Inspection on 05/10/07 for Ingestre Road (12)

This inspection was carried out on 5th October 2007.

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 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) 16/08/06

Ingestre Road (12) 24/11/05

Ingestre Road (12) 18/05/05

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) 12 Ingestre Road 12 Ingestre Road Tufnell Park London NW5 1UX Lead Inspector Pippa Canter Unannounced Inspection 5th October 2007 10:00 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 Ingestre Road (12) DS0000037254.V353610.R01.S.doc Version 5.2 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. Ingestre Road (12) DS0000037254.V353610.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ingestre Road (12) Address 12 Ingestre Road 12 Ingestre Road Tufnell Park London NW5 1UX 020 7267 4713 020 7267 0769 paula.peake@camden.gov.uk 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) London Borough of Camden Ms Paula Peake Care Home 48 Category(ies) of Dementia - over 65 years of age (48), Old age, registration, with number not falling within any other category (48) of places Ingestre Road (12) DS0000037254.V353610.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th August 2006 Brief Description of the Service: 12 Ingestre Road is a care home provided by London Borough of Camden. 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 the community health services. The current level of fees is £866 per week. The fees are calculated according to income following a financial assessment. The accommodation for service users is on two floors, at lower ground andd ground floor level; 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. Since the last inspection the home has varied their registration to include people with Dementia. The home is divided into six units. Each unit is self-contained with bedrooms, a small kitchenette, and a sitting-cum-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 (12) DS0000037254.V353610.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit for this key inspection was unannounced, and took place on a weekday from 10.00 to 15.00. One inspector carried it out. Prior to the site visit all information held at our office had been reviewed. This included reports that had been sent to us on a monthly basis, and about any incidents/changes that had occurred since our last visit. The manager had completed an Annual Quality Assurance Assessment (AQAA), which gave us information about the people living and working in the home as well as the home’s compliance with the key standards. Based on the above we developed an inspection plan. This concentrated on those key standards that we could not make a full judgement on without a site visit. Questionnaires had been sent to the home prior to the visit for people who live there, for staff, relatives and professionals who visit the home. Because of the impact of the postal strike the surveys could not be returned in time for the completion of the draft report. Feedback from the surveys will be included in the final report. During the visit we spoke to people living in the home, and examined six case files in depth. We talked to three of these people, and compared the planned care with the care they were actually receiving. We carried out a small sample audit of medication on each floor. We went round the home speaking to other people living in the home, to some staff and checking bathrooms and bedrooms. We directly observed the interaction between the care staff and people living in the service. We have used the information collected from all sources to reach the judgments made in this report. At the end of the visit we discussed our findings with the manager, and a form will be sent with the draft report so they can let us know how they felt we had conducted the inspection. What the service does well: The evidence that we had on file showed that this is a consistently well run home, where the interests of the people living there are foremost. The evidence we found during the visit supported this view, as did the views expressed by some of the people living there. Ingestre Road (12) DS0000037254.V353610.R01.S.doc Version 5.2 Page 6 Individuality, dignity, respect and personal choice are given priority. Staff were knowledgeable about the personal and health care needs of the people in their care as well their personal preferences. Although there is some evidence that staff should reflect this more in their care plans and daily recordings, but this will be discussed later in the summary. There is a welcoming atmosphere, homely environment and comfortable surroundings. The transformation of the internal courtyard garden into a very attractive and usable space for the residents to enjoy. The home provides rehabilitation beds where people are discharged from hospital in preparation for returning home. The home has a good reputation of supporting people to return to the community. There was a commitment to seeking the views of the people who lived at the home, and making improvements based on these. 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. The summary of this inspection report can be made available in other formats on request. Ingestre Road (12) DS0000037254.V353610.R01.S.doc Version 5.2 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 Ingestre Road (12) DS0000037254.V353610.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service can be confident that their needs and aspirations will be met. EVIDENCE: The care records of six people were examined, one person from each unit. All people are admitted to the care home through the care management approach and copies of the community care assessments were available. The home also undertakes their own assessment. In respect of the rehabilitation unit, there is a multidisciplinary approach. The manager is clear that people are admitted to the home if they are able to meet their particular needs. Ingestre Road (12) DS0000037254.V353610.R01.S.doc Version 5.2 Page 9 For planned admissions, people are encouraged to visit the home with family or friends and to have a meal. The admission process is designed to follow the pace of the person being admitted. Each person will find a copy of the service user guide in his or her room. Although some people could not recall it other others had said that it is useful; however they had found any questions answered by staff that were described as “very approachable”. Ingestre Road (12) DS0000037254.V353610.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8, 9 & 10 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are arrangements in place to meet the health care needs of the people living in the home. The residents are protected by the homes’ approach to medication management. EVIDENCE: A sample of six care plans were examined, which included looking at the daily recording for the previous three weeks. The care records were a sample from each unit. They included needs specific to racial origin, medical conditions, recent admissions and dementia. In each case we met with the person concerned but could not discuss their care with them in all cases. A comparison was made between the care recorded in the records and the care being received by each resident. A sample audit was taken on each unit of the medication administration systems. The care plans were found to be comprehensive with important health and personal care needs being identified in most care plans. Examples seen Ingestre Road (12) DS0000037254.V353610.R01.S.doc Version 5.2 Page 11 generally reflected both the needs and the wishes of each individual. Where additional assessments were indicated, such as manual handling, risk of pressures sores and nutritional risks, these had been carried out and were reflected in the care plans. Samples of falls risk assessments and incontinence were also available. From observation and discussion with people using the service is was clear that service delivery was meeting individual needs even if this was not always reflected in the care plans. There is ongoing work to support staff to record more detail in the care plans and for the daily records to reflect the content of the care plan. Training has been given and it is evident that staff are more adept at recording pertinent information. The issue of consistency remains but again this is part of the ongoing training and development of the staff team. As from previous inspections the care records clearly show referrals to and the involvement of other health care professionals. All people living in the care home are registered with a GP. A surgery is held in the home every Friday but the GP will make house calls as appropriate. The home has good support and input from the Community Nursing Services. The Rehabilitation Unit has separate arrangements but retains good medical and nursing input to benefit the people admitted to this unit. A sample audit was taken on each floor relating to the handling and control of medication. This was judged to be managed well. The service has a robust policy and procedure for the ordering receipt, storage, administration and disposal of medication. This is known to the staff that are responsible for the administration of medication and underpins their practice; backed up by attending regular training. Observation on the day of the site visit, discussion with staff, feedback from people using the service and the examination of the care records confirmed that staff respect the privacy and dignity of the people they look after. Feedback from residents was positive and they confirmed that staff are sensitive when they needed help with personal care and that gender specific care was given Ingestre Road (12) DS0000037254.V353610.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Ingestre Road supports people to live the life they choose respecting their choices and individuality. EVIDENCE: All six care plans seen included the person’s wishes and preferences. Feedback from the people living in the home confirmed that they have access to activities taking place in the home as well as in the community. This is an area that the registered manager has earmarked for development especially since the care home has been registered to accept people with dementia. The internal courtyard garden has been improved dramatically and provides a safe but very attractive outdoor space, which can be used all year round if the weather is dry. People living in the care home are understandably proud of the garden and as they have been involved in its’ development, they have a sense of pride. Further development is planned for the quiet lounge downstairs. Those spoken to said that they were satisfied with the level and variety of activity provided. They all confirmed that they were given the choice to attend and felt no Ingestre Road (12) DS0000037254.V353610.R01.S.doc Version 5.2 Page 13 pressure to be involved. Staff are receiving training around meaningful occupation as part of their person centred care training. People living in the home have contact with their respective churches and services are held in the home. Generally people felt that they had control over their lives and there was praise for the staff in supporting people to be independent Visitors said that they are made to feel welcome in the home. This is supported through an open flexible visiting policy. There are varying options for people living in the home to meet with visitors. The menus were noted to be varied and nutritionally balanced. The menu reflected peoples’ choices as meat eaters, vegetarians and varying cultural tastes. The food served at the lunchtime meal looked appetising and peoples’ preferences were being served. Meal times were seen to be relaxed and social events and where people required assistance to eat and drink this was done in a sensitive manner. Ingestre Road (12) DS0000037254.V353610.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home are fully protected by the approach to complaints, incidents and allegations. EVIDENCE: Complaints, incidents and accidents are being recorded. These records were cross-referenced with the care records of the people being case tracked. The accident reports were compared with the Regulation 37 notifications sent by the service since the last inspection. The home has a comprehensive complaint’s policy and procedure. Feedback clearly identifies that this is known to both staff, people living in the home and their relatives. Comments received were all positive about how staff are responsive to comments and/or suggestions as well respond appropriately to any concerns raised. Overall residents said that they felt safe in the home. The service has a robust policy and procedure on adult protection, which is linked to local authority guidance. Staff have received training on adult protection and showed that they understood their role and responsibilities in this area for the safety and protection of the service users. Ingestre Road (12) DS0000037254.V353610.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who reside in the home live in comfortable, homely and clean surroundings. EVIDENCE: The rooms of the service users being case tracked showed that individuals can personalise their private space. This is an area being developed as part of the staff training on person centred care. Individuals said that they liked their bedrooms. They said that they found the home to be warm and comfortable. All the rooms were clean and there were no odours detected. Chemicals were being stored correctly and COSHH assessments and data sheets were in place. There was hand cleanser and protective clothing available in all required areas. Aids and equipment were available to meet the assessed needs of the people living in the care home. The stock available was Ingestre Road (12) DS0000037254.V353610.R01.S.doc Version 5.2 Page 16 in reasonable condition although the manager acknowledges that an area for improvement is the general replacement of equipment to ensure that health and safety is maintained. Ingestre Road (12) DS0000037254.V353610.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team has the skills, knowledge and appropriate attitudes to meet the needs of the people admitted to their care. Staff assist people to reach their full potential to enable them to return home following a stay in hospital. EVIDENCE: Staff were described by people living in the care home as “very caring”, “really helpful” as well as “reliable and approachable”. Feedback from the staff group showed that they found working in the home a very positive experience and were proud of the care they provided. Previous inspections have sown that the provider has a thorough and robust recruitment and selection process. This has been tested recently and the service has responded approriately. Staff confirmed that the induction process covered what they needed to know about their role and repsonsibilities. They are provided with training that is relevant to their role, helps them to understand and meet the individual needs of the service users (including disability, gender, age, race, ethncity, faith and sexual orientation) and keeps them up-to-date with new ways of working. Ingestre Road (12) DS0000037254.V353610.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The quality assurance are effective and the service is proactive in addressing quality issues within the home ensuring that the home is being managed in the best interests of the people who live there. EVIDENCE: The manager completed and returned an Annual Quality Assurance Assessment (AQAA) prior to the inspection. The AQAA is a self assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. The information within the AQAA and further discussions with the manager during the site visit demonstrated a good level of awareness of the strengths of the service and the areas where improvements are necessary. Ingestre Road (12) DS0000037254.V353610.R01.S.doc Version 5.2 Page 19 The judgements in preceding sections of this report have contributed to the judgement in this outcome area. The care home has a welcoming environment and promotes an open and transparent style of management. People using the service are protected by the policies and procedures. The quality assurance systems are effective and the manager is proactive in addressing quality issues within the home. All incidents and concerns are reported fully to the Commission for Social Care Inspection. The manager has demonstrated competence in dealing with untoward situations. The manager is committed to promoting equality and diversity in the service and meeting service users individual needs. There are effective systems in place to manage financial arrangements within the home. The home’s Public Liability Insurance certificate is on display and is current. A sample of health and safety records were looked at. These confirmed that the home is being managed responsibly with essential checks being made. The provider monitors health and safety in the home. There are robust procedures in place to monitor compliance. Ingestre Road (12) DS0000037254.V353610.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 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 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Ingestre Road (12) DS0000037254.V353610.R01.S.doc Version 5.2 Page 21 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 Ingestre Road (12) DS0000037254.V353610.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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