Inspection on 14/11/05 for Integrated Care Services Limited

This inspection was carried out on 14th November 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 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 18 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 11/04/06

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 Unannounced Inspection 14th November 2005 09:30 Integrated Care Services Limited DS0000056792.V262616.R01.S.doc Version 5.0 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.V262616.R01.S.doc Version 5.0 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.V262616.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Integrated Care Services Limited Address 2a Tudor Gardens Kingsbury London NW9 8RN 020 8959 3965 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.V262616.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd May 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. Integrated Care Services Limited DS0000056792.V262616.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place during a morning in November 2005. The inspector spoke to al three residents, two staff, the registered manager and the registered individual. The registered manager and the registered individual were available throughout this inspection. The inspector viewed care plans, financial records, policies and procedures and other records made available to him on request. The inspector would like to take the opportunity thanking residents, staff and management of being welcoming and helpful during this inspection What the service does well: What has improved since the last inspection? This was the agencies second inspection and residents have settled in very well in the new home. All residents have been on a holiday in Somerset and informed the inspector that they enjoyed this holiday immensely. New garden furniture has been purchased and the home has currently only one vacancy. The responsible individual has completed his registered manager award and NVQ Level 4 in Care qualification and is currently awaiting his certificate. The registered manager is half way through with the completion of her registered manager award. Integrated Care Services Limited DS0000056792.V262616.R01.S.doc Version 5.0 Page 6 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. Integrated Care Services Limited DS0000056792.V262616.R01.S.doc Version 5.0 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.V262616.R01.S.doc Version 5.0 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; 5 Further work is required in providing prospective service users with the appropriate information about the home. All residents with the exception of one have an individual written contract EVIDENCE: The manager informed the inspector that some work has been done in regards to the service users guide and statement of purpose. The responsible individual provided service users in a service users friendly format. The inspector assessed s the homes’ service users guide and statement of purpose and found a number of issues non compliant with National Minimum Standards. The inspector informed the registered manager that she must revise the statement of purpose and service users guide and send a revised copy of both documents to the Commission for Social Care Inspection as required in the previous inspection. Two of the three residents living at the home have a contract, but only one of these have been signed. The contacts viewed by the inspector are compliant with National Minimum Standards. The inspector informed the registered manager that all residents must have a signed contract, which must be made available in a service user-friendly format. Two of the three residents living in the home can read, the inspector suggested to the registered manager of ways to make contract more user friendly. Integrated Care Services Limited DS0000056792.V262616.R01.S.doc Version 5.0 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 All residents have individual care plans and are involved within the care planning processes. Residents are very vocal and are involved in the decision making processes of the home, there is however a need to clearly document these EVIDENCE: The inspector viewed all care plans, which hold a lot of very valuable and good information. Care plan files however were found to be disorganised and there is a need to review all files in their entirety. The inspector discussed this with Registerd manager, the current practice is that when documents are received they are filed on top of the care plan file; this leads to information regarding health, community participation, etc. being ain different places within the file. Residents care plans have been reviewed with their involvements and the inspector has viewed minutes of these. Residents living in Tudor Gardens are all verbal and very vocal. All residents confirmed that they feel listened to by the staff and the registered manager. However residents informed the inspector of not having residents meetings and minutes were not available on request by the inspector. Residents’ families and friends are invoked and advocating on their behalf. There is a need for the Integrated Care Services Limited DS0000056792.V262616.R01.S.doc Version 5.0 Page 10 manager to explore independent advocacy services for the residents living in Tudor Gardens. The registered manager manages the finances of two residents living at the home; records viewed by the inspector were not all up to date. The inspector discussed this with the registered manager and made the following requirements. Monies received from family members must be recorded and financial records must be updated in regular intervals. One resident is not allowed to use the telephone independently, this is clearly explained in her care plan and the resident agrees guidelines. Integrated Care Services Limited DS0000056792.V262616.R01.S.doc Version 5.0 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): 13 Service users access and take part within the community regularly. EVIDENCE: Residents informed the inspector that they go to the local pub; shopping trips at the local super market, attend the local church on Sundays. All this was recorded in service users files and confirmed by staff and management. During the day of this unannounced inspection one resident attended the North West London College for different courses. He informed the inspector of going to the college four times a week and having chosen the courses he is attending. Another resident informed the inspector of attending Barnet College and certificates of this have been viewed in the service users files. The manager informed the inspector that all residents went to somerset for their annual holiday, residents confirmed of having had a great time and thoroughly enjoyed this holiday. Integrated Care Services Limited DS0000056792.V262616.R01.S.doc Version 5.0 Page 12 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): 20; 21 The home has acceptable procedures in place regarding protecting service users medication, there is however a need for further work to reach full compliance. Residents’ wishes of dying and death are discussed with service users. EVIDENCE: The inspector assessed requirements made by the Commission for Social Care Inspection pharmacy inspector in May 05 a number of requirements have not been addressed, the inspector informed the registered manager that this is required to reach full compliance. The registered manager informed the inspector that she is currently in the process of changing the pharmacist. Medication procedures were discussed, the manager explained that she is currently filling a doset box for a resident who is self-administering; the inspector explained that this is not an acceptable practice and must stop. Medication must only dispensed by the dispensing pharmacist. One of the residents living at the home is self-administering, the inspector informed the registered manager that it is required preparing a risk assessment for this resident. The home has a policy for death and dying in place, which was assessed as compliant in the previous inspection. The home begun discussing funeral Integrated Care Services Limited DS0000056792.V262616.R01.S.doc Version 5.0 Page 13 arrangements with one resident; it is required that funeral arrangements, illness and ageing is discussed with all residents. Integrated Care Services Limited DS0000056792.V262616.R01.S.doc Version 5.0 Page 14 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): The above standards have been assessed and met during the homes’ previous inspection EVIDENCE: Integrated Care Services Limited DS0000056792.V262616.R01.S.doc Version 5.0 Page 15 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 The home is nicely decorated and residents live in a homely and comfortable environment. Residents live in a clean and hygienic environment, which is free of any offensive odours. EVIDENCE: 2a Tudor Gardens is a detached two- storey property; there are two bedrooms, bathroom, lounge, diner and kitchen on the ground floor. The property has only a front garden, which is however well maintained and large enough for the size of the home. There are an additional two bedrooms, bathroom/WC and office on the first floor. Furnishing provided is of domestic character and the home is nicely decorated. The laundry room is in the homes’ garage, which can be reached through the path in the garden. The laundry area is clean, tiled and has a washing machine and dryer as well as a Belfast sink. The home was free from offensive odours and clean during this unannounced inspection. Integrated Care Services Limited DS0000056792.V262616.R01.S.doc Version 5.0 Page 16 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): 31; 36 Roles and responsibilities are clearly defined and residents are aware of whom to approach. Staffing files have not been assessed during this inspection; therefore the inspector is not able making a clear judgement regarding staff supervision. EVIDENCE: The home has clearly defined roles and responsibilities and job descriptions have been assessed during previous inspections. One of the staff members the inspector has spoken to is currently on her induction and is supervised by the registered manager, she was not aware of the Code of Conduct set by the General Social Care Council, the manager must raise awareness about this and all staff must receive the Code of Conduct in social care. Staff the inspector has spoken to staff, which confirmed that they have received regular supervisions. Staff files however were not available to assess. The manager explained that all staffing files are in the organisations other homes’ office. The inspector will therefore repeat the requirement made in the previous inspection. Integrated Care Services Limited DS0000056792.V262616.R01.S.doc Version 5.0 Page 17 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 The Home is managed and run by an experienced manager. Residents are very vocal and will raise their views, there is however a need doing further work to reach full compliance. Residents live in a safe and well-maintained, there is however a need to review fire procedures. EVIDENCE: The registered manager is currently doing her registered managers award and certificates of achieved units were shown to the inspector. Staff and residents spoke very positive about the support they receive from the manager. Residents told the inspector that the manager and responsible individual are approachable and listen to their requests. The inspector viewed one service users questionnaire during this inspection, the inspector informed the registered manager that all residents should have the opportunity in voicing their opinion regarding the care received at Tudor Gardens. In addition to this the registered manager must involve family Integrated Care Services Limited DS0000056792.V262616.R01.S.doc Version 5.0 Page 18 members, stakeholder and clinicians in surveys. The home does not have an annual service development plan; this is required. Health and Safety certificates have not been assessed on this occasion. The inspector however received a letter from the London Fire and Emergency Planning Authority while producing this report. The inspector informed the registered manager that requirements made following this inspection must be complied with, within the given timescale Integrated Care Services Limited DS0000056792.V262616.R01.S.doc Version 5.0 Page 19 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 X X X 2 Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 2 X X X X 2 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Integrated Care Services Limited Score X X 2 2 Standard No 37 38 39 40 41 42 43 Score 3 X 2 X X 2 X DS0000056792.V262616.R01.S.doc Version 5.0 Page 20 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA1 Regulation 5(1)(f) Requirement The CSCI address must be included in the Service Users Guide. (Expired 30/06/05) The manager must forward a copy of Service Users Guide and Statement of Purpose to the inspector. (Expired 30/06/05) The manager is required providing a written and signed contract to all residents. (Expired 30/06/05) The contract must be provided in a user-friendly format. (Expired 31/07/05) All residents must have an upto-date plan of care. (Expired 30/06/05) Resident meeting must be held regularly minutes must be provided. (Expired 30/06/05) Financial records for all residents must be up dated and money received by the family or the resident must be signed for. The registered manager must find independent advocacy services for the residents. DS0000056792.V262616.R01.S.doc Timescale for action 31/12/05 2. YA1 5(2) & (4)(2) 31/12/05 3. YA5 5(1) c 31/12/05 4. 5. 6. YA5 YA6 YA7 5(1) c 15(2)(a) 17 31/12/05 31/12/05 30/11/05 7. YA7 16(2)(l) 15/12/05 8. YA7 20(3) 31/12/05 Integrated Care Services Limited Version 5.0 Page 21 9. YA20 13(2) 10. YA20 13(2) 11. 12. 13. YA20 YA20 YA21 13(2) 13(2) 12(3) 14. 15. YA36 YA31 18(2) 18(4) 16. YA39 24(3) 17. YA39 24(1&2) The home must expand their medicines policy to include the actual procedures for ordering, administration (including when away from the home) and recording in the home. Procedures should also be available for managing service users who may refuse their medication errors and the disposal of medication. (Expired 01/08/05) When completed there must be a list of approved signatures and initials of staff trained in the safe handling of medicines and who have read and understood the homes’ medication policy. (Expired 01/08/05) The registered manager must not do any secondary dispensation of medicines. The home must have a risk assessment for residents who self-administer. Wishes of dying and death must be discussed with residents as appropriate. (Expired 31/07/05) All staff must receive regular supervisions. (Expired 30/06/05) The manager must ensure that staff is aware of the Code of Conduct. (Expired 31/07/05) The home must seek feedback from all service users, families, and stakeholders and outside professionals. 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. 31/12/05 31/12/05 30/11/05 30/11/05 31/12/05 30/11/05 30/11/05 31/01/06 31/01/06 Integrated Care Services Limited DS0000056792.V262616.R01.S.doc Version 5.0 Page 22 18 YA42 23(4) The registered manager must ensure to comply with all requirements following the most recent inspection by the LFEPA. 1. Fire resisting doors on 1st floor bedroom require maintenance. 2. Fire resisting doors to the kitchen and front bedroom require maintenance. 3. The registered manager must provided fire safety training, including details of fire drills that have been carried out. 4. The registered manager must provide records for monthly testing of the emergency lighting system. 14/02/06 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. Refer to Standard YA5 Good Practice Recommendations The registered manager could produce the contract in audio format. Integrated Care Services Limited DS0000056792.V262616.R01.S.doc Version 5.0 Page 23 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. Extracts may not be used or reproduced without the express permission of CSCI Integrated Care Services Limited DS0000056792.V262616.R01.S.doc Version 5.0 Page 24 - 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. 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