Inspection on 18/05/05 for Ingestre Road (12)

This inspection was carried out on 18th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Ingestre Road (12) 05/10/07

Ingestre Road (12) 16/08/06

Ingestre Road (12) 24/11/05

Ingestre Road (12) 14/09/04

Ingestre Road (12) 21/06/04

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 Ingestre Road 12 Ingestre Road Tufnell Park London NW5 1UX Lead Inspector Pippa Treadwell-Smith Unannounced 18 May 2005 11:00am th 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. Ingestre Road G58 s37254 Ingestre v210268 180505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ingestre Road Address 12 Ingestre Road Tufnell Park London NW5 1UX 020 7267 4713 020 7267 0769 Paula.Peake@camden.gov.uk London Borough of Camden 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) Ms Paula Peake Care Home 48 Category(ies) of OP 48 registration, with number of places Ingestre Road G58 s37254 Ingestre v210268 180505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: There are no conditions applicable. Date of last inspection 14th September 2004 Brief Description of the Service: 12 Ingestre Road is a care home provided by London Borough of Camden. The line management of the home is delegated to the Primary Care Trust although all the staff are employed by the Local Authority. The home is located in Tufnell Park and that is the nearest underground station (Northern Line). The home can be accessed by car via Burghley Road and there is a frequent bus service either to Highgate Road (214, C2) or Tufnell Park (4, 10, 134). The home is sited within a council housing complex and it is sign posted. The home caters for older persons and is able to accommodate 48 people. The home provides full personal care only. Health care needs are met by community heath services. The accommodation for service users is on two floors, at basement level and ground floor; there is an annexe, which is used for staff sleeping-in accommodation and an office. There is level access into the building and a shaft lift allows access between floors. The facilities are arranged around a large landscaped courtyard. At basement level there is a seating area to the front of the building. The home is divided into six units. Each unit is self-contained with bedrooms, a small kitchenette, and a sittingcum-dining room and served by toilets and bathrooms. There is a quiet lounge on the lower floor. Five of the units are home to older persons with long-term care needs, the sixth unit provides specialist intermediate care (rehabilitation). The units are staffed separately with each one having its own dedicated staff. Ingestre Road G58 s37254 Ingestre v210268 180505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was arranged on an unannounced basis. It took place during one Saturday morning and lasted about three and a half hours. A further visit was arranged the following Thursday afternoon and the inspector stayed for two hours. Both senior and administrative staff assisted with the inspection. The inspector was able to observe the interaction between staff and service users and engage eight of the service users in general discussion about living in the home. Two of the service users were from the rehabilitation unit. Part of the inspection included a look around the building and included a sample of bedrooms and the communal areas. There was an opportunity to observe a medication round and sit in on a staff hand over. A variety of records, including care plans, risk assessments, servicing documents and medication administration records were looked at. What the service does well: What has improved since the last inspection? What they could do better: Areas where the home could be making better progress have been discussed with the management of the home. More detail is needed when writing up Ingestre Road G58 s37254 Ingestre v210268 180505 Stage 4.doc Version 1.30 Page 6 care plans regarding keeping service users safe from harm. Further work is necessary to ensure that the administration of medication meets the current guidance. 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. Ingestre Road G58 s37254 Ingestre v210268 180505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Ingestre Road G58 s37254 Ingestre v210268 180505 Stage 4.doc Version 1.30 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 standard(s) 6 Service users who are admitted to the intermediate unit are given as much support as required in order for them to return home. EVIDENCE: The home has a separate unit for intermediate/rehabilitation. The unit has dedicated accommodation and a team of staff. This staff team, in conjunction with the local multi-disciplinary team known as REACH, deliver short-term intensive rehabilitation. There is a close working relationship between the unit, the REACH team and a local rapid response team. An assessment process is done prior to admission to ensure that the potential service user is within the category of registration of the home and whether the home is a suitable placement. Two service users who participated in the inspection spoke positively about their experiences since being admitted to the home for rehabilitation. Although the intermediate unit is a separate facility, service users have access to communal areas of the home including a garden area. Each service user has a single room with a washbasin but share bathroom, toilet and loungecum-dining facilities. The service users confirmed that their accommodation Ingestre Road G58 s37254 Ingestre v210268 180505 Stage 4.doc Version 1.30 Page 9 was comfortable and they had their privacy. They said that they had received the encouragement and practical help needed in order to improve their situations and to be able to return home. One had been on a home visit and was due for discharge the following week. The care records confirmed that the service users were receiving input from the Community Re-enablement Team for Adults (REACH). The team consists of a range of health and social service staff from relevant professions such as medical consultants, nurses, occupational therapists, psychologists, physiotherapists, rehabilitation assistants, social workers and speech and language therapists. The motto of this team is “Helping you reach your potential”. One service user said that this motto was true in their case and that he could not speak too highly of the staff of the staff involved. He said that staff in the unit had been approachable and knowledgeable and always willing to assist his recovery. Ingestre Road G58 s37254 Ingestre v210268 180505 Stage 4.doc Version 1.30 Page 10 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 & 9 There are care plans for each service user so that needs can be addressed however in some instances risk assessments need to be more specific. The home has systems in place for the ordering, storage and administration of medication however some improvements are required to ensure that service users are not potentially put at risk. EVIDENCE: All service users have an assessment and a care plan. There is clear evidence that the care plans are reviewed on a monthly basis however there is a danger that this is becoming a desktop exercise only. Care staff demonstrated that they had considerable knowledge of service user’s needs and behaviours but this was not always documented in sufficient detail. Not all risk assessments were as detailed as they could be. One instance of this was a service user who staff said was smoking in the bedroom. The care plan acknowledges that the service user smokes in the bedroom and that reminders are given about using the designated area. Staff commented that if caught smoking the service user can discard the cigarette in a dangerous way. A risk assessment was available dated 25.02.05 but this did not record that smoking was a risk. Staff were unable to locate a more updated risk assessment. Discussions with the Ingestre Road G58 s37254 Ingestre v210268 180505 Stage 4.doc Version 1.30 Page 11 manager highlighted that the home is prepared to be proactive in protecting the service user’s rights and the safety of the other occupants in the home. There was also evidence that care staff had made incorrect entries in care records and then attempted to obliterate them. There was no date or initials of the person correcting the error. Senior staff confirmed that this is an ongoing issue and staff have had training in respect of record keeping. Senior staff on duty confirmed that only designated staff are eligible to administer medication. The inspector was able to observe a medication round. The home has a monitored dosage system in place. The medication round is done by one person on each floor. On the upper floor the medication is secure in a locked room. A fridge is available to store medication at the correct low temperature. There is a thermometer in the fridge and staff confirmed that the temperature is monitored however this is not recorded. One service user is an insulin controlled diabetic and ampoules of insulin are kept in the fridge. Injections are administered by the Community Nursing Service. The staff are not aware of any arrangement to remove the insulin so that the service user does not get an injection of cold fluid as this can be painful. Medication is transported about in a medicine trolley. The trolley does not hold all the medication for this floor at the same time. In practice staff are expected to return to the medical room to exchange medication for the next unit. However the trolley was still too full and staff were unable to lock it securely when it was left unattended. Some medication, not supplied in blister packs, was being carried in a cardboard box. The inspector observed medication administration sheets (MARS) being signed before the service user had been offered the medication. Some of the MARS sheets had hand written entries, which did not include the date, received, the quantity of tablets or the initials of the person making the entry. Ingestre Road G58 s37254 Ingestre v210268 180505 Stage 4.doc Version 1.30 Page 12 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) 13 & 14 Service users are able to keep in contact with their family and friends as visitors are able to visit regularly and are made to feel welcome. The homes’ visitor’s policy keeps both the service users and visitors safe. EVIDENCE: The home has a visitors policy. The main door is kept secured therefore staff are responsible for allowing visitors entry. This means that staff can monitor the number of visitors for security reasons and in the event of a fire an up-todate register is available. Information about visiting is set out in the service user guide. During the two visits the inspector observed staff welcoming visitors into the home and reminding them to sign the visitors’ book. The book showed that visitors are able to visit throughout the day and into the evening, which is in line with the open visiting policy. Service users said that they have regular visitors and are able to visit family and friends at home. Although there are programmes of forthcoming events posted around the building about indoor activities, service users are still able to enjoy activities in the community. The service user guide has information about service users taking trips into the local community. Service users confirmed that they are able to retain their links with previous activities if they choose. Ingestre Road G58 s37254 Ingestre v210268 180505 Stage 4.doc Version 1.30 Page 13 The likes and dislikes of the service users are known to care staff and are recorded in care files. Service users said that they are able to follow their preferred lifestyle and staff will assist them to exercise choice. Evidence of this was also heard during the staff handover. Ingestre Road G58 s37254 Ingestre v210268 180505 Stage 4.doc Version 1.30 Page 14 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 There is a satisfactory complaint’s procedure in place and service users, relatives and staff are asked for their views about the service. EVIDENCE: The complaints procedure is available in the service user guide although the copy seen during this visit needs to be updated with the name of the Commission for Social care Inspection. Copies of the procedure are located about the home. Service users said that they comfortable with approaching members of staff is they were not happy with any aspect of their care. There is a system in place to record and monitor complaints. This is turn is monitored by the registered provider through the Regulation 26 visits and reports. These reports also show that people are asked for their comments about the home about the standard of care and staff in the home. Ingestre Road G58 s37254 Ingestre v210268 180505 Stage 4.doc Version 1.30 Page 15 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 & 26 There is a continuous effort to ensure that the environment in the home is sufficient to provide service users with an attractive and comfortable place to live. The overall appearance of the home is clean, well presented and generally free from offensive odours. EVIDENCE: The building is tucked away as part of a housing development but it is signposted. Public transport is available but care parking is restricted on the estate. There is level access into and throughout the building. Access between floors is via a lift, which gives verbal information and service users are able to use it independently. Service users said that they were generally satisfied with their accommodation. They said that they were comfortable and felt safe. Door widths and corridors are sufficiently wide enough for the use of walking frames and wheelchairs. There is a programme of routine maintenance and a system in place to report and effect repairs. The decoration and renewal of the fabric of the building is Ingestre Road G58 s37254 Ingestre v210268 180505 Stage 4.doc Version 1.30 Page 16 done on a cyclical basis however improvements can be carried out beforehand. Service users have access to outside space in front of the house, a patio area and a central courtyard garden. Overall these are well maintained and enjoyed by service users although some work has been identified at the front of the building. There is a garden maintenance contract so that all necessary work will be attended to. The home has an integrated and automatic fire alarm system and there are records to show that the alarm sounders are tested regularly. This is serviced according to a contract. The home does have a prevention of cross infection policy with procedures in place. Ancillary staff are deployed in sufficient numbers to ensure that the home is kept clean. At the weekend there were four on duty. A sample of rooms was taken and these were found to clean and tidy. Ingestre Road G58 s37254 Ingestre v210268 180505 Stage 4.doc Version 1.30 Page 17 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 Staff have a clear understanding of their role and are deployed in sufficient numbers to meet the needs of the service users. EVIDENCE: An inspection of the rota showed that 10 staff were being deployed across the home and there was a senior member of staff allocated to each floor with one identified as being in overall charge. There are separate night staff to cover each unit. As previously stated there were four ancillary workers on shift and separate catering staff deployed in the kitchen. The atmosphere in the home was calm and relaxed. Service users said that they felt at ease and were not hurried by staff. Staff said that the staffing levels were reasonable. This home has generally relied on agency workers to supplement the permanent work force however a recent successful recruitment campaign has generated a lot of applicants for vacant posts. Interviews were being held during one of the visits made by the inspector. Ingestre Road G58 s37254 Ingestre v210268 180505 Stage 4.doc Version 1.30 Page 18 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) 38 Satisfactory arrangements are in place for the management of health and safety on the premises to ensure the welfare of service users, staff and visitors. EVIDENCE: The home has a health and safety policy in place and cover relevant safe working practices. Staff undertake the appropriate training. Records show that equipment is serviced and there is a system in place to report repairs. During a tour of the premises there were no hazards identified. Staff have access to protective clothing in the form of disposable aprons and gloves. There are adequate arrangements in place for the removal of clinical waste. All accidents are recorded and there is a system in place to monitor falls. Falls are recorded in a register and as part of a pilot study, which is looking at the prevention of falls. Staff are paying particular attention to the fluid intake of Ingestre Road G58 s37254 Ingestre v210268 180505 Stage 4.doc Version 1.30 Page 19 service users during a recent spell of very hot weather. There are fans available and drinks were accessible. Ingestre Road G58 s37254 Ingestre v210268 180505 Stage 4.doc Version 1.30 Page 20 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 x x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x x x 3 Ingestre Road G58 s37254 Ingestre v210268 180505 Stage 4.doc Version 1.30 Page 21 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 7 Regulation 13(4)b&c Requirement Timescale for action 31.08.05 2. 9 13(2) In order to ensure the safety of service users, their individual risk assessments must be reviewed and updated. A safer method of drug 31.08.05 administration must be found and a new system of transporting the medication must be used. Only staff who have been trained and assessed as competent are to administer medication. 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. Refer to Standard Good Practice Recommendations Ingestre Road G58 s37254 Ingestre v210268 180505 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Centro 4 20-23 Mandela Street Camden Town London NW1 0DW 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. Extracts may not be used or reproduced without the express permission of CSCI Ingestre Road G58 s37254 Ingestre v210268 180505 Stage 4.doc Version 1.30 Page 23 - 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. 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