Inspection on 10/11/06 for Grove Road (48)

This inspection was carried out on 10th November 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Grove Road (48) 29/08/07

Grove Road (48) 24/02/06

Grove Road (48) 07/11/05

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 Grove Road (48) 48 Grove Road Walthamstow London E17 9BN Lead Inspector Harun Rashid Unannounced Inspection 10th November 2006 09:55 Grove Road (48) DS0000065858.V318544.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 Grove Road (48) DS0000065858.V318544.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. Grove Road (48) DS0000065858.V318544.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grove Road (48) Address 48 Grove Road Walthamstow London E17 9BN 020 8509 9875 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 *** Post Vacant *** Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Grove Road (48) DS0000065858.V318544.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home can provide continuous care for two named Service Users with visual impairment 24th February 2006 Date of last inspection Brief Description of the Service: 48 Grove Road is a care home, situated in the area of Walthamstow. The home provides 24 hours care services to five people with learning disabilities. In April 2005 Canopy Care merged fully into Outlook Care, which now operates as one organisation. The home provides single bedroom accommodation to all service users with one en-suite facility. The home consists of a two-storey terraced house and is indistinguishable from other adjacent properties. The service users have lived together for many years and are supported by the staff in accessing facilities in the community. The home is located within walking distance of shops, the pub and there are good public transport links. Grove Road (48) DS0000065858.V318544.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key unannounced inspection was conducted on a weekend morning on 10/11/06. The inspector was able to interview three members of staff including the manager. A tour of the premises was carried out and care records were inspected during the inspection process. The inspector also briefly spoke to a therapist and the housing officer of Outlook Care. What the service does well: 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. Grove Road (48) DS0000065858.V318544.R01.S.doc Version 5.2 Page 6 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Grove Road (48) DS0000065858.V318544.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 Grove Road (48) DS0000065858.V318544.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has not had an admission for a number of years; however, the service is able to meet service users assessed needs. Service users are provided with contract letters. EVIDENCE: The current five service users have been living in the home together for a number of years. Therefore, the home has not made any admission for more than ten years. However, Outlook Care has an admission policy, which was seen. The admission policy stated that a prospective service user’s needs assessment would be carried out prior to the admission. The home is currently accommodating five service users including two service users with visual impairments. Staff interviewed and daily records suggest that they were able to meet the assessed needs of service users. Care files suggest that staff sought specialist advice in order to meet service users complex needs. Service users have access to speech therapist, physiotherapist and Psychiatrist. Outlook Care developed and signed a written and costed contract/statement of terms and conditions between the home and service users. Care files examined confirmed that a pictorial version of contract also given to service users. Grove Road (48) DS0000065858.V318544.R01.S.doc Version 5.2 Page 9 Grove Road (48) DS0000065858.V318544.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. All service users have individual care plans, however, care plans must be reviewed on a six monthly basis and minutes of reviews must be available for inspection. Staff encourage service users to make choices and decisions about their lives with input from family and an advocate. EVIDENCE: Staff developed care plans for each service user known as ‘ person centred planning’. Care plans described how service users’ specialist needs would be met. Daily records showed how these needs were met. The home accommodated two service users with visual impairments. Adaptations and equipment for these two service users are provided. Following the requirement of the previous inspection report the home had applied for a variation to the CSCI for two service users out of category due to visual impairments. This variation was awarded as the home demonstrated that they are meeting these two service users current assessed needs. Grove Road (48) DS0000065858.V318544.R01.S.doc Version 5.2 Page 11 However, it was evident from the examination of care files and discussion with the management that the six monthly review meetings’ minutes were not available for inspection. Staff encourage service users to make decision about their lives. Staff encourage service users and their family members to attend service users monthly meetings. Staff consult service users family members in order to promote service users rights and choices. An advocate from North East London Advocacy (NELA) services is allocated who is advocating on behalf of service users. He visits the home at least once a month. Staff consult with the advocate for the promotion of service users rights and making decisions about their lives. The risk assessments were examined which were comprehensively written. This identified risk factors and a strategy is in place to reduce/eliminate risk factors. The risk assessment is reviewed as and when required. Two of the service users who have visual impairments have been living in the home for more than 15 years. Adaptations and equipment are provided to maximise their mobility and reduce risk factors. The home has a confidentiality policy and procedure in place. Staff and care files were kept locked in a cabinet in the office. Service users and their family members have access to service users files. Grove Road (48) DS0000065858.V318544.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13, 14,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A significant improvement has been made in order to develop structured daily activities for all service users. Service users maintain good links with friends and family members. Staff encourage freedom of movement for service users. Staff consult service users to develop weekly menus and involve them in weekly shopping. EVIDENCE: Since the last inspection (following the requirement of the previous inspection report) there is a significant improvement made to improve the day activities programmes for service users. Structured activity programmes are developed for all five-service users considering their high level of dependencies. A service user with visual impairment is encouraged to engage in art. This service user’s art were displayed in her room and in the communal area. Staff encourage service users to recognise various objects through ‘object of reference’. Grove Road (48) DS0000065858.V318544.R01.S.doc Version 5.2 Page 13 Service users have regular opportunities to make use of services and facilities in the local community. On the day of inspection, the inspector observed that three service users attended drama therapy in the morning and the other two service users attended in the afternoon sessions. The drama therapy lasted for two hours and a member of staff accompanied service users. Care files and activity programmes suggest that service users visit a local pub, cinemas and park. Service users are involved in weekly shopping. In the house, service users have opportunities to watch films, DVD and listening to music. All service users and staff at Grove Road are female. Therefore, staff support service users with nail painting and encourage expressing their sexualities. At the time of the inspection a therapist visited the home who conducted aromatherapy, head massages and foot spa. Service users have opportunities to meet their friends and family members in private in their bedrooms or in the office. One service user’s family visits her every Saturday. Other service users family visit them from time to time. The neighbours also visit the home for example, Christmas party and barbeque in the summer. All service users have freedom of movement in the house. Two service users who have visual impairments have been living in the home for more than 15 years and know their way to the bedroom, kitchen and lounge. Staff interact with service users with object of reference as four out of five service users are not able to communicate verbally. Staff encourage service users with carrying out house keeping tasks, for example, cleaning and tidying bedrooms. Staff develop weekly menus in consultation with service users. Service users individual likes and dislikes were taken into consideration. It was evident from the examination of the weekly menus that staff provide nutritious, varied and balanced diet. Staff involve service users with weekly shopping. It was observed that staff provide fresh fruit for service users. It was also observed that staff displayed the picture of the ‘today’s menu’ on the noticed board in the kitchen. Grove Road (48) DS0000065858.V318544.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff support service users with personal care and meeting health care needs due to their high dependency levels. Staff administer medications to service users and they were provided safe handling of medications training. EVIDENCE: All five service users have high dependency levels; therefore they require support with personal care. Same gender of care provided as all service users and staff of the home are female. Staff support service users with nail painting, maintaining personal hygiene, choosing clothes and hairstyle. Staff support all service user to meet their health care needs. Service users are accompanied to all medical appointments. Service users are accompanied to G.P. appointments. Service users also attend six monthly appointments to a consultant Psychiatrist. Staff maintain a record of all medical appointments in service users care files. Currently three service users are on prescribed medications. Care plans suggest that none of the service users would be able to self medicate. Therefore, staff administer all medication to service users. Medications are Grove Road (48) DS0000065858.V318544.R01.S.doc Version 5.2 Page 15 supplied in ‘ Nomad Cassettes’ (monitored dosage system) by a local chemist. Staff keep record of all medications administered. Medication Administration Record sheets were examined and found to be satisfactory. Staff attended safe handling of medication training on 31/3/06. Grove Road (48) DS0000065858.V318544.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an appropriate complaint policy and procedure in place. Staff were provided adult protection training and they have awareness of adult protection issues. EVIDENCE: Outlook Care has a clear and effective complaint policy and procedure. The home also has developed a pictorial version of complaint procedure which is appropriate to service users living in the home. The complaint procedure also included in the service users’ guide. The home also maintains a complaint folder. Since the last inspection neither the home nor the CSCI received any complaint. Outlook Care has an adult protection policy and procedure in place. Following the requirement of the previous inspection report, the home has provided refresher adult protection training. Staff interviewed confirmed that they have attended refresher training and they have awareness of the adult protection issues. The manager ensures that Regulation 37 notifications are sent to the CSCI without delay. Grove Road (48) DS0000065858.V318544.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,27 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is suitable for its stated purpose. The home was clean and free from offensive odour at the time of the inspection. The management and staff have improved the physical environment of the home and are working towards further development. EVIDENCE: Some significant improvement has been made to improve the environment since the last inspection. It was evident from the tour of the premises and discussion with the manager that the home has recently replaced service users beds and bedding. A number of plants were placed in the communal areas. The manager is working towards making this home more homely. The manager informed that complete decoration works would be carried out in December. At the time of the inspection the housing officer visited the home for this purpose. Overgrown garden’s hedges/plants were trimmed and garden fences were installed. Service users had a barbeque in the garden this summer. The premises are suitable for its stated purpose. The premises are safe, comfortable, and bright and provide sufficient and suitable light, heat and Grove Road (48) DS0000065858.V318544.R01.S.doc Version 5.2 Page 18 ventilation. Fittings, furnishing, adaptations and equipment are of a good quality and are domestic in nature. The premises are situated in a residential area of Walthamstow and have easy access to all community facilities including local shops, pub and public transport. The home provides single bedroom accommodation to all service users. Bedrooms were personalised with service users pictures, posters and paintings. Service users have adequate furniture in their bedrooms. One out of five bedrooms have an en-suite facility. The other four bedrooms have washbasin facilities. There are two toilets/bathrooms on the first floor and one toilet on the ground floor. A tour of the premises was carried out and the home was found cleaned, hygienic and free from offensive odour throughout. The washing machine has specific programming ability to meet disinfection standards. Grove Road (48) DS0000065858.V318544.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. More than 50 of care staff have completed NVQ level 2/3 training in care. Outlook Care provides staff training for its staff development. All staff are receiving regular supervision and they are supported by the management. However, all staff must receive infection control training. EVIDENCE: Two of the care staff have completed their NVQ level 2 qualifications in care and another three have completed their NVQ level 3 qualifications in care. Certificates of qualifications were available. The deputy manager is attending her NVQ level 4 training in health and social care. The senior support worker is also attending NVQ level 4 training. The home employs eight members of staff in addition to the manager. At the time of the inspector two members of staff were on duty in addition to the manager. One walking night staff is on duty at night. Outlook Care operates a thorough recruitment procedure based on equal opportunities and ensure the protection of service users. Two written references were available in the staff files. The management carried out all Grove Road (48) DS0000065858.V318544.R01.S.doc Version 5.2 Page 20 relevant checks including the Criminal Record Bureau (CRB) prior to the staff being appointed. The home has a training and development plan and training budget. All newly appointed staff received a structured induction and this is linked to the aims and objectives of the home stated in the statement of purpose. Since the last inspection the home has provided further training to its staff. Safe handling of medication was completed in March 2006 and adult protection training is provided. The home also provided a valuing people and continuous improvement of programmes training. However, it is required that all staff must attend infection control training as one service user is incontinent. Such training will enable all staff to prevent from potential risk of spreading infection. All staff receive a minimum of six one to one supervision sessions in a year. Records of supervision were available for inspection. Staff interviewed confirmed that they all are receiving regular supervision from the manager. Staff also receive annual appraisals, next appraisal are due in December 2006. This will be assessed at the next inspection. Grove Road (48) DS0000065858.V318544.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The management ensures staff and service users health and safety at all times. The manager is required to apply for her registration to the CSCI. Service users satisfaction questionnaires must be completed and results of the surveys must be published for all relevant parties. EVIDENCE: The acting manager has been in post since July 2006. She is a qualified nurse. For fourteen years prior to the taking up her current post she worked in another Outlook Care home. She had obtained her registration. The manager intends to take up this position permanently. The inspector advised her that she must apply for registration to the CSCI. The home’s quality programme involves service users and their relatives and seek their comments on the service delivery. However, there was no evidence that the home has conducted a service user survey. Therefore, the Grove Road (48) DS0000065858.V318544.R01.S.doc Version 5.2 Page 22 management must ensure that this is done and the results of the service users surveys are published and made available to all relevant parties. Outlook Care provides the Commission with a copy of the report of the regulation 26 visit each month. It was also evident from the examination of documents and discussion with the manager that the home has an internal audit system in place to monitor the quality of care. The management ensures staff and service users health, safety and welfare. Staff were provided training with manual handling, fire safety, first aid and food hygiene. Regular checks are carried out on gas and electric appliances. Staff carry out fire alarm tests on a weekly basis. A fire safety risk assessment of the premises is carried out. An annual health and safely audit action plan was completed on 12/09/06. The home has a valid insurance cover against loss or damage to the assets of the property. Grove Road (48) DS0000065858.V318544.R01.S.doc Version 5.2 Page 23 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 3 4 X 5 3 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 3 26 x 27 3 28 x 29 x 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 2 X X 3 X Grove Road (48) DS0000065858.V318544.R01.S.doc Version 5.2 Page 24 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 YA6 Regulation 15 Requirement Timescale for action 31/01/07 2. YA35 18 3. YA37 8&9 4. YA39 24 The manager must ensure that all service users six monthly reviews take place on time and the minutes of the review meetings are available for inspection. It is required that all staff must 31/01/07 attend infection control training in order to acquire knowledge to prevent the potential risk of spreading infection. The manager is required to apply 31/01/07 for her registration to the Commission for Social Care Inspection. The management must ensure 31/01/07 that service users satisfaction questionnaires are completed and the results of the surveys are published and made available to all relevant parties. Grove Road (48) DS0000065858.V318544.R01.S.doc Version 5.2 Page 25 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 Grove Road (48) DS0000065858.V318544.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection East London Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Grove Road (48) DS0000065858.V318544.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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