Inspection on 29/08/07 for Grove Road (48)

This inspection was carried out on 29th August 2007.

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

Grove Road (48) 10/11/06

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 Julie Legg Unannounced Inspection 29th August- 3 September 2007 10:00 rd Grove Road (48) DS0000065858.V349368.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.V349368.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.V349368.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) evelynm@outlookcare.org.uk Outlook Care Vacant post Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Grove Road (48) DS0000065858.V349368.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 10th November 2006 Date of last inspection Brief Description of the Service: 48 Grove Road is a care home that is operated by Outlook Care and is registered for five people with a learning disability. The home is situated in a residential area of Walthamstow and is undistinguishable from other houses in the road. The home is close to numerous bus routes and the railway station Walthamstow Central is within walking distance. Shops, restaurants, pubs, park and other community resources are also nearby. The home has five single bedrooms; one of these is on the ground floor and has an ensuite shower and toilet. The other four bedrooms are on the first floor and have their own washing facilities. There is a separate lounge and dining room, a kitchen, toilets on both floors and an upstairs bathroom and at the back of the house there is a sensory garden. The home’s Statement of Purpose is made available to service users on request and a copy is kept in the office. Every service user/relative has been given a copy of the home’s Service User Guide. The fees for the home are £1035.11 a week, this does not include hairdressing, toiletries, holiday spending money or any other sundries. This information was given by Evelyn Madrid (manager) on 29th August 2007. Grove Road (48) DS0000065858.V349368.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a day. The manager was present for the duration of the inspection and was available for feedback at the end of the inspection. Discussion took place with the acting manager and care staff. Care staff were asked about the care that service users receive and were also observed carrying out their duties. The inspector spoke to relatives and health care professionals to ask for their opinions on the care provided at Grove Road. Social care professionals and the advocacy service was also contacted, neither of these services responded. A tour of the home was undertaken and all of the rooms were seen to be clean and free from any offensive odour. Service users’ files were case tracked; including risk assessments and care plans, together with the examination of staff files and other home records. These included medication records, staff rotas, menus, and accident/incident records and staff recruitment procedures. Additional information relevant to this inspection has been gained from the Annual Quality Assurance Assessment, Regulation 37 notifications and Regulation 26 reports. The inspector had a discussion on the broad spectrum of equality & diversity issues and the manager was able to demonstrate a good understanding of the varied needs around religion, sexuality, culture, disability and gender. The inspector had a discussion with the manager as to how the people living in the home wished to be referred to in this report. The manager stated that the home and the organisation use the term ‘service user’. This is reflected accordingly throughout this report. The inspector would like to thank the service users, the manager and staff for their input during this inspection. What the service does well: It was evident that the manager and staff are operating the home for the benefit of the service users. The home has very good staff retention and this reflects in the care being provided, as the staff are very aware of the service users and their needs. The manager and the staff are working with the service users to enable them to retain a level of independence and to exercise choice and control over their lives. Some of the service users require a high level of support in meeting some of their needs and every effort has been made in ensuring that their needs are being met by working closely with the psychiatrist and physiotherapist. Grove Road (48) DS0000065858.V349368.R01.S.doc Version 5.2 Page 6 The home has an experienced manager who is setting standards for the home. She has met all of the requirements of the previous inspection and has further plans for the home that will further enrich the lives of the service users living at Grove Road. Relatives that were spoken to were very complimentary of Grove Road, “I wouldn’t want my daughter to live any where else”, “They all do a marvellous job”, “My daughter is so happy, she is well looked after”. What has improved since the last inspection? What they could do better: Care plans were examined alongside the daily records and compared with the support being given. Most of the daily records were informatative, however there was one entry where it was recorded that a service user had an appointment for a blood test but it was not noted whether or not this took place. All daily records need to reflect the well being of the service users. Service users are accessing some leisure activities within the community but these need to be more varied and suitable to individual needs. Grove Road (48) DS0000065858.V349368.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Grove Road (48) DS0000065858.V349368.R01.S.doc Version 5.2 Page 8 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.V349368.R01.S.doc Version 5.2 Page 9 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): 1,2 and3 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Prospective service users and their relatives have the information they need to be able to make an informed choice about moving into the home. The assessment of needs and other information received from health and social care professionals means that staff have detailed information to enable them to determine whether or not they can meet the needs of prospective service users. Prospective service users know that the home can meet their needs. EVIDENCE: The Statement of Purpose and the Service User Guide have been produced in a format that is easy to read and the Service User Guide is in a pictorial format. The Statement of Purpose has also been amended and now has details of the present acting manager and the home’s staffing levels. This information enables prospective service users and relatives to know what the home is like and what services they can offer. Grove Road (48) DS0000065858.V349368.R01.S.doc Version 5.2 Page 10 The current five service users have been living together at Grove Road for a number of years. Therefore the home has not had any admissions for more than ten years. Outlook Care has a comprehensive admission policy and procedure. The admission policy states that all prospective service users’ needs would be assessed prior to them moving into the home. The manager stated that all prospective service users would be appropriately assessed prior to admission and that information would also be gathered from health and social care professionals as well as relatives and other significent people. The admission process would be designed around the needs of the prospective service user. The prospective service user may make several visits to the home and possibly overnight and weekend stays. This would enable the prospective service user to meet the other service users and to see whether liked the home. This transition period would also allow staff to get to know the prospective service user and to know whether they can meet their needs. Grove Road (48) DS0000065858.V349368.R01.S.doc Version 5.2 Page 11 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 and 9 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. All of the service users’ identified needs are reflected in up to date care plans and risk assessments. However one of the daily recordings did not reflect whether an appointment had taken place, failure to demonstrate this could have an impact on the service users’ needs not being appropriately met. The service users, with assistance are able to participate in all aspects of life in the home and to make decisions about their lives. EVIDENCE: The manager and staff have ensured that the service users are involved in all decisions about their lives. There is a care planning system in place that is clear and concise. Each service user has an individual person centred plan and this information is also provided in pictorial format. These care plans were Grove Road (48) DS0000065858.V349368.R01.S.doc Version 5.2 Page 12 completed with the involvement of the service user and their relatives (if appropriate). These comprehensive documents cover areas of the service users’ lives, such as, things that I am good at, special people in my life, how I communicate, things I need help with, likes and dislikes, places that I like to go to and things I like to be reminded of. One service user does not like two staff in her room at the same time, she does not like her nails cut and prefers a shower to a bath. Whilst verbal communication is limited, the staff have spent some considerable time in learning about the different ways the service users communicate either through noises, body language and facial expressions. One of the service users will bend her left knee and put her arm around herself when she is happy and when she is unhappy she will point to you and scream. Two of the service users have a visual impairment and one of the service users has a talking photo album, this shows photographs of activities that the service user enjoys and there is a narrative explanation as well; this explains what support the service user requires to undertake these activities. Service users’ files indicated that person centred plans and service user profiles have all been regularly reviewed and updated. Care plans were examined alongside the daily records and compared with the support being given. The care staff know the service users extremely well and give a verbal and written handover. Each service user has their own daily log sheet, which is completed by the care staff. The majority of these daily logs were of a good standard; however on one entry it was recorded that a service user had an appointment for a blood test but it was not noted whether or not this took place. All daily records need to reflect the well being of the service users. This is Requirement 1. All of the service users are in regular meetings with the manager and their key workers. Relatives and an advocate from North East London Advocacy (NELA) service who visits once a month are involved with the service users and assist them in decision making within the home, such as, the recent redecoration of their bedrooms and implementation of a service user survey. Most of the service users, to varying degrees are able to participate in activities within and outside of the home. They assist with making cups of tea, menu planning, shopping trips, laying the tables, dusting and taking their laundry basket to the laundry room. Other records seen by the inspector showed service users’ choice of meals and whether or not they participated in activities within the home and the community. Staff were observed interacting with the service users, their relationship was easy going and friendly but in a professional manner. Staff were seen to ask service users what they wanted and gave the service users ample time to express their wishes. Staff also advised service users of what they were going to do such as, “Let me help you to the table, is that ok?” and the appropriate assistance was given. Grove Road (48) DS0000065858.V349368.R01.S.doc Version 5.2 Page 13 Service users are encouraged to take reasonable risks and there were detailed risk assessments, guidelines and protocols in place. These cover areas, such as, assisting with a shower, managing a service user’s liking for plastic bags, self dressing, having a key to their bedroom, using public transport, cutting nails and making a cup of tea. There was evidence that these risk assessments have been regularly reviewed or when a change in a risk has been identified. These risk assessments have been forwarded to the service users’ care plans. Grove Road (48) DS0000065858.V349368.R01.S.doc Version 5.2 Page 14 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 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Service users have the opportunity for personal development within the home and access to day services but more community-based activities need to be developed. Service users have appropriate personal and family relationships. Their rights are respected and they are supported to take responsibility for their actions. Service users are offered and encouraged to eat a healthy diet. EVIDENCE: The inspector spoke to the manager; staff and relatives as well as looking at service users’ care plans. Service users’ care plans identify lifestyle choice, such as leisure activities, activities within the home, day service and family Grove Road (48) DS0000065858.V349368.R01.S.doc Version 5.2 Page 15 contact. Daily logs record whether these activities have taken place. All of the service users have opportunities for some personal development within the home and in the community, however activities in the community could be more varied taking into account the service users’ preferences and interests. This is an area that has been identified by the manager, who is currently seeking the views of the service users. Some relatives commented on ‘a lack of activities’ especially in the wider community. This is Requirement 2 Activities within the home are; story reading, sensory bath, hand and body massage, jigsaws, puzzles, foot spa, musical evenings and watching television. Birthdays are celebrated by a buffet tea and birthday cake. The sensory garden and painting are particular favourites with most of the service users particularly with the service users who have a visual impairment. Her artwork is displayed in her bedroom and in the hallway of the home. Birthdays are celebrated with a party and birthday cake, which relatives and friends are invited to. The home has recently had a garden party; which was very well supported by the relatives and was a great success. Barbeques are a regular feature in the summer and other activities with the other local Outlook Care homes also take place. There has been two themed evenings an ‘Abba’ night and an ‘African’ night were service users and staff were dressed in traditional costumes and danced to traditional music. The photographs that were seen by the inspector showed that all had a good time. Some of the service users attend day services were they participate in art, music and drama; other activities that take place include visits to the park, cinema, and eating out in restaurants and pubs. The service users also enjoy shopping with their key worker for their own toiletries and clothes. All of the service users are going on holiday; some are going the Isle of Wight, one service user is going to Spain and the manager is looking at the feasibility of one service user visiting her parents whilst they are on an extended holiday to Italy (country of origin). As stated earlier in the report, some of the service users are able to participate in activities within the home, assisting with tasks such as, taking the laundry basket to the laundry room, assisting with making a cup of tea, setting the table for meals and dusting. All of the service users receive visitors; some more regularly than others and one of the service users goes home to her family. Service users can see their relatives in the lounge, the dining room, the garden or the privacy of their bedrooms and there are no restrictions on visiting times. Relatives stated, “We are always made to feel welcome, we are offered tea/coffee” and “we feel like part of one big family”. There are no set ‘house rules’ and residents were observed to move around the home freely. At the time of the inspection service users were taking part in various activities; listening to music, drawing, talking to staff and one of the service users with a visual impairment was completing a ‘touch’ puzzle with a member of staff. At Grove Road (48) DS0000065858.V349368.R01.S.doc Version 5.2 Page 16 lunchtime some of the service users went to a party at another Outlook Care home. The inspector examined the menus, which are also in pictorial format. The manager confirmed that the service users had been involved with the choosing of the meals. The meals for the day are placed on a white board and the service users are able to point to what they want, the manager advised the inspector that something different would be cooked if it was not to the service user’s liking and this is recorded on the menu sheets. On the day of the inspection the main meal was shepherds pie and fresh vegetables. Service users’ care plans also state food likes and dislikes such as, ‘I like cornflakes, sandwiches and any kind of drinks, and I do not like spaghetti, salad, porridge or soup’. Service users medical dietary needs are catered, such as, one service user has high cholesterol and yoghurts and other cholesterol reducing foods are available. Fresh fruit, fruit juices and vegetables are also available on a daily basis. Takeaway meals are bought in moderation and the favourite seemed to be fish and chips. One relative stated, “Sometimes I visit straight from work and very often they are cooking the evening meal, it smells lovely and Y always enjoys her food”. Grove Road (48) DS0000065858.V349368.R01.S.doc Version 5.2 Page 17 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 and20 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Service users receive personal care support in the way they prefer and their physical and emotional needs are met. None of the service users are able to administer their own medication. There are policies and procedures in place to ensure that staff administer medication safely. EVIDENCE: Care plans were examined and discussed with the manager. The care plans identify health and personal care needs and there are clear guidelines on how staff should support service users. All of the service users require assistance with their personal care, though they are encouraged to participate wherever possible. Same gender care is provided as the service users and staff are female. One relative stated, “ I’m very happy with the care she is getting”. Care plans are specific to the service user and one care plan states, Grove Road (48) DS0000065858.V349368.R01.S.doc Version 5.2 Page 18 ‘I do not like my nails being cut’. Service users are able to have a bath at a time of their choosing, some like to have a bath in the evening with aromatherapy candles and others prefer to bathe in the mornings, some have a bath at night and a shower in the morning. Staff had very clear views on each service users’ style of dress and their preferences and some of the service users are able to choose by pointing to what clothes they want to wear. Service users were seen to be dressed in clothes that were appropriate for the time of year and which suited their personalities; one service user was wearing jogging bottoms and a tee-shirt, another service user was wearing trousers and a blouse. All of the service users had hairstyles that were in keeping with the current fashion, one service user had her hair tinted and some had their nails varnished. One relative stated, “She always looks nicely dressed”. Records that were inspected showed that all service users have personal health records and health action plans. All of the service users are supported to access dentist, breast screening, opticians, chiropody, psychiatrist, physiotherapy (if appropriate), community nurse and any GP or hospital outpatient appointments. All of the service users are weighed regularly and any significent weight loss or gain is addressed through the GP. The community nurse has been supporting the staff in dressing a service user’s wound and the physiotherapist from the Community Learning Disability team has also been working with the staff and this service user, to ensure that their safety is not being compromised. On the day of the inspection one of the service users had a health appointment and her key worker had come in on her day off to accompany her. One health professional stated, “The staff are very professional, they liaise closely with me and have carried out my instructions”. Staff have also been working with some of the service users in improving their continence. One relative stated “They are really on the ball and if they think X is not well, they notify me and take her to the doctors”. There are policies and procedures for the handling, administration and recording of medication within the home. Staff have received medication training and the manager carries out weekly audits; this ensures that service users receive the appropriate medication. The inspector also checked Medication Administration Record (MAR) charts and the medication cupboard. There were no gaps noted on the MAR charts and appropriate records in relation to medication received by the home and disposed of were also found to be in order. Grove Road (48) DS0000065858.V349368.R01.S.doc Version 5.2 Page 19 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 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The service users’ views are listened to and acted upon. Service users are protected by the policies and procedures and the monitoring systems within the home. EVIDENCE: The home has a clear complaints procedure, which is available in easy to read language and pictorial format. A copy of the procedure has been made available to all of the service users and relatives. The complaints procedure is also included in the Service User Guide. The home maintains a complaints book and since the last inspection neither the home nor the Commission have received any complaints. The inspector is satisfied that any complaints would be dealt with appropriately. The manager welcomes complaints and suggestions about the service. In discussions with the relatives, it was obvious that they were aware of the complaints procedure and would have no hesitation in making a complaint if necessary. All of the relatives that were spoken to stated that they were very happy with the service and felt that “the staff were doing a really good job”. One relative stated, “If I had a problem I would go and tell Evelyn (manager)”. All of the service users’ communication is conveyed through gestures and noises. In the care plans, the section on ‘How I communicate’ clearly details Grove Road (48) DS0000065858.V349368.R01.S.doc Version 5.2 Page 20 how each service user indicates their needs, likes and dislikes. This assists staff in ensuring that service users are happy with the care being provided. Staff that were spoken to were clear in that each service user had their own way of communicating, they all spoke about getting to know the service user really well and giving them time to convey how they are feeling and what they wanted. During the inspection the service users appeared to be calm, relaxed, smiling and laughing, nobody appeared distressed or agitated. An advocate regularly visits the home and their service users’ and relatives meetings where suggestions, concerns and complaints can be discussed. Service users are encouraged to participate in decision making on issues and events within the home; colour schemes for the bedrooms were decided on through staff knowledge of service users likes and dislikes and if service users indicate that they enjoy an activity, then they are organised again, likewise if an activity is not enjoyed an alternative would be found. Menu planning again was through the staff’s knowledge and service users indicating whether they enjoyed a meal or not. The home has policies and procedures for the safekeeping and expenditure of service users’ money. The finance department of the organisation monitors service users’ money, which is held in safekeeping by the home. Service users are given support to make purchases and receipts are kept for all expenditures and records of money held. Every service users’ money is checked at the handover of each shift; this ensures that any discrepancies are dealt with promptly. The responsible individual when carrying out the Regulation 26 visits will also monitor service users finances. The home has comprehensive ‘Safeguarding Adults’ policies and procedures; these include the local authority (London Borough of Waltham Forest) policy and procedure. There was signed evidence that these documents have been read by the staff. The manager was clear in that incidents needed to be referred to the Local Authority as part of the local safeguarding procedures. Staff members that were spoken to were very clear on what constituted abuse and their responsibility in reporting any potential or actual abuse. Staff files indicated that all members of staff have attended safeguarding adults’ training and this subject has been dealt with through individual supervisions and staff meetings. Grove Road (48) DS0000065858.V349368.R01.S.doc Version 5.2 Page 21 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): 24,25,26,27,28 and 30 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The home is very homely and provides the service users with a comfortable and safe environment. The standard of cleanliness was high and the home was free from any offensive odour. Service users’ bedrooms suit their needs and are decorated and furnished in a way that suits their lifestyles. The communal rooms and the garden complement and supplement the service users’ individual rooms. EVIDENCE: The home is in keeping with other properties in the road, it is a terraced Victorian style property. A tour of the home was undertaken including the service users’ bedrooms. The home is furnished in a homely and comfortable fashion and the entire home was very clean, tidy and free from any offensive odour. There was an abundance of plants in the lounge, dining room and the hallway; pictures and service users’ paintings were also displayed on the walls, which gave Grove Road a real feeling of ‘home’. On the ground floor of the Grove Road (48) DS0000065858.V349368.R01.S.doc Version 5.2 Page 22 home there is a separate lounge and dining room, both of these rooms have been redecorated. The dining room has been refurbished with a new dining room suite and curtains and new curtains for the lounge have been ordered. The kitchen has been redecorated and in the past year new carpets have been fitted through out the home. Toilets and bathroom were very clean and a new extractor fan has recently been fitted in the bathroom. One of the bedrooms is on the ground floor and this has an en-suite shower/toilet, the other four bedrooms are on the first floor and they all have washing facilities. One of the service users has a television in her bedroom and all of the service users have CD players. All of the bedrooms have been redecorated in very individual colour schemes; one of the service users likes the colour red and this has been introduced on the walls and soft furnishings, another service users likes the colour pink and this has been introduced in the curtains and bed cover. Service users’ interests were also apparent, with their own paintings on the wall, vases of silk flowers, family and holiday photographs as well as televisions and CD players. All of the service users have new beds and bedding, some have had new curtains and new chest of drawers and bedside tables have been ordered. One relative stated, “her bedroom looks lovely, the staff have made a real effort”. The garden is maintained and is accessible to all of the service users. The garden is a sensory garden, which is particularly beneficial to the service users with sight impairment. On the day of the inspection the service users were sitting out in the garden under a gazebo doing puzzles and colouring. There is also a barbeque, which is used during the summer months. As stated earlier the home was very clean and tidy and appeared to be well maintained. The home has a robust infection control policy, staff have attended infection control training and advice would be sought from external specialist if and when required. The manager and staff have made a great effort to ensure that the home does indeed feel like home. A score of 4 has been given in recognition of the work carried out by the manager and staff in ensuring that the physical environment of the home provides a homely and comfortable and safe environment for all of the service users. Grove Road (48) DS0000065858.V349368.R01.S.doc Version 5.2 Page 23 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 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Qualified and competent staff support the service users. Staffing levels are satisfactory and there is sufficient staff on duty. The staff have the skills and training to ensure that they are able to meet the individual needs of the service users. Staff are being regularly supervised and annual appraisals have taken place. EVIDENCE: The manager confirmed that the home is fully staffed and that bank/agency staff are only used to cover emergencies, sickness and annual leave. The agency/bank staff are known to the service users and therefore are able to offer continuity of care. Duty rotas were inspected and they correlated with the staff members on duty and on the day of the inspection there were sufficient staff on duty to meet the needs of the service users (the acting manager and two support workers). During the day there are at least two support workers (depending on the needs of the service users) and one waking night staff. The home employs a Grove Road (48) DS0000065858.V349368.R01.S.doc Version 5.2 Page 24 manager, a senior support worker and seven support workers. There is good staff retention and sickness levels are satisfactory. Outlook Care has thorough recruitment policies and procedures. Staff files are kept at the home and the inspector was able to examine three of the staff files. These files showed robust recruitment procedures had taken place; a completed application form, two written references, copies of qualifications, driving licence and a current Criminal Records Bureau (CRB) check. Staff that were spoken to confirmed that they had a face-to-face interview and that references and checks had been carried out prior to them commencing work at the home. There was also evidence on files that all new members of staff undertook an induction programme and were subject to a satisfactory probation period. Equality and Diversity is monitored through the recruitment and selection procedure. The majority of the staff are from diverse cultures and backgrounds, which are different from the people living in the home. However, staff have undertaken training in ‘valuing people’ and this ensures that the cultural, spiritual and other diverse needs of the service users are understood and met. There was evidence on staff files that an induction programme has been undertaken as well as Food & Hygiene, fire training, manual handling, first aid, administration of medication, infection control and safeguarding adults. Only one member of staff has not attained her NVQ, however she is commencing her training in September. Staff files indicate that staff are receiving supervision in line with the National Minimum Standards, which states ‘at least six times a year’. There was also written evidence that staff have received annual appraisals and that staff meetings are held regularly and well attended. Staff that were spoken confirmed that supervision and staff meetings were taking place and that as well as formal supervision, the manager had an open door policy and that they could go to her at anytime. Staff spoke highly of Evelyn (manager) and comments were “she is a very good manager, she keeps the home all together”, “I feel valued, she is very fair and there is good team work”. Relatives that were spoken to were also complimentary of the staff stating, “nothing is too much trouble” and “they are all really caring”, “Her key worker is brilliant, she really responds to her” Grove Road (48) DS0000065858.V349368.R01.S.doc Version 5.2 Page 25 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): 37,38,39 and 42 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The home is managed by a qualified and experienced manager who also has sound management practices, this means that service users’ health, safety and welfare are promoted and protected. Service users can be confident that their views underpin the self -monitoring, review and development of the home. Grove Road (48) DS0000065858.V349368.R01.S.doc Version 5.2 Page 26 EVIDENCE: The manager has applied to the Commission to become the registered manager of Grove Road. Prior to her current post she was a registered manager for a number of years in another Outlook Care establishment. She is committed to providing and improving the quality of care at the home, to achieve this she works closely with health professionals, advocacy service and the Commission. The manager holds her NVQ4 in Management and though she is a qualified nurse, she has let her registration lapse, however she will be undertaking her NVQ4 in Care in September. She has responsibility for the financial budget of the home and is aware of her budgetary limitations. In previous discussions with the service manager and discussions with the manager it is clear that the home has effective and regular support from the organisation and there are clear lines of accountability. Discussions with the manager showed she was able to describe a clear vision of the home based on the organisation values. It was evident that she was able to communicate a clear sense of direction and demonstrated a sound understanding and application of good practices particularly in relation to continuous improvement of the service. The manager has covered all of the shifts within the home and this is supported by regular supervision of all the staff and other quality monitoring systems, such as, service users’ meetings and feedback from the advocate. The manager in conjunction with the advocate, staff and service users are looking at a service user survey that is appropriate for the people who live in the home. Grove Road service users also take an active role in Waltham Forest Learning Disability Forum. Informal meetings with the relatives have taken place and formal meetings are commencing and will take place every three months. Questionnaires from relatives showed that all were satisfied with the service being provided at Grove Road. A relative had commented, “I am very happy with the care Z gets and I can sleep at night knowing she is well looked after”. Regulation 26 visits are regularly undertaken by the responsible individual to monitor and report on the quality of the service. Copies of these reports are available to the Commission. During the course of the inspection the manager was observed leading from the front, by directly engaging with service users and staff. There was also a high level of praise from relatives and staff and it was evident from her interaction with the service users that they enjoyed her company. One relative stated, “Evelyn is lovely, she has really improved the home”, another relative stated, “She is a superb manager”. A member of staff stated, “she is an excellent manager, she is always there for us”. All of the staff that was spoken to spoke very highly of the manager and how well they felt supported by her. There was evidence that staff receive regular supervision, annual appraisals, regular staff meetings and direct observation of their care practices. Grove Road (48) DS0000065858.V349368.R01.S.doc Version 5.2 Page 27 The manager was able to demonstrate her knowledge and commitment to equality and diversity issues, which are given priority in caring for the service users. It was also evident that the manager followed the policies and procedures of the organisation. As previously stated, in the main record keeping is of a high standard, with records being kept securely in accordance with the Data Protection Act. All of the working practices are safe, within a risk management framework. The manager proactively monitors the home’s Health & Safety performance and consults other experts and specialist agencies when necessary. Risk assessments were in place for fire, first aid, infection control and moving and handling. Fridge and freezer temperatures are taken and recorded daily and food that was stored in the fridge and freezer was covered and dated. Fire drills are taking place regularly and it is recorded as to where the ‘fire’ had started and how long it took to evacuate the building. Fire extinguishers received their annual check in February 2007; the fire officer visited June 2007 and the automatic door closures were tested in August 2007. The annual Gas safety certificate is dated February 2007; the five-year Electrical safety certificate is dated February 2004 and the Portable Appliance Testing was carried out April 2007. The annual Health and Safety audit took place in September 2006 and the environmental risk assessment was undertaken in October 2006. At the time of the inspection there were no issues relating to Health & Safety, which means the service users at safety is assured. Grove Road (48) DS0000065858.V349368.R01.S.doc Version 5.2 Page 28 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 3 2 3 3 3 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 4 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 X LIFESTYLES Standard No Score 11 X 12 2 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 3 3 3 X X 3 X Grove Road (48) DS0000065858.V349368.R01.S.doc Version 5.2 Page 29 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 17(1)(a) Requirement The registered person must ensure that all daily records are fully completed; this will ensure that service users’ well-being is recorded. The registered person must ensure that all of the service users are offered more varied and person centred activities in the wider community. Timescale for action 30/11/07 2. YA12 16(2)(m) 30/11/07 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.V349368.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Ilford 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.V349368.R01.S.doc Version 5.2 Page 31 - 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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