undergone Glen Pat Homes DS0000050726.V289743.R01.S.doc Version 5.1 Page 14 medicines training. The registered manager confirmed and staff training records showed there are a number of new staff who need medication training. Staff were observed administering medication and this was done safely. There was clear guidance on the use of ‘when required’ medicines. The medication policy has been seen and found to be complete. Glen Pat Homes DS0000050726.V289743.R01.S.doc Version 5.1 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 good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users are confident that their complaints will be listened to, taken seriously and acted upon. Service users are protected from abuse. EVIDENCE: Service users said that they felt confident in making their concerns known to staff. The complaints policy explained how to make a complaint and how it would be dealt with. This was available in symbol form and displayed prominently in the home. The complaints record showed actions taken to resolve complaints. One complaint had been received since the last inspection. This concerned the care of serive users and response to an unexplained injury. The Commission had asked the providers to investigate and they will shortly be responding to the complaint. There were comprehensive policies on handling abuse and protection. Staff spoken to by the inspector were able to show that they understood issues to do with adult protection. Training had taken place on adult protection. There had been one adult protection investigation. Issues arising from this had been addressed in the last inspection report. The inspector confirmed that these issues have been addressed appropriately in line with the local authorities adult protection procedures. Glen Pat Homes DS0000050726.V289743.R01.S.doc Version 5.1 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 30 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users live in a safe and comfortable environment. The home is a clean and hygienic environment for service users to live in. EVIDENCE: The inspector found that the home was generally in a good state of repair. The bathroom on the second floor has been redecorated. The window in the bathroom has been repaired. The light switch on the third floor, which had been broken, has now been repaired. Service users bedrooms were decorated in a manner that reflected their personal preferences. One service user commented that they “liked” their bedroom. The inspector found that the home was clean and hygienic. Equipment was provided for this purpose. The home has an infection control policy. Glen Pat Homes DS0000050726.V289743.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): 32 34 35 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Staff do not have all the skills to meet the safety needs of service users. There are sufficient staff to meet the needs of the service users. Service users are protected by the home’s recruitment procedures. EVIDENCE: Service users commented that staff were “alright” and “OK”. Staff were observed throughout the inspection and demonstrated understanding of service users needs. The inspector saw staff support a service user who was becoming over excited. This was done by distraction and involving the service user making tea. The inspector spoke with the member of staff who was able to explain how to respond to service users. Training records showed staff had had training on all the statutory required training with the exception of fire training and infection control. Not all staff have completed Learning Disabilities Award Framework training. 50 of staff have completed the National Vocational Qualification at level 2. A number of staff are now doing the same qualification at level 3. The registered manager explained that the training plan is being developed so that training is linked to the objectives of the home and needs of individual service users. The staff rota showed that a consistent level of staff was maintained. Staff spoken to told the inspector they felt that there were sufficient staff available. The registered manager said that she keeps the staff level under review to Glen Pat Homes DS0000050726.V289743.R01.S.doc Version 5.1 Page 18 ensure that the needs of service users are met. The inspector examined files of three new members of staff. These were found to contain all the relevant documentation. Records of staff supervision and discussions with staff confirmed that they had regular supervision. Glen Pat Homes DS0000050726.V289743.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): 37 39 42 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The registered manager has the necessary qualifications to manage the home effectively in the best interests of service users. Service users views of the service are sought and used as the basis for improvement. Service users and staff health and safety is promoted. EVIDENCE: A service user said that she “likes” the registered manager. Staff said they felt “supported” and that they were able to discuss issues with the registered manager. The registered manager has completed the Registered Manager’s Award and has now commenced the National Vocational Qualification in care at level 4. Also, the registered manager explained that she was doing a management course. The registered manager has completed training on person centred care and has now arranged for all staff to undergo this training. This will be used to further develop the service through the introduction of person centred care and care planning. The registered manager explained she has been developing the activities programme in consultation with service users and has ensured that sufficient staff are available. Glen Pat Homes DS0000050726.V289743.R01.S.doc Version 5.1 Page 20 The home has a system to monitor the views of the service users on the service that is provided. The registered manager explained that she has set up a family circle meeting. The agenda for this showed that it is used to discuss general issues and quality of the service provided. Ideas for improvement are sought. A quality survey was last carried out in January 2006 and the Commission had received a report on the findings of this. The inspector saw that staff meetings and supervision are taking place regularly. These were used to discuss issues concerning the consistency and quality of care provided. Records showed that fire equipment was tested regularly and maintained. Drills were taking place. The fire risk assessment had been updated and provides more details of potential risks of fire. The registered person was able to confirm that the fire service had examined the fire risk assessment and had confirmed it was in line with their guidance. All health and safety policies were available. Certificates for gas and electrical testing were in date. COSHH guidance was in place and chemicals were stored safely. Training on health and safety topics was not complete. Records and discussions with staff showed that training is required on fire safety and infection control. Glen Pat Homes DS0000050726.V289743.R01.S.doc Version 5.1 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 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Glen Pat Homes DS0000050726.V289743.R01.S.doc Version 5.1 Page 22 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 YA20 Regulation 18(1) Requirement The registered persons must ensure that all staff are trained in the safe handling of medication. The registered persons must ensure that all staff are trained in: Fire Safety Infection control. Timescale for action 10/09/06 2 YA35 18(1) 10/09/06 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 Glen Pat Homes DS0000050726.V289743.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Glen Pat Homes DS0000050726.V289743.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. 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!