Inspecting for better lives Random inspection report
Care homes for adults (18-65 years)
Name: Address: H.C.S. (Enfield) Ltd (Southbury Road) 20-24 Southbury Road Enfield Middlesex EN1 1SA The quality rating for this care home is: The rating was made on: one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Jane Ray Date: 1 8 1 1 2 0 0 8 Information about the care home
Name of care home: Address: H.C.S. (Enfield) Ltd (Southbury Road) 20-24 Southbury Road Enfield Middlesex EN1 1SA 02083646923 Telephone number: Fax number: Email address: Provider web address: southburyroad2024@btconnect.com Name of registered provider(s): Type of registration: Number of places registered: H.C.S.(Enfield) Ltd care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability 11 Over 65 1 Conditions of registration: Five specific service users who are currently resident in the home and are over 65 years of age may remain accommodated in the home. This condition must be reviewed at such times as any of the specified service users vacate the home. Date of last inspection Brief description of the care home Southbury Road is a care home managed by HCS (Enfield) Ltd and the registered provider is Mr Crausaz. The service is registered to provide 12 places to younger adults with a learning disability. The home was originally established to provide support to older people with a learning disability but over the years the service has been extended to younger adults with a learning disability and high physical care needs. The home currently has 6 residents who are over the age of 65. The home consists of a group of terraced houses, which were combined into one dwelling. Each resident has a large single bedroom. The home has a lift to the first floor. The people with higher physical care needs have bedrooms on the ground floor. There is one assisted bathroom on the ground floor. There are two dining areas. People can either eat at a Care Homes for Adults (18-65 years)
Page 2 of 10 table in the large kitchen area or alternatively in a small separate dining area, where a few of the more independent residents choose to eat. There are two lounges on the ground floor. Most of the residents also have a TV and a music system in their own rooms. There is a conservatory at the rear of the house, which acts as a sitting area and as a smoking area. There is a very pleasant garden with some sensory features. Staffing consists of a manager, deputy and team of care staff working on a morning and afternoon shift. The night shift is covered by two waking night staff. The home also has a domestic and cook who work on weekdays. The weekly fees of the home range between 883.00 and 1380.00 pounds. The level of the fees depends on the support and services provided. Care Homes for Adults (18-65 years) Page 3 of 10 What we found:
We spoke to the manager who was working at the time of the inspection. She explained that there are still 10 residents living in the home and there have been no changes since the last key inspection. We looked at the case notes for three of the residents. Since the last inspection the manager has introduced person centred care plans in the home. These have been prepared with the residents and their key worker. The person centred plans include individual goals. The residents have all had a review meeting with their social service care manager and a record of these meetings is available in their case notes. Risk assessments were also available for each resident and these had been amended to reflect pressure care where this was needed for two of the residents. It was evident from reading the person centred plans that the key workers need to become more involved in reviewing and updating the care plans as needed with the residents. The three residents whose case noted were seen all had contracts in place between themselves and the home. One had not been signed by the home manager and the resident or their representative. It was observed from looking at the case notes that some of the information was now out of date and would benefit from being archived. Since the previous inspection staff have been helping residents to monitor their weight on a monthly basis. This is not possible for residents who cannot stand, as the equipment is not available in the home. It is recommended that the home looks into purchasing weighing scales that work with a hoist. The records show that some of the residents had significantly increased their weight and this needs to be investigated further and action taken to address this issue if needed. The personal monies for three residents were inspected. The manager explained that all the residents now have their personal finances managed by social services or their relatives. The residents all had a record of their expenditure and current receipts available. The manager talked about how she would like to enable some residents to look after some of their own cash in their rooms. The record of medication administration was seen. This now includes a list of all the staff who have been trained to administer medication and their signatures. It is also recommended that the signatures as they appear on the medication administration records are recorded so that the appropriate staff can be identified if there are any queries. The manager explained that there have been no further issues of residents making allegations of possible abuse. The allegation that was discussed at the previous inspection had been referred appropriately to social services. Since the last inspection the lounge and kitchen area have been decorated. The manager also explained that the conservatory was being replaced in the New Year. The maintenance record book was also observed and this shows that ongoing maintenance is taking place in the home. Since the key inspection four new permanent care staff have started working in the Care Homes for Adults (18-65 years) Page 4 of 10 home. Their recruitment records were inspected and they had completed the necessary recruitment checks to safeguard the residents including a photo ID. They had not yet received a contract of employment, as they had not completed their probationary period. The manager explained that the deputy post had been advertised but an interview date not arranged. It is recommended that this post is filled. The manager is working hard to complete supervisions every two months. The night staff are being given group supervisions. Whilst this is a reasonable short term measure, individual supervision is better practice. The manager is developing a supervision schedule and once this is complete the regularity of supervisions needs to be maintained. The manager has not yet applied for a CRB as part of her application for registration. This needs to be completed as a matter of urgency and the registration process completed. This requirement is outstanding from the key inspection. The home has also not completed this years quality assurance process seeking the views of residents, relatives, care professionals and staff. This requirement is also outstanding. In terms of health and safety, the manager has completed a fire safety emergency plan. The portable electrical appliances and hoists have also been serviced and a record is available to monitor when other systems in the home also need a maintenance check. The staff team have recently had their fire safety training updated. What the care home does well: What they could do better:
There are two outstanding requirements from the previous inspection. The first is for the manager to complete the registration process. The second is for the home to complete a quality assurance process that seeks the views of residents, relatives, staff and care professionals so the service can evaluate its performance and improve where needed. It is also recommended that contracts between the home and residents are Care Homes for Adults (18-65 years)
Page 5 of 10 appropriately signed. Staff should become more involved in reviewing and updating person centred plans. A new set of weighing scales for people who cannot stand should be purchased and where residents have weight changes this should be addressed as needed to ensure the residents are healthy. Residents should be supported to hold some money for themselves to give them greater independence where possible. The home should complete the recruitment of a deputy manager to provide sufficient management support. The manager needs to ensure staff are supervised at least every two months. Out of date records should be archived to enable staff to access current information. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 6 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
No. Standard Regulation Requirement Timescale for action 1 37 9(1) The registered person must 31/08/2008 ensure the manager completes the registration process. This is a new requirement as a new manager has come into post. The registered person must 30/09/2008 complete this years quality assurance exercise to seek the views of residents, relatives and other stakeholders on the standard of service provided by the home. 2 39 24 Care Homes for Adults (18-65 years) Page 7 of 10 Requirements and recommendations from this inspection
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No. Refer to Standard Good Practice Recommendations 1 2 5 6 The registered person should ensure contracts between the home and the residents are appropriately signed. The registered person should ensure the staff are familiar with the person centred plans and are supporting the residents to review and update their care plans as needed. The registered person must support the residents to hold some of their own spending money where their person centred plans indicate this will support them to develop greater independence. The registered person should try and purchase weighing scales suitable for residents who are unable to stand. Residents weight changes should be monitored and action taken where needed to address these changes. The registered person should keep a record of staff signatures as they appear on the medication administration record. The registered person should complete the recruitment of a deputy manager to provide adequate management support in the home. The registered person should ensure individual supervisions continue on a regular basis for all staff including the night staff.
Page 8 of 10 3 16 4 19 5 20 6 33 7 36 Care Homes for Adults (18-65 years) 8 37 The registered person should ensure old records are archived to avoid confusion with current records. Care Homes for Adults (18-65 years) Page 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 10 of 10 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
