Inspection on 12/07/05 for Juliana Close 46

This inspection was carried out on 12th July 2005.

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

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 12/12/05

Juliana Close 46 12/08/04

Juliana Close 46 30/04/04

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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 46 JULIANA CLOSE off Thomas More Way East Finchley London N2 0TJ Lead Inspector Tom McKervey Announced 12 July 2005 @ 09.30am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. 46 JULIANA CLOSE G59 S10456 Juliana Close V230896 12.07.05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 46 Juliana Close Address off Thomas More Way, East Finchley, London N2 0TJ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8364 0016 020 8343 0016 Cedric Frederick of PentaHact Vacant PC Care Home only 6 Category(ies) of LD Learning Disability registration, with number PD Physical Disability of places 46 JULIANA CLOSE G59 S10456 Juliana Close V230896 12.07.05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Limited to 6 adults of either gender who have learning disabilities (LD) and who may also have physical disabilities (PD). 2. 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. 3. The home must advise the regulating authority at such times as the specified service user vacates the home. Date of last inspection 12 August 2004 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. 46 JULIANA CLOSE G59 S10456 Juliana Close V230896 12.07.05 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was carried out in a period of seven hours. The lead inspector was accompanied by Regulatory Inspector, Wendy Heal. At the time of the inspection the manager post was vacant, and a manager from another Pentahact home was covering for three days per week while the post was advertised. The acting manager assisted fully 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 residents and staff, looking at records and examining documents pertaining to the running of the home. Prior to the inspection, three written comments from relatives were sent to the Commission for Social Care Inspection. Five other comments came from residents, supported by staff because they were non-verbal, and one comment was received from a care manager. In general, the comments were positive about the service. However, one relative was concerned about a transport issue, which is addressed in the body of the report. What the service does well: What has improved since the last inspection? New kitchen units have been installed, and residents’ case files are stored more securely. Recruitment for the vacant manager post is taking place. 46 JULIANA CLOSE G59 S10456 Juliana Close V230896 12.07.05 Stage 4.doc Version 1.30 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. 46 JULIANA CLOSE G59 S10456 Juliana Close V230896 12.07.05 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection 46 JULIANA CLOSE G59 S10456 Juliana Close V230896 12.07.05 Stage 4.doc Version 1.30 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 standard(s) 2 & 3 There are good systems in place to ensure that service users’ needs are properly assessed, and their wishes and aspirations are being met. EVIDENCE: The case files of three residents were examined. They contained good assessments from social workers and the care staff. Potential risks to residents were identified, including steps to minimise these. The files contained life histories, likes and dislikes, which enabled the individual’s needs and wishes to be identified, especially for people who were non-verbal. There was evidence that annual care reviews were carried out by local authority care managers to ensure that the service continued to meet service users’ needs. 46 JULIANA CLOSE G59 S10456 Juliana Close V230896 12.07.05 Stage 4.doc Version 1.30 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 standard(s) 6, 7, & 10 There is appropriate guidance in place to guide staff in understanding service users’ needs and means of communicating their wishes. EVIDENCE: Three care plans were sampled. These described the service user’s likes and dislikes. 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 best to communicate with service users who were non-verbal. Staff were observed communicating with service users about specific activities, and responding appropriately to their wishes. The daily diaries of service users, contained evidence of when service users took decisions about their lives. Service users’ case files and other important documents were stored securely and staff who were spoken to, were aware of the need for confidentiality. 46 JULIANA CLOSE G59 S10456 Juliana Close V230896 12.07.05 Stage 4.doc Version 1.30 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 standard(s) 11, 12, 13, 14 15, 16 & 17 Service users are well integrated with the local community and they enjoy a lifestyle that reflects their individual needs and aspirations. However the rights of residents with mobility problems are being infringed by the lack of appropriate transport. EVIDENCE: 46 JULIANA CLOSE G59 S10456 Juliana Close V230896 12.07.05 Stage 4.doc Version 1.30 Page 11 At the time of the inspection, four of the service users were out at their various day centres. There was evidence in the service users’ case files that communication skills programmes were being provided by the day centres. During the inspection two service users went shopping, supported by staff. 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. There is a policy about sexuality and relationships between service users. There is full access to all parts of the home, including residents who use wheelchairs. However, concern was expressed by staff and a relative, that the rights of service users who have mobility problems were being infringed because the minibus does not accommodate wheelchair users. A requirement is made regarding this matter. All residents had a holiday this year. The menus showed a good variety of nutritious meals and fresh fruit was available. The food actually eaten was recorded for each resident, which confirmed that they were able to choose alternatives to the planned menu. One service user has diabetes and is provided with an appropriate diet on the advice of the dietician. 46 JULIANA CLOSE G59 S10456 Juliana Close V230896 12.07.05 Stage 4.doc Version 1.30 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 standard(s) 18, 19 & 20 The general healthcare needs of service users are being met, and there are good systems in place for safe storage of medication. There needs to be better recording of the application of lotions and creams. EVIDENCE: The interactions between staff and two service users who were present during the inspection, were observed. Staff approached the residents with warmth and affection and in a dignified and respectful manner. No personal care was observed, however, the manager stated that this is carried out in the privacy of a locked bathroom, toilet or the service user’s bedroom, as appropriate. All residents were registered with a G.P, and there were good records of a range of healthcare appointments. None of the residents were able to self-medicate. Medication was stored safely, and the temperature of the medication cupboard was monitored. However, application of creams and lotions were not clearly coded in the records of administration of medicines. A requirement is made regarding this. 46 JULIANA CLOSE G59 S10456 Juliana Close V230896 12.07.05 Stage 4.doc Version 1.30 Page 13 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 standard(s) 22 & 23 There are good systems to ensure that service users’ complaints are dealt with appropriately and they are protected from potential abuse by good procedures and staff awareness. However, there is poor record keeping of staff training in adult protection. EVIDENCE: There is a complaints procedure in place, and there was one complaint logged in the past year, which had been substantiated. Staff who were spoken to, were aware of the Whistle-blowing procedure, and their responsibilities regarding reporting suspected abuse. They also stated that they had attended training in adult protection procedures. However, there were no records of attendance in their files. A requirement is made regarding this matter. 46 JULIANA CLOSE G59 S10456 Juliana Close V230896 12.07.05 Stage 4.doc Version 1.30 Page 14 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 standard(s) 24, 25, 27, 28 & 30 The standard of maintenance and cleanliness in the home is poor, and affects the welfare and comfort of residents. EVIDENCE: A tour of the premises was carried out. A new kitchen had been installed this year, and some bedrooms had been decorated. However, the overall appearance of the home was not attractive and looked drab. Requirements are made to address the following issues: The gardens were poorly maintained and there were dead flowers in the hanging baskets. In one toilet, the seat was broken and the floor needs to be resealed. In the large bathroom, there was stagnant water on the floor causing a bad odour. The area around the bath needs to be resealed and a shower curtain was missing. In the small shower, there were damp patches on the ceiling. There were no hand towels in any of the toilets. D.F.’s bedroom needs to be repainted behind the headboard, and there was a bad odour of stale urine in one bedroom. 46 JULIANA CLOSE G59 S10456 Juliana Close V230896 12.07.05 Stage 4.doc Version 1.30 Page 15 The bathrooms and toilets contained special baths and rails to aid people with mobility problems. Some of the lounge furniture, although still serviceable, is looking old and it is recommended that it should be replaced within the next year. All residents’ bedrooms were visited. Each room was individually decorated to the resident’s taste and needs. There was evidence of personal possessions in the bedrooms. As noted above, there were offensive odours in some areas of the home. The inspector noted that the care staff have to do the cleaning in addition to their other tasks. It is recommended that a cleaner be employed in the home. 46 JULIANA CLOSE G59 S10456 Juliana Close V230896 12.07.05 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35 & 36 Service users needs are being met by a well-trained, dedicated and competent group of staff. The appointment of a cleaner would further complement the staff team, and provide more time for care staff to support the residents. There are thorough staff recruitment procedures in place to ensure that service users’ best interests are protected. However, the records of staff training are incomplete. EVIDENCE: The inspector had a discussion with four members of staff. They were very knowledgeable about their roles and responsibilities. They described various training courses they had attended, which were appropriate for their caring roles, but in some cases there were incomplete records to provide evidence of the courses attended. The staff rota confirmed that there are sufficient staff on duty to meet service users’ needs. However, it is recommended that a cleaner be employed to support the care staff. Staff files contained evidence of proper recruitment procedures, and checks had been obtained from the Criminal Records Bureau. There were records to show that regular staff supervision was carried out. 46 JULIANA CLOSE G59 S10456 Juliana Close V230896 12.07.05 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38 & 42 EVIDENCE: There has not been a substantial manager in the home for over a year. However, at the time of the inspection, a manager from another Pentahact home was overseeing this home for three days per week and the post was currently advertised. Although the staff expressed concern about the lack of continuity of management, they stated that the temporary manager was approachable and provided good leadership. The inspector noted that there was a good team spirit and there was a good atmosphere in the home. The inspector examined two residents’ cash tins and noted that the amounts balanced against the records. There were records to show that staff received training in health and safety issues, and there were certificates of safety for gas, electrical and fire installations. Fire alarms were regularly tested and fire drills were held. Cleaning materials were stored securely. 46 JULIANA CLOSE G59 S10456 Juliana Close V230896 12.07.05 Stage 4.doc Version 1.30 Page 18 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 3 3 x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x x 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 3 x 3 3 x 2 Standard No 11 12 13 14 15 16 17 3 2 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 46 JULIANA CLOSE Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x 2 x G59 S10456 Juliana Close V230896 12.07.05 Stage 4.doc Version 1.30 Page 19 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 12 20 Regulation 16(m) 13(2) Requirement The registered person must provide a vehicle which can accommodate wheelchair users. The registered person must ensure that when creams and lotions are applied, these are properly recorded in the medication records. The registered person must ensure that there is a record of staff training in adult protection. The registered person must ensure that all maintenance deficits identified under Standard 24 are addressed The registered person must ensure that hand towels are provided in toilets and bathrooms, and all bedrooms are clean and odour free. Timescale for action 30/9/05 30/9/05 3. 4. 23 & 35 24 18(1)(i) 23(2)(b) 30/9/05 30/9/05 5. 30 16(k) 30/9/05 6. 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 G59 S10456 Juliana Close V230896 12.07.05 Stage 4.doc Version 1.30 Page 20 46 JULIANA CLOSE 1. 2. 3. 24 33 The registered person should replace the old lounge furniture within the next year. The registered person should employ a cleaner in the home. 46 JULIANA CLOSE G59 S10456 Juliana Close V230896 12.07.05 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 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. 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