CARE HOMES FOR OLDER PEOPLE
Homesdale 5-7 New Wanstead Wanstead London E11 2SH Lead Inspector
Ms Harina Morzeria Unannounced Inspection 7th February 2006 02:00 X10015.doc Version 1.40 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 Homesdale DS0000025904.V282872.R01.S.doc Version 5.1 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 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 DS0000025904.V282872.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Homesdale Address 5-7 New Wanstead Wanstead London E11 2SH 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) 020 8989 0847 020 8989 0847 Woodford Baptist Homes Limited Ms Brenda Jean Jones Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Homesdale DS0000025904.V282872.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. To accommodate one named individual with learning difficulties aged over 65 years at Homesdale. 26th May 2005 Date of last inspection 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. Homesdale DS0000025904.V282872.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This is was the second statutory inspection visit of the inspection programme for 2005/06. Over the course of the two visits, all core standards have now been assessed. Four requirements were set at the previous inspection and the registered person has complied with the required action. A number of residents were spoken to and a variety of records were examined, including care plans, staff files, medication records and the adult protection policy and procedure. The new manager for the service was present during the inspection. What the service does well: What has improved since the last inspection?
Homesdale DS0000025904.V282872.R01.S.doc Version 5.1 Page 6 At the previous inspection four requirements were set around the issue of care plans which were required to be reviewed and updated on a monthly basis, ensuring that changing needs were identified and met. The home also needed 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 were required to receive induction and foundation training within six weeks and six months of commencing employment. The medication policy and procedure was required to be followed thoroughly by staff. All the above requirements were tested by the inspector and are complied with. 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. Homesdale DS0000025904.V282872.R01.S.doc Version 5.1 Page 7 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 Outcomes Statutory Requirements Identified During the Inspection Homesdale DS0000025904.V282872.R01.S.doc Version 5.1 Page 8 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 the following standard(s): 2, 3 Each resident has a written contract, statement of terms and conditions and each prospective resident receives a comprehensive assessment. 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. 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 here – I am settling down.” Homesdale DS0000025904.V282872.R01.S.doc Version 5.1 Page 9 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 the following standard(s): 7, 9 Residents have an individual care plan and their health care needs are fully met. The residents’ privacy and dignity are respected at all times by the staff. 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. Evidence was seen from the care plans examined that they are now being regularly reviewed and updated by the key workers to reflect changing needs. The residents’ files also covered areas of health care and documented visits from the dentist and other health appointments. Homesdale DS0000025904.V282872.R01.S.doc Version 5.1 Page 10 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 the following standard(s): 12, 13, 15 The home encourages and facilitates the residents to have contact with family and friends. 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. The residents receive a balanced and healthy diet that they enjoy. EVIDENCE: All residents spoken to in the home said that the food is always good and mealtime arrangements are flexible enough to accommodate individual preferences. 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. 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.
Homesdale DS0000025904.V282872.R01.S.doc Version 5.1 Page 11 Visiting times are very flexible and visitors commented that they are always made to feel welcome by staff. Residents are able to receive visitors in one of the lounges, or in their own rooms, as they wish. Homesdale DS0000025904.V282872.R01.S.doc Version 5.1 Page 12 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 the following standard(s): 16, 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. The home have developed their own adult protection/abuse awareness policy and procedure which staff have been made aware of, to ensure a proper response for reporting any suspected or witnessed abuse. Homesdale DS0000025904.V282872.R01.S.doc Version 5.1 Page 13 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 the following standard(s): 19, 26 The general décor in the home is well maintained and service users live in safe, comfortable surroundings. There is a good standard of cleanliness and hygiene. EVIDENCE: At the time of inspection the lounge was being decorated and re-carpeted as well as some vacant bedrooms. There is an ongoing programme of refurbishment and redecoration for the home. A number of residents were resting in their rooms, and others were sitting in the lounge. The inspector spoke to three residents at the time of inspection who said they liked their bedrooms and the home. They said the staff were kind and looked after them well. One visitor was also spoken to who said her mother had recently arrived at the home and was still settling in but was happy so far.
Homesdale DS0000025904.V282872.R01.S.doc Version 5.1 Page 14 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 and enjoyed by them during fine weather. Homesdale DS0000025904.V282872.R01.S.doc Version 5.1 Page 15 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28, 30 Residents benefit from a committed and experienced team of staff at the home, who have the skills and training to meet their needs. Staff are trained and competent to do their jobs. EVIDENCE: The home has a stable team of staff, with only a small turnover. Most of the staff 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 were adequate to ensure the residents needs continue to be met. Staff continue to access relevant training courses and evidence was seen of various courses being available to them on the notice boards. Staff files showed that they have done training in essential areas, such as food hygiene, health & safety, administering medication, and first aid. 90 of the staff have achieved NVQ level 2, with six having completed NVQ level 3. A good comprehensive training programme is in place. Homesdale DS0000025904.V282872.R01.S.doc Version 5.1 Page 16 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 The home is being managed well by registered manager. The staff team work well together to make sure that residents are safe and secure whilst living at Homesdale. There are sufficient policies and procedures in place to safeguard the residents’ financial interests. EVIDENCE: The manager and the deputy manager work closely together to achieve high standards for the home. Feedback from both residents and staff was positive about the way in which the home is run.
Homesdale DS0000025904.V282872.R01.S.doc Version 5.1 Page 17 During the inspection the home’s policies and procedures were looked at and seen to safeguard the residents. There are policies and procedures on complaints and adult protection as well as medication administration and safeguarding the residents’ financial interests. The home deal with financial matters for four residents, with relatives handling other residents’ finances. The residents’ have financial record books where their incoming and outgoing money is recorded with receipts. Records are kept in the office and an administrator is employed to oversee this. 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 monitoring the service provided in the home. Homesdale DS0000025904.V282872.R01.S.doc Version 5.1 Page 18 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 X 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Homesdale DS0000025904.V282872.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? no 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. Standard Regulation Requirement Timescale for action 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 Homesdale DS0000025904.V282872.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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