Inspection on 26/05/05 for Homesdale

This inspection was carried out on 26th May 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 but made no statutory requirements on the home.

Other inspections for this house

Homesdale 04/12/06

Homesdale 07/02/06

Homesdale 13/07/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Homesdale 5-7 New Wanstead Wanstead London E11 2SH Lead Inspector Harina Morzeria Unannounced Inspection 26 May 2005 09:30 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 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 Older People. 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. Homesdale G55_S0000025904_Homesdale_V230946_260505_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Homesdale Address 5-7 New Wanstead, Wanstead, London E11 2SH Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8989 0847 020 8989 0847 Woodford Baptist Homes Ltd David Bolton CRH Care Home 18 Category(ies) of OP Old age (18) registration, with number of places Homesdale G55_S0000025904_Homesdale_V230946_260505_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. To accomodate one named individual with learning difficulties aged over 65 years at Homesdale. Date of last inspection 13 July 2004 Homesdale G55_S0000025904_Homesdale_V230946_260505_Stage 4.doc Version 1.30 Page 5 Brief Description of the Service: Homesdale (Woodford Baptist Ltd) is a Christian organisation that provides a residential care home and sheltered accommodation for older people. The complex is situated in a residential area of Wanstead, close to bus and train services and local shopping facilities. The residential home is registered for 18 service users and is based in two inter connecting houses. The home is linked to the sheltered housing accommodtion. Bedrooms are located on the ground floor as well as the first and second floors and a new lift has been installed. Work has been carried out to provide more rooms with en-suite facilities. There is a separate lounge and dining area downstairs overlooking a well maintained garden to the back of the house. In line with the Baptist ethos, a daily service is held either in the home or in the adjoining sheltered accomomdation lounge. The home does not allow smoking, alcohol or gambling on the premises. Homesdale G55_S0000025904_Homesdale_V230946_260505_Stage 4.doc Version 1.30 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day and lasted 5 ½ hours. The deputy manager, as well as a number of staff were interviewed and assisted with the inspection. A tour of the downstairs part of the home was carried out and about 10 residents in the home were spoken to. Two relatives were also spoken to, to get their views and comments on the home. A variety of records, including care plans, staff files and Health & Safety documents were examined. The current registered manager has been off sick since December 2004. The deputy manager is in charge of the home in his continued absence and is receiving support and supervision from the Responsible Individual for the home, as well as other Committee members. What the service does well: Residents feel at home and relaxed at Homesdale because staff pay close attention to meeting their individual needs. Residents said that they enjoyed living at Homesdale and were very happy with the quality of care they were getting. The two relatives also were very positive about the quality of care in the home and emphasised that they felt welcomed when they visited and that they appreciated being able to visit whenever they wanted. One relative commented, “We are extremely fortunate to have mother placed here.” Both residents and relatives said that they felt able to talk to the deputy manager, or staff, if they had any concerns or worries. The home supports the residents to exercise choice and control over their lives and the routines of daily living and daily activities available are flexible and varied to suit individual expectations, preferences and capacities. Residents and their relatives are consulted and informed about issues affecting the home through residents’ meetings. All necessary health care services are accessed for the residents in order to meet their assessed and specialist needs. Homesdale G55_S0000025904_Homesdale_V230946_260505_Stage 4.doc Version 1.30 Page 7 An activities co-ordinator takes responsibility for arranging a weekly programme of activities, which is displayed on the notice board, as well as the white board for the residents. What has improved since the last inspection? What they could do better: At the time of the inspection, although care plans were available for each service user, it was not clear if these were reviewed and updated on a monthly basis. Ongoing reviews and updating of care plans must improve, to ensure that staff are able to know what to do for each resident and to ensure that changing needs are identified and met. The involvement of residents and relatives in the written care plans made by the home needs to be increased. The home also needs to develop their Adult Protection policy and procedure, to ensure that all staff are aware of the issue and would know how to respond in the event of a concern being raised. All newly recruited staff must receive induction and foundation training within six weeks and six months of commencing employment. Homesdale G55_S0000025904_Homesdale_V230946_260505_Stage 4.doc Version 1.30 Page 8 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. Homesdale G55_S0000025904_Homesdale_V230946_260505_Stage 4.doc Version 1.30 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Homesdale G55_S0000025904_Homesdale_V230946_260505_Stage 4.doc Version 1.30 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, 4 and 5 The pre-admission assessment process undertaken for all service users prior to their admission to the home, ensures that all the care needs of the individual are understood and met. The residents and their representatives know that the home they enter will have the knowledge to meet their needs. Residents and their relatives are offered the chance to visit the home and look at the facilities and the suitability of the home. EVIDENCE: The admission procedure seen for two of the most recently admitted residents showed that it is adequate to guide staff on the actions to be taken to make sure that the new resident’s needs will be properly assessed and planned for. The deputy manager and staff were able to discuss the service users needs and how to meet these. Individual records are kept of the residents and an inspection of the records showed that proper assessments are carried out before prospective residents move into the home. One resident who had recently moved in said: “I like it Homesdale G55_S0000025904_Homesdale_V230946_260505_Stage 4.doc Version 1.30 Page 11 here – I am very happy.” Another new resident had visited the home before moving in, so that she could be sure it was the right place for her. The records showed that the deputy manager had put together a plan of care, setting out how the new service users’ needs and wishes would be met by the home. She had also completed a risk assessment to ensure that any risks identified could be managed by the home. Homesdale G55_S0000025904_Homesdale_V230946_260505_Stage 4.doc Version 1.30 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 Residents benefit from the close attention paid by staff at Homesdale to meet their health needs. The individual plans of care for each resident would be improved by increasing further the involvement of the residents and their relatives, so that these plans reflect as accurately as possible the needs and wishes of the residents themselves. Care staff in the home must review the care plans at least once a month, update these to reflect changing needs and current objectives for health and personal care and action them. Residents are able to take responsibility for their own medication if they wish, but adequate risk assessments must be in place, which must be reviewed regularly to ensure that residents are protected and their changing needs identified. The MAR charts must accurately reflect which medication the residents are taking and a consistent practice to be applied for each service user, for example, for all the residents there should be a clear entry as to whether they wish to take all their own medication or whether they want staff to administer it. All the residents spoken to said that they are treated with respect and their right to privacy is upheld. Homesdale G55_S0000025904_Homesdale_V230946_260505_Stage 4.doc Version 1.30 Page 13 EVIDENCE: Individual plans of care are available for each service user, which identify all aspects of health, personal and social care needs of the service user. Care plans are in place and daily entries into case records are made, which indicate the actual care given. Discussion with the deputy manager and staff suggested that they constantly observe and talk to the service users, so that they can take swift action if anyone becomes unwell. However, information in some of the care plans was not being regularly reviewed or updated to reflect changing needs. Discussion with the deputy manager indicated that needs were being identified verbally and met. This approach is dependant on staff memory and verbal communication systems. Residents are at risk of not having their health care needs met if this system breaks down. The medication at this home is generally well managed, promoting good health. Only senior staff are responsible for administering medication, after having received adequate training from the pharmacist. A record is maintained of current medication and a lockable facility is provided in which to store the medication. The inspection of the MAR charts for the residents showed that the medication policy and procedure is not being consistently applied. The inspector noted that for one service user, staff were administering one prescribed medication to her and she was responsible for self-administering two other medications. The deputy manager was informed that this needs to be immediately discussed with the service user and a decision made, following an appropriate risk assessment, whether she wishes to be responsible for her own medication or whether all the medication should be administered by the staff. One other service user is being given over the counter multi vitamins. The deputy manager stated that this was following the GP’s advice. The deputy manager has been required to discuss this with the GP and ensure that should the resident require multi vitamins, then these must be prescribed. Homesdale G55_S0000025904_Homesdale_V230946_260505_Stage 4.doc Version 1.30 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 Social activities and meals are both well managed, creative and provide daily variation and interest for the service users living in the home. The home is particularly good at being able to meet the cultural and religious needs of the residents, all of whom have a strong Baptist belief. EVIDENCE: All residents spoken to in the home said that the food is always good and they are given choices from the planned menu, which is discussed at the residents’ meetings. Menus were inspected and were found to be balanced and interesting and mealtime arrangements are flexible enough to accommodate individual preferences. One service user said “Staff have been wonderful, I have the fullest praise for them.” Another service users said, “Staff are all very nice to us, I like living here.” An activities co-ordinator comes to the home three times a week and undertakes organised activities with the service users, as well as staff members, who take responsibility for arranging activities at other times. These include: armchair exercises, listening to music, reminiscence, watercolour painting, playing games and knitting. Homesdale G55_S0000025904_Homesdale_V230946_260505_Stage 4.doc Version 1.30 Page 15 Residents are also responsible for taking the daily service and those wishing to join them are encouraged to do so, otherwise they are given the opportunity to go to the service held at the adjoining sheltered accommodation lounge. Visiting times are very flexible and visitors commented that they are always made to feel welcome by staff. Service users are able to receive visitors in one of the lounges, or in their own rooms, as they wish. They can also request a meal by phoning in advance. Homesdale G55_S0000025904_Homesdale_V230946_260505_Stage 4.doc Version 1.30 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The home has a satisfactory complaints’ procedure and residents and their relatives feel that their views are listened to and acted upon. Staff have received training in Adult Protection/abuse awareness. EVIDENCE: The home has a clear complaints’ procedure, which is followed when a complaint is received. At this visit, the complaints’ record did not show any complaints. Following discussion with the deputy manager and staff, it was clear that they have received training relating to Adult Protection. However, although the home has the London Borough of Redbridge Adult Protection policy document, they have not developed their own policy and procedure. Hence, the deputy manager must develop an Adult Protection/abuse awareness policy and procedure to ensure a proper response for reporting any suspected or witnessed abuse. This requirement has been outstanding from the previous inspection. It is a requirement that is considered to be a priority and must be complied with by the new timescale. Homesdale G55_S0000025904_Homesdale_V230946_260505_Stage 4.doc Version 1.30 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 The general décor in the home is adequate for its stated purpose and service users live in safe, comfortable surroundings. There is a good standard of cleanliness and hygiene. EVIDENCE: Residents spoken to at the time of inspection said they liked their bedrooms. Two of the residents visited in their own rooms have made their bedrooms very homely with photos of their family and said they were happy in the peace and quiet of their own rooms. The external areas of the home are well maintained and there is a garden at the back of the house, which is fully accessible to the residents. From discussion with the residents and their relatives, it was clear that they gain much pleasure from the garden. Homesdale G55_S0000025904_Homesdale_V230946_260505_Stage 4.doc Version 1.30 Page 18 Throughout the inspection, the home was found to be clean and hygienic. Comments from residents and relatives indicated that they consider a very good standard was being achieved in this area. Homesdale G55_S0000025904_Homesdale_V230946_260505_Stage 4.doc Version 1.30 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 Staffing levels are satisfactory and there are sufficient staff on duty to meet the individual assessed needs of the service users. Residents benefit from a committed and experienced team of staff at the home, who have the skills and training to meet their needs. The procedures for the recruitment of staff are robust and provide safeguards for people living in the home. Staff are trained and competent to do their jobs. EVIDENCE: A good deal of positive feedback about the staff at the home was received from the residents and their relatives. A typical comment being: “The staff are very kind.” As a result, the residents’ experience of the home is of a caring environment where they feel they will be looked after and allowed to make choices. Many residents said that they liked to spend time in their rooms and commented that this wish was respected by staff. Most staff at the home have worked there for a number of years and have built up a good knowledge and understanding of the needs of each resident. Staffing levels for both care and domestic staff are sufficient to meet the needs Homesdale G55_S0000025904_Homesdale_V230946_260505_Stage 4.doc Version 1.30 Page 20 of the residents. Staff in the home usually support each other when on leave or off sick by working additional hours, avoiding the need to use agency staff. Staff files show that staff had done training in essential areas, such Health & Safety, administering medication, fire safety and awareness and Adult Protection. Most staff have undertaken NVQ Level 2 training to improve their caring skills further. As a result, residents get a good quality of support and care from the staff at the home. The staff files examined of two staff members employed since the last inspection indicated that the home is undertaking all the necessary recruitment checks to ensure the safety of service users. All newly recruited staff must receive induction and foundation training within six weeks and six months of commencing employment. Homesdale G55_S0000025904_Homesdale_V230946_260505_Stage 4.doc Version 1.30 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32 and 33 The home is being managed well by the deputy manager. in the absence of the registered manager. Residents benefit from living at Homesdale because the home is run in the best interests of the residents. The home is good at making sure the residents are kept safe and secure whilst living at Homesdale. EVIDENCE: The current registered manager has been on extended leave due to ill health since December 2004. The deputy manager is managing the home in his continued absence. The Responsible Individual nominated by the Committee has put in place satisfactory interim arrangements to support the deputy manager during this time and the situation is being regularly reviewed. Homesdale G55_S0000025904_Homesdale_V230946_260505_Stage 4.doc Version 1.30 Page 22 Regulation 26 visits are undertaken by the Responsible Individual on a monthly basis. A copy of the report is supplied to the Commission to show that the registered providers are effectively monitoring the service provided in the home. Feedback from residents, relatives and staff was positive about the way in which the home is run, in the absence of the registered manager. There is a system in place for all care staff to receive supervision on a regular basis and staff stated that they are well supported in their work by the deputy manager. The home is well maintained and provides a safe environment for the residents and staff. Inspection of a sample of records indicated that regular tests to emergency lights and fire alarms had been carried out. Evidence was seen of consultation having taken place, which includes seeking the views of service users, staff and relatives as well as other professionals visiting the home. The inspector saw evidence of positive comments from all of these groups. The deputy manager holds regular residents’ meetings in order to consult with them as well. Satisfactory comments have been received from the relatives and friends of service users. Homesdale G55_S0000025904_Homesdale_V230946_260505_Stage 4.doc Version 1.30 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 3 3 x x x x x Homesdale G55_S0000025904_Homesdale_V230946_260505_Stage 4.doc Version 1.30 Page 24 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 7 Regulation 15 Requirement Timescale for action 31/07/05 2. 9 13 3. 18 13 & 18 4. 28 & 30 18 All service users must have a written care plan in sufficient detail to provide staff with clear guidance on the actions required by staff to meet health, personal and social care needs. The care plan must be reviewed regularly and updated to reflect changing needs. The manager must ensure that 31/07/05 staff adhere to the medication policy and procedure by ensuring that for each service user they administer all their medication, or, where service users are able to take responsibility for their own medication, staff must ensure that risk assessments are in place and regularly reviewed. Under this requirement, over the counter medication must not be administered to any service user. The registered provider must 31/07/05 ensure that there is an Adult Protection policy and procedure in place to ensure a proper response for reporting any suspected or witnessed abuse by staff. The registered provider must 31/07/05 ensure that all recently Version 1.30 Homesdale G55_S0000025904_Homesdale_V230946_260505_Stage 4.doc Page 25 appointed staff receive induction training to NTO specification within 6 weeks of appointment and foundation training within 6 months of appointment to their post. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 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