Inspection on 07/11/05 for Grove Road (48)

This inspection was carried out on 7th November 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 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) 10/11/06

Grove Road (48) 24/02/06

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 7th November 2005 10:00 Grove Road (48) DS0000065858.V262642.R02.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Grove Road (48) DS0000065858.V262642.R02.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Grove Road (48) DS0000065858.V262642.R02.S.doc Version 5.0 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 Ms Fiona Baines Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Grove Road (48) DS0000065858.V262642.R02.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26/1/05 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.V262642.R02.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was conducted on a weekend morning on 12/11/05. The inspector was able to interview two members of staff on duty and spoke to two service users. A tour of the premises took place and care records were inspected during the inspection process. 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. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Grove Road (48) DS0000065858.V262642.R02.S.doc Version 5.0 Page 6 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.V262642.R02.S.doc Version 5.0 Page 7 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): 2,3 and 5 Outlook Care ensures that a prospective service user’s assessment of needs is carried out prior to the admission. The home can demonstrate that service users assessed needs are met. All service users are provided with written and costed contracts. EVIDENCE: All five current service users living together since the home was opened in 1996. Therefore, the home has not made any new admission since. However, the inspector was advised that a prospective service user would be assessed by the manager of the home (or by a person who is competent to conduct assessment of needs) prior to the admission to the home. All current service users were referred through social services. Copies of old assessments were available in the files. From discussion with staff and examining care files it was clear that staff can demonstrate if any specific needs are identified, specialist services advice is sought, for example, speech therapy. All service users are non-verbal and staff are able to communicate with service users through ‘objects of reference’, which were developed with support from a speech therapist. Service users family members visits them and they advocates for them. Staff also provided information to family members how to access an independent advocate for their relatives. Grove Road (48) DS0000065858.V262642.R02.S.doc Version 5.0 Page 8 Outlook Care Ltd. developed and signed a written and costed contract/statement of terms and conditions between the home and service users. Following the recommendation of the previous inspection report, the manager has updated the contracts by including a description of the rooms to be occupied by individual service users in the home. Grove Road (48) DS0000065858.V262642.R02.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 All service users have care plans and these are reviewed on a six monthly basis. The home can demonstrate that service users choices are adequately met and risk is appropriately assessed and managed. EVIDENCE: Staff developed individual care plans for all service users. The care plans set out how current and anticipated specialist requirements would be met, for example, language development and communication for all service users. The home provided adaptations and equipment for two service users who have visual impairments. The management is required to apply to the Commission for the variation to their registration certificate for service users out of category due to visual impairments. Care plans were reviewed on a six monthly basis. Service users, family members and professionals attended review meetings and minutes were kept in the care files. Grove Road (48) DS0000065858.V262642.R02.S.doc Version 5.0 Page 10 Staff promote service users’ right to make decisions involving them; family members are invited to review meetings and service users meetings. Usually family members advocate for the service users. Staff respect service users’ wishes in relation to the time to go to bed and get up from bed. At the time of inspection it was observed that the time from getting up from bed and having breakfast was flexible. Risk assessments were examined which confirmed that staff take actions to minimise or eliminate risk factors inside and out side the home. Risk assessments were reviewed on a six monthly basis. Staff informed that they provide training to service users about their personal safety. Two of the service users who have visual impairments are able to move around the buildings and staff support them to do so. Staff seek advice from the specialist services for this purpose. Grove Road (48) DS0000065858.V262642.R02.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 The home provides opportunities for social activities in both home and in the community. However, the management is required to look into options for service users to engage in educational programmes or training as valued and fulfilling activities. EVIDENCE: Staff informed that finding employment is not a realistic option for the current service users. Staff provide in-house activities, for example, art therapy. A service user who has visual impairment enjoys painting works. Staff support service users for setting tables before meals and putting cutlery away after the meals. However, it is required that the management look into options for service users within their capacities, how they can be engaged in educational programmes or training as valued and fulfilling activities. Staff encourage service users to integrate into community life by visiting the local pub, café and shops. Staff support service users to maintain neighbourly relationship with neighbours and invite them to home’s parties. Grove Road (48) DS0000065858.V262642.R02.S.doc Version 5.0 Page 12 Service users receive visits from their family members and friends. One service user’s family member visits almost every Saturday. Service users have opportunities to meet their friends and family members in their bedrooms in private. Service users families, friends and neighbours always attend barbeque, which is held in the back garden in summer and Christmas party in the house. All service users of the home are females and the home provides same gender care. Female staff support service users with personal care, maintaining their personal appearances and grooming. Service users have freedom of movement both inside and outside the house. Staff do not enter service users’ bedrooms without knocking. Service users have opportunities to be alone or in company according to their wishes. It was observed that staff interact with service users by engaging various communication methods. Service users were offered bedroom keys, however, they choose not to use the keys. From the examination of weekly menu plan it was evident that staff provide nutritious, varied and balanced meals to service users. Staff support service users to choose menus and cook meals for them. It was observed that Saturday breakfast time was flexible and unrushed. Grove Road (48) DS0000065858.V262642.R02.S.doc Version 5.0 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 and 20 The home identifies health care needs of service users and these are met accordingly. Same gender of care provided by staff. EVIDENCE: Due to the high dependency levels of the service users at 48 Grove Road, they all require support with personal care. Personal care is provided by female members of staff as all service users are females. Staff interviewed informed that they provide personal care in private, which promotes service users dignity and privacy. The inspector observed that time for getting up and going to bed, bath, and meals were flexible. As stated before, due to service users high dependency levels they all require support and escort for visits to G.P. and other medical appointments. Care plans identified service users health needs and how those would be met. Members of staff informed that one service user require wheelchair during the visit into the community. It was evident from discussion with staff and examining care files that none of the service users are able to self medicate. Therefore, staff administer medications for three service users. Medications are supplied in’ Nomad Cassettes’ (monitored dosage system) by a local chemist. Records of all Grove Road (48) DS0000065858.V262642.R02.S.doc Version 5.0 Page 14 medication administered were checked and found to be satisfactory. Staff keep records of all medication received and disposed of to ensure that there is no mishandling. The organisation provides staff training on administering medication. Grove Road (48) DS0000065858.V262642.R02.S.doc Version 5.0 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 and 23 It is required that all staff to attend a refresher adult protection training to update their knowledge. The manager must ensure that Regulation 37 notifications are sent to the Commission without delay. EVIDENCE: The complaint procedure of Outlook Care is clear and effective and included stages of and time scale of the process. The home has developed pictorial information for service users describing how to make complaints. This has been included in the Service Users’ Guide. This information was made available for service users and all relevant parties. The organisation has an adult protection policy and procedure in place. The policy complies with the DHO guidance ‘ No Secrets’. Staff informed that they all attended adult protection training and were aware of the issues in order to protect service users from potential abuses. At the time of the inspection members of staff informed that a member of staff of the home is deployed to another home in September 2005, following an allegation of abuse. The organisation is internally investigating this now. However, the home failed to notify this to the Commission as required by Regulation 37. On 14/11/05, the inspector spoke to the acting manager of the home who informed that it was not an abuse allegation; it was an allegation of neglect. The inspector said to the manager that the neglect is also regard as an abuse. The inspector also advised to put all information in writing to the commission. Grove Road (48) DS0000065858.V262642.R02.S.doc Version 5.0 Page 16 The acting service manager of Outlook Care informed the Commission in writing that, the senior support worker had been temporarily deployed to another service pending an investigation that was initiated following a number of staff raising grievances. The head of Outlook Care learning disability services attended the service and nothing was found of major concern or that substantially affected the wellbeing of the service users. The service manager of Outlook Care will write to the Commission again when the investigation is concluded. To meet this standard in full, the manager must ensure that Regulation 37 notifications are sent to the commission without delay. All staff to attend a refresher adult protection training to update their knowledge in this area. Grove Road (48) DS0000065858.V262642.R02.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 The home is suitable for its stated purpose. The home was clean and free from offensive odour at the time of the inspection. EVIDENCE: The premises are suitable for its stated purpose. The premises are safe, comfortable, bright and provide sufficient and suitable light, heat and ventilation. Fittings, furnishing, adaptations and equipments are in good quality and are of domestic in nature. The premises are situated in a residential area of Walthamstow and has easy access to all community facilities including local shops, pub and public transport. The home is kept clean, hygienic and free from offensive odour throughout and a system in place to control the spread of infection. The washing machine has specific programming ability to meet disinfection standards. Grove Road (48) DS0000065858.V262642.R02.S.doc Version 5.0 Page 18 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, 35 and 36 The deployment and current number of staff was sufficient to meet service users current needs. The organisation provides training for staff development. Staff receive regular supervision. EVIDENCE: Staff have a wide range of qualifications, experience and life skills relevant to the aims and objectives of the service. Staff use age-appropriate communication, in simple language. Staff training records included evidence of training in the needs of people with learning disabilities and induction training; food hygiene; health and safety; first aid and medication administration. Staff informed that the management is working towards meeting the target of 50 care staff to achieve a minimum of NVQ level 2 by 2005. A wide range of training has been taking place, some of which is arranged inhouse, using skills of staff team and others in the community. A staff-training schedule for the year was available. The home has a training and development plan and dedicated budget. Staff received equal opportunities training; the training and development is linked to the aims and objectives of the home. Staff advised the inspector that there are regular opportunities for informal and formal supervision. The manager ensures that all staff receive regular supervision at least six times a year. All staff receive annual appraisal against their job description and plan/agreed career development. Grove Road (48) DS0000065858.V262642.R02.S.doc Version 5.0 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 and 42 There is an effective system in place to monitor the quality of the service. The home ensures staff and service users health, safety and welfare at all times. EVIDENCE: The acting manager was not available during the unannounced inspection as he was off duty. The acting home manager is a qualified enrolled nurse and has several years of management experience. Previously he managed another home for people with learning disabilities with the same organisation. He has applied for his registration to the Commission and the application is in process. The outcome of the fit person’s interview with the Commission would be notified in due course. The Statement of Purpose stated that within the home, there are various systems, which ensure that close monitoring is maintained on all of the home’s services and procedures. The home’s quality programme involves service users and their relatives and seek their comments on the service delivery. Grove Road (48) DS0000065858.V262642.R02.S.doc Version 5.0 Page 20 Outlook Care provides the Commission with a copy of the report of the Regulation 26 visit each month. The manager ensures staff and service users health, safety and welfare. Staff were provided training with manual handling, fire safety, first aid, food hygiene and infection control. Regular checks are carried out on gas and electric appliances. Staff carry out fire alarm tests on a weekly basis. The home has a valid insurance cover against loss or damage to the assets of the property. Staff informed that following the recommendation of the previous inspection report; the manager has completed a fire safety risk assessment of the premises. However, at the time of the inspection staff were not able to locate this for inspection. On 14/11/05 the acting manager informed the inspector that he has completed the fire risk assessment of the premises. The inspector informed the manager that as this was not available during the inspection, this would be examined at the next inspection. Grove Road (48) DS0000065858.V262642.R02.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 x 3 Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 LIFESTYLES Standard No Score 11 x 12 2 13 3 14 x 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x 3 x x 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 ΠΕΡΣΟΝΑΛ AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Grove Road (48) Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 2 x DS0000065858.V262642.R02.S.doc Version 5.0 Page 22 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA12 Regulation 4 & 12 Requirement It is required that the service to look into options how to engage service users in educational programmes or trainings as valued and fulfilling activities. The manager must ensure that Regulation 37 notifications are sent to the Commission without delay. The management to provide staff training on adult protection. The management must ensure that fire risk assessment of the premises is available for inspection. The management is required to apply to the Commission for the variation to their certificate for service users out of category due to visual impairments. Timescale for action 31/03/06 2 YA23 37 31/12/05 3 4 YA23 YA42 18 23 31/03/06 31/12/05 5 YA6 14 31/12/05 Grove Road (48) DS0000065858.V262642.R02.S.doc Version 5.0 Page 23 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.V262642.R02.S.doc Version 5.0 Page 24 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford London E15 4BQ 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. 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