Inspection on 12/12/05 for Juliana Close 46

This inspection was carried out on 12th December 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 no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Juliana Close 46 13/06/08

Juliana Close 46 23/11/07

Juliana Close 46 11/04/07

Juliana Close 46 04/04/06

Juliana Close 46 12/07/05

Juliana Close 46 12/08/04

Juliana Close 46 30/04/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

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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 Juliana Close 46 Off Thomas More Way East Finchley London N2 0TJ Lead Inspector Tom McKervey Unannounced Inspection 12th December 2005 09:00 Juliana Close 46 DS0000010456.V265655.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 Juliana Close 46 DS0000010456.V265655.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. Juliana Close 46 DS0000010456.V265655.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Juliana Close 46 Address Off Thomas More Way East Finchley London N2 0TJ 020 8343 0016 020 8343 0016 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) PentaHact Ms Afsaneh Alizadeh Alamdari Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places Juliana Close 46 DS0000010456.V265655.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Limited to 6 adults of either gender who have learning disabilities (LD) and who may also have physical disabilities (PD). One specified service user. One specified service user who is over 65 years of age, may continue to be accommodated in the home for as long as the home continues to meet the service user`s needs. The home must advise the regulating authority at such times as the specified service user vacates the home. 12th July 2005 3. Date of last inspection Brief Description of the Service: 46 Juliana Close is a purpose-built home designed to provide personal care and support for six younger adults who have a learning and a physical disability. The home, which opened in November 1993, is leased from Servite Housing Association and is managed by PentaHact, which is a Barnet based organisation. PentaHact also manage several other homes in the borough. The six places available, are funded by a block contract with the local authority. The home is a six-bedded bungalow in a quiet cul-de-sac in a housing estate. The communal areas comprise of a large lounge, a quiet room and a kitchen/diner. There are two assisted bathrooms, two toilets and a shower room. The home has its own transport. However, the vehicle, which is leased, does not have a tail-lift, which restricts some service users who use wheelchairs, from benefitting from going on outings. This issue is addressed in the main body of the report. The stated aims of the home are to provide twenty-four hour care and support for people with profound learning disabilities and to enable them to live as independently as possible in the community. Juliana Close 46 DS0000010456.V265655.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out in a period of two and a quarter hours. At the time of the inspection the manager was not on duty and a senior carer assisted the inspector in the inspection process. There were six people living at the home and there were no vacancies. The inspection was conducted by touring the premises, speaking to two residents and two staff, looking at records and examining documents pertaining to the running of the home. What the service does well: What has improved since the last inspection? What they could do better: The recent incidence of falls by a specific resident must be monitored and a referral should be made to a specialist in this subject for advice. Superfluous medication must be disposed of and there must be more diligence by staff about signing when they administer medication. Identified maintenance issues need to be addressed and a cleaner must be employed to improve the cleanliness of the home and relieve the care staff from this task. Juliana Close 46 DS0000010456.V265655.R01.S.doc Version 5.0 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. Juliana Close 46 DS0000010456.V265655.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 Juliana Close 46 DS0000010456.V265655.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): No new residents have been admitted since the last inspection; therefore, none of these standards were assessed. EVIDENCE: Juliana Close 46 DS0000010456.V265655.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, 8 & 9 There is clear guidance for staff to help them to understand residents’ needs and how to respond appropriately to their wishes. EVIDENCE: Two care plans were examined. The residents’ likes and dislikes were recorded. Goals were set for each individual, with actions required to meet them. Risk assessments were an integral part of the plans and six-monthly reviews of the risks were recorded. The case files included advice for staff about how to communicate with residents who were non-verbal. At the time of the inspection, four residents were at various day centres and there were two residents staying in the home. Observation of how staff communicated with residents indicated that they understood their wishes and responded appropriately. The daily diaries of service users, contained evidence of how they took decisions about their lives. Juliana Close 46 DS0000010456.V265655.R01.S.doc Version 5.0 Page 10 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): 11, 12, 13 & 17 The residents are well integrated with the local community and they have a lifestyle that reflects their individual needs and aspirations. Access to community facilities has been further improved by the provision of an appropriate minibus. EVIDENCE: At the time of the inspection, four of the residents were at day centres, where communication skills programmes were being provided along with other activities. The residents’ daily records showed that they frequently access the local community. For example; residents assist with food shopping, go out for meals and use all the other leisure amenities. An outside entertainer provides a music session every week. A new communal vehicle to accommodate wheelchairs has been purchased to provide better access to community facilities for all the residents. All residents were supported by staff to have a holiday during the summer, either individually or in twos. Juliana Close 46 DS0000010456.V265655.R01.S.doc Version 5.0 Page 11 The menus showed a good variety of nutritious meals and fresh fruit was available. The residents choose meals from pictures, and the food actually eaten is recorded for each resident. One service user has diabetes and has an appropriate diet as advised by the dietician. Juliana Close 46 DS0000010456.V265655.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): 19 & 20 The general healthcare needs of service users are being met. However, in the case of one resident, expert advice should be sought, and there needs to be better monitoring of these incidents. Residents are potentially being put at risk because of poor recording of the administration of medicines. EVIDENCE: All residents were registered with a G.P, and there were good records of a range of healthcare appointments. One resident has diabetes, and all staff had been trained by the District Nurse to monitor blood glucose and to administer insulin. A resident had recently suffered a number of falls. Although the resident was being referred to the G.P, there was no chart to monitor the frequency and pattern of falls, and a requirement is made to do this and to refer this person to an occupational therapist for assessment and advice. The medication records showed several gaps where staff had not signed for the administration of medicines. This is a frequent problem in this home. In addition, a supply of medication for each resident, dating back to April 2005 was being kept as a “back-up”. This is not required nor good practice, and the medication should be returned to the pharmacy. A requirement is made for the manager to address these issues. Juliana Close 46 DS0000010456.V265655.R01.S.doc Version 5.0 Page 13 Juliana Close 46 DS0000010456.V265655.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): 22 & 23 There are good systems to ensure that residents’ complaints are dealt with appropriately and they are protected from potential abuse by good procedures and staff training on this subject. EVIDENCE: The last complaint logged was in April 2005, which was about the lack of suitable residents’ transport. This matter has been resolved. There was evidence that staff had attended training in adult protection procedures. Juliana Close 46 DS0000010456.V265655.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, 25, 26 & 30 Although some improvements to the environment have taken place, there are still concerns about cleanliness and hygiene in the home, which compromises residents’ comfort and welfare. EVIDENCE: A tour of the premises was carried out, including five residents’ bedrooms. A new kitchen had been installed this year, and some bedrooms had been decorated. The following issues were identified, about which, requirements are made: • • • • The glass doors in the oven in the kitchen were very dirty. Although new disposable hand towel dispensers had been purchased, these had not been installed. There was a large damp patch on the ceiling of one corridor, and also, some cobwebs were seen. Some paving slabs at the front of the building were uneven. The inspector was informed that currently, there was no cleaner employed for the home, and the care staff were carrying out this task. A requirement is made about this under Standard 33. Juliana Close 46 DS0000010456.V265655.R01.S.doc Version 5.0 Page 16 Juliana Close 46 DS0000010456.V265655.R01.S.doc Version 5.0 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): 31, 33 & 36 The residents’ needs are being met by a well-trained, dedicated and competent group of staff. However, care staff could devote more time to the residents if they were not required to do the cleaning. EVIDENCE: The inspector was informed that vacancies were being covered by bank staff who were familiar with the residents. Four new care staff had recently been recruited, but in the absence of the manager, staff personal records were not available for inspection. The staff who were spoken to, were very knowledgeable about their role as key-workers. The staff rota showed that there was sufficient care staff on duty to support the residents during the day and night. However a cleaner must be recruited for the home. The staff said that they received regular supervision from the manager. Juliana Close 46 DS0000010456.V265655.R01.S.doc Version 5.0 Page 18 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, 38, 40 & 42 The home is well managed and there is a good team spirit. Residents’ interests are safeguarded by good systems for managing their personal finances. EVIDENCE: The current manager is now working full time in the home. She has many years experience of managing another Pentahact home and is in the process of applying for registration with the Commission for Social Care Inspection. The staff were complimentary about the manager, describing her as being “service user orientated”. They also said that the morale within the team was good. The personal money held for one resident balanced against the recorded amount, and receipts were seen for goods purchased on their behalf. The fire log showed that fire alarms were checked weekly. Juliana Close 46 DS0000010456.V265655.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 X X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 X X X 2 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 3 X 3 X X 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Juliana Close 46 Score X 2 2 X Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X 3 X DS0000010456.V265655.R01.S.doc Version 5.0 Page 20 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 YA19 Regulation 12(1)(a) & 13(2)(b) Requirement Timescale for action 28/02/06 2 YA20 3 4 YA20 YA24 The registered person must monitor the incidence of falls and refer a specific resident to the occupational therapist for advice. 13(2) The registered person must ensure that old stock medication is returned to the pharmacy. 13(2) The registered person must ensure that staff sign for all administered medication. 23(2)(b)(d) The registered person must ensure that: • The glass doors in the oven are cleaned. • Disposable hand towel dispensers are installed. • The damp patch on the ceiling is attended to. • Cobwebs are removed. 18(1)(a) The registered person must recruit a cleaner for the home. 28/02/06 28/02/06 28/02/06 5 YA30 31/03/06 Juliana Close 46 DS0000010456.V265655.R01.S.doc Version 5.0 Page 21 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 Juliana Close 46 DS0000010456.V265655.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Juliana Close 46 DS0000010456.V265655.R01.S.doc Version 5.0 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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