Inspection on 11/04/06 for Integrated Care Services Limited

This inspection was carried out on 11th April 2006.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Integrated Care Services Limited 01/05/07

Integrated Care Services Limited 14/11/05

Integrated Care Services Limited 23/05/05

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Integrated Care Services Limited 2a Tudor Gardens Kingsbury London NW9 8RN Lead Inspector Andreas Schwarz Key Unannounced Inspection 11th April 2006 09:30 Integrated Care Services Limited DS0000056792.V287744.R01.S.doc Version 5.1 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 Integrated Care Services Limited DS0000056792.V287744.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 Adults 18-65. 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. Integrated Care Services Limited DS0000056792.V287744.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Integrated Care Services Limited Address 2a Tudor Gardens Kingsbury London NW9 8RN 020 8200 1158 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) Integrated Care Services Limted Mrs Moline Bamunuwatte Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Integrated Care Services Limited DS0000056792.V287744.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th November 2005 Brief Description of the Service: 2A Tudor Gardens is a newly registered home. The registered person is Mr Percy Bamunuwate and the manager is Mrs Moline Bamunuwate. The home is located in a residential area of Kingsbury. The property is detached; there are two bedrooms, bathroom, lounge/diner and kitchen on the ground floor. Two more bedrooms, office/sleep-in room and bathroom/WC can be found on the first floor. There is parking space for two cars in the homes own drive and free kerbside parking on a road around the home. There are a few shops in walking distance. More shopping facilities are in Wembley or Harrow, which can be reached through public transport. The home is registered for four residents and is currently occupied by three residents. The registered provider informed the inspector of the homes charges, but asked that they will not be published in the report. Integrated Care Services Limited DS0000056792.V287744.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place during a day in April 2006 and lasted over 5 ½ hours. The registered manager Mrs Moline Bamunuwate was available during this inspection. The inspector spoke to two service users and one member of staff during this unannounced key inspection. A variety of files and documents have been assessed during this inspection. The inspector would like to thank service users, staff and manager for being open and helpful during this inspection. What the service does well: What has improved since the last inspection? What they could do better: The home must involve and consult residents more within the running of the home and regular questionnaires must be sent out to families, visitors and stakeholders. More work is needed around medication administration and staff recruitment, but overall services have improved since the last inspection. Integrated Care Services Limited DS0000056792.V287744.R01.S.doc Version 5.1 Page 6 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. Integrated Care Services Limited DS0000056792.V287744.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Integrated Care Services Limited DS0000056792.V287744.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1; 2; 5 Overall quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New prospective residents are supported making an informed choice if they want to move into the home. EVIDENCE: The registered manager send the Statement of Purpose and Service Users Guide to the inspector prior to this visit and both documents have been reviewed and are now compliant with National Minimum Standards. The inspector found these documents in service users files and one service user informed the inspector of having seen the document before. Previous inspection demonstrated clearly of the homes assessment process and was judged as being compliant. The home did not have any new admission since the last inspection. Assessment policy is in place and procedures are followed. The home has now issued contracts to all residents and residents informed the inspector of having signed the contract and being aware of their responsibilities. Contracts are available in pictorial form. Integrated Care Services Limited DS0000056792.V287744.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6; 7; 9 Overall quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged making choices about the care and support received by the home. EVIDENCE: The inspector viewed two care plans during this inspection and care plans have been updated and regularly reviewed. The care plan file is of good standard and contains detailed information about the resident and what care would be required. Care plans have been reviewed with service users involvement and clear records have been made available. The inspector noted that care plans contained behaviour guidelines, psychology reports, contracts, etc. Residents are registered with the electoral register and register for postal vote. Residents informed the inspector of having residents meetings and records of these have been viewed. The inspector informed the registered manager to provide these meetings on a more regular basis. Finance records have now been updated and residents are supported with their finances. Residents are supported by the home to receive the appropriate benefits and regular correspondence is on file. Residents informed the inspector that they can make Integrated Care Services Limited DS0000056792.V287744.R01.S.doc Version 5.1 Page 10 choices and staff and manager respect their choices. Residents living in the home are all verbal and informed the inspector that they don’t want to have an independent advocate. The inspector viewed risk assessments, which are judged as appropriate and compliant. The home has assessed a wide variety of risks and residents have been involved within this process. There is however a need to review the risk assessments on regular intervals. The home has a written missing persons procedure in place. Integrated Care Services Limited DS0000056792.V287744.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the 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; 16; 17 Overall quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported fully by the home in accessing activities and participating in the community, attending colleges and daycentres, etc.. Residents can choose their activities and staff supports residents in meeting their choices. EVIDENCE: Two residents attend local colleges four days per week and attend a variety of classes ranging from cooking, art to computers. The inspector spoke to one resident regarding his college courses and he was very enthusiastic about what he has achieved and informed the inspector that he likes meeting new people. The home has no volunteers employed. Residents informed the inspector of going regularly to church and the inspector observed residents going shopping during this inspection. Daily records stated that residents go out regularly to the cinema, dinners, discos, etc. Residents informed the inspector of having been on holiday and the registered manager informed the inspector of planning a holiday to Somerset this year. Integrated Care Services Limited DS0000056792.V287744.R01.S.doc Version 5.1 Page 12 The home has a relationship policy in place. Service users informed the inspector of maintaining relationships with friends at the college and friends they have made in the past. This is monitored by the home to maintain service users safety. Service users’ families are involved in the care and regular contact is recorded in service users files. Residents confirmed of having a key, but feel they don’t want to use it. Mail received during this inspection was given to service users unopened. The inspector observed staff interacting with residents and service users confirmed of staff listening to their needs. Residents informed the inspector that they can choose without any reprimand if they want to be on their own socialise with their flat mates. This was observed during this visit by the inspector. Service users are involved within the running of the home and make their own breakfast or clean their room with staff support. The home has clear guidelines regarding smoking, alcohol or illegal drugs. The inspector viewed the home’s menu, this is judged as being wholesome, varied and healthy. A large bowl of fruit was available during this inspection and residents confirmed receiving regularly salads, vegetable and fruit. Residents told the inspector that they liked the food and alternative meals are offered if they don’t like the collectively chosen meal. The kitchen was found to be very clean and regular fridge and freezer temperature records have been viewed. Integrated Care Services Limited DS0000056792.V287744.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18; 19; 20; 21 Overall quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is meeting service users health care needs and support residents attending health care and doctor appointments; the home must address service users wishes regarding ageing, illness and death. EVIDENCE: Residents informed the inspector that they are happy with the support they receive by staff and personal care needs are documented in service users files. Service users were judged as being dressed appropriately and confirmed having chosen of what they wear independently. The home does not provide currently any technical aids to transfer service users, due to all residents being fully mobile. The home has physiotherapist, bereavement counsellor, chiropodist involved in service users’ care. This was found to be clearly recorded in service users’ daily records. Service users living at the home have no continence issues. Records provided clear evidence of service users visiting opticians, dentists, and chiropodists, GP’s regularly. One of the residents has Diabetes and the practice nurse does blood tests. Residents confirmed that they could see health care professionals in their room if they wish to do so. Integrated Care Services Limited DS0000056792.V287744.R01.S.doc Version 5.1 Page 14 The home is using Boots MDS system and records were found to be in order and had no gaps. The inspector noted that medication started on different days and recommends streamlining this, so that all medication commences on the same day of the months to maintain consistency. The inspector found eye drops not to be stored according to manufacturers’ guidelines. The medication policy has been updated and is now found to be compliant with National Minimum Standards. The home provided a signatory list of staff being trained in the medication administration. The home does not record service users’ allergies, which is required. Previous inspection noted that service users wishes regarding ageing, illness and death must be addressed and recorded within their files, this was found still to be outstanding. The registered manager informed the inspector that she finds this difficult to address and the inspector recommended involving the bereavement counsellor already involved with the home. Integrated Care Services Limited DS0000056792.V287744.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22; 23 Overall quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents concerns and complaints are recorded and dealt with in an appropriate manner. Clear guidelines protect residents from abuse. EVIDENCE: The home complaints policy has been assessed previously and was found to be compliant with National Minimum Standards. The inspector viewed the homes incident book and found incidences being recorded in detail. The home did not receive any complaints since the last inspection. The home has a Protection of Vulnerable Adults policy in place, which was judged as compliant previously. All staff attended Brent’s Protection of Vulnerable Adults training and hosting boroughs guidelines are available. Staff demonstrated good knowledge of who and how to report allegations of abuse. Integrated Care Services Limited DS0000056792.V287744.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24; 30 Overall quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a clean and nicely decorated home; personal possessions and pictures are in communal as well as private areas. EVIDENCE: The registered manager showed the inspector around the home. The home is nicely furnished and decorated. Furnishing is of domestic character and are not damaged. The lounge and dining room was used by service users during this visit and service users informed the inspector that they like the home and feel very comfortable and at home. The inspector noted that the service user’s bedrooms carpet leading from the lounge was very stained and must be cleaned. There is a large well-maintained front garden. The laundry room is located in the homes garage, the clothes dryer and washing machine are of domestic character and programmes allow laundry to be washed above 65 degrees Celsius. The home was clean and free of any offensive odours during this inspection. Service users informed the inspector that staff support them in cleaning their room. Integrated Care Services Limited DS0000056792.V287744.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32; 34; 35 Overall quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is providing an adequate number of staff trained and skilled to support the residents in their home and the community. EVIDENCE: The inspector spoke with one member of staff on duty informing him of having received a comprehensive induction before starting work. The inspector found clear records of this on the staff member’s personal file. The home does not employ staff under the age of 18 and all staff has been issued with a General Social Care Councils Code of Conduct. Four staff employed by the home have their Health and Social Care Level 2 qualifications and three staff are currently work towards achieving their Health and Social Care Level 3, this means approximately 60 of care staff are trained to or above National Vocational Level 2. The inspector assessed two recruitment files, which are of acceptable standard. One of the files, however, did miss a copy of the employees’ passport, which is required. The home has a recruitment policy in place and practice confirmed that the home follows this procedure. Service users informed the inspector that they would like to be involved in the recruitment process and the registered manager should explore this and enable service users to participate. Integrated Care Services Limited DS0000056792.V287744.R01.S.doc Version 5.1 Page 18 The home is keeping a separate training record for all staff; these records confirmed that staff has received a number of mandatory training such as Food Hygiene, First Aid, Fire Safety, etc. Staff the inspector has spoken to confirm this. All staff have a training and development plan, which is in need for updating. Integrated Care Services Limited DS0000056792.V287744.R01.S.doc Version 5.1 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37; 39; 42 Overall quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is judged as being managed very well and residents live in a safe and comfortable environment. EVIDENCE: The registered manager has been working in care for a number of years; she is currently in the process of completing her Registered Managers Award and informs the inspector that this should be done by September 2006. Staff the inspector has spoke to confirm that the manager is very supportive and is available if needed. The manager is fully involved in service users care. The home has a good history of compliance within the regulatory context. The home viewed one service user questionnaire during this visit and informed the registered manager that this must be done with all residents, their representatives, visitors and stakeholders on a regular basis to obtain clear information about the service. The registered manager informed the inspector of not having an annual development plan, which is required. The inspector did Integrated Care Services Limited DS0000056792.V287744.R01.S.doc Version 5.1 Page 20 not receive any regulation 26 report since opening and informed the registered manager and registered provider that this is required. The inspector assessed the following certificates Electrical Installation and Wiring (Expires 14/07/07); Landlords Gas Safety Certificate (Expires 24/01/07), the home did not have a valid Portable Appliances Test Certificate; the inspector informed the registered manager that a copy of the Portable Appliances Test Certificate must be send to the Commission for Social Care Inspection. Fire records viewed by the inspector where of good standard and requirements made during the last visit by the Fire Authority have been complied with. Integrated Care Services Limited DS0000056792.V287744.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 2 3 X 2 X X 2 X Integrated Care Services Limited DS0000056792.V287744.R01.S.doc Version 5.1 Page 22 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. 2. 3. 4. Standard YA9 YA20 YA20 YA21 Regulation 14(2)(a) 13(2) 13(2) 12(3) Requirement The registered manager must ensure to review risk assessments in regular intervals. Medicines must be stored according to manufacturers guidelines. The registered manager must record service users allergies on the MAR sheet. Wishes of dying and death must be discussed with residents as appropriate. (Expired 31/07/05 & 31/12/05) Timescale for action 15/05/06 30/04/06 30/04/06 30/05/06 5. YA23 6. 7. 8. 9. YA24 YA34 YA39 YA36 The registered manager must obtain Protection of Vulnerable Adults guidelines of funding boroughs. 23(2)(d) The registered manager must ensure that carpets in service users rooms are steam cleaned. 19 All staff must have proof of the Schedule2 right to work in the United Kingdom in place. 9(2)(b)(i) The registered manager must complete her Registered Manager Award. 19 The registered manager must up Schedule2 date all training and DS0000056792.V287744.R01.S.doc 13(6) 15/05/06 15/05/06 30/04/06 30/09/06 15/05/06 Integrated Care Services Limited Version 5.1 Page 23 development plans. 10. YA39 24(1&2) The registered manager must produce an annual service development plan. The registered manager must forward the annual development plan to the Commission for Social Care Inspection. (Expired 31/01/06) 11. YA39 26 The registered provider must forward a record of the monthly provider visit to the Commission for Social Care Inspection. The registered manager must forward a copy of the Portable Appliances Test Certificate to the Commission for Social Care Inspection. 30/05/06 31/05/06 12. YA42 13(4)(c) 30/05/06 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. 2. Refer to Standard YA7 YA34 Good Practice Recommendations Residents meetings should happen on a more regular basis. The registered manager should explore in how he can involve residents in recruitment process. Integrated Care Services Limited DS0000056792.V287744.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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. 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