Inspection on 04/04/06 for Juliana Close 46

This inspection was carried out on 4th April 2006.

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 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 7 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 12/12/05

Juliana Close 46 12/07/05

Juliana Close 46 12/08/04

Juliana Close 46 30/04/04

Similar services:

Ashlong House

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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 Juliana Close 46 Off Thomas More Way East Finchley London N2 0TJ Lead Inspector Tom McKervey Key Unannounced Inspection 4 & 18th April 2006 10:15 th Juliana Close 46 DS0000010456.V287863.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 Juliana Close 46 DS0000010456.V287863.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. Juliana Close 46 DS0000010456.V287863.R01.S.doc Version 5.1 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) www.pentahact.org.uk 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.V287863.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Limited to 6 adults of either gender who have learning disabilities (LD) and who may also have physical disabilities (PD). 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 December 2005 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 with a tail-lift, which enables the residents to go on outings. 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. The fees for the service are £1,450 per week. Juliana Close 46 DS0000010456.V287863.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out as part of the Commission’s inspection programme and to check compliance with the key standards. The inspection was completed in two visits over a total period of five and a half hours. At the time of the first visit, the manager was on leave and a further visit was arranged to inspect confidential records, held by the manager, in order to complete the inspection process. There were six people living at the home, the majority of whom had been there for several years and there were no vacancies. The inspection process included touring the premises, speaking to two residents, the manager and two staff. The process also included looking at records and examining documents pertaining to the running of the home. What the service does well: Residents receive a good quality of care from a dedicated staff team. The parent organisation provides a very good training and development programme for its staff. One resident who had limited verbal skills, demonstrated their satisfaction with the home by showing the inspector their room and the artwork they had done with the support of the staff. Of particular note is a recent successful campaign by a resident of the home to prevent the closure of a local education centre for people with learning disabilities. This issue was reported in the local press. This initiative was a good example of how staff support the residents to be fully integrated and involved in the local community. The accommodation is homely and resident’s bedrooms are individualised to reflect their personal tastes. Juliana Close 46 DS0000010456.V287863.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Juliana Close 46 DS0000010456.V287863.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 Juliana Close 46 DS0000010456.V287863.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&3 Residents and their representatives have good information about the service, but reviews of some residents’ care are not being carried out annually to ensure that the home still meets residents’ needs. EVIDENCE: There is a Statement of Purpose and Service User Guide in place to provide residents and their relatives with information about the service, however no new residents have been admitted since the last inspection. The home was purpose-built and is spacious enough to accommodate wheelchair users. Staff records show that they receive training appropriate to the needs of people with learning disabilities, and thorough observation of their interactions with residents, they demonstrated their ability to communicate effectively with them. Juliana Close 46 DS0000010456.V287863.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, 8 & 9 Residents are consulted about their views of how the home is run and they are supported to make choices. Risk assessments are carried out to support residents to be as independent as possible while ensuring their safety. Care plans are not being reviewed at least six monthly, which could lead to changes in residents’ needs not being monitored properly. EVIDENCE: The care plans of two residents who were case tracked, were sampled. These described their likes and dislikes and how best to communicate with them. Goals were set for each individual, and there were guidelines about the actions required to meet them. In one instance, there was a letter from a resident’s father, which indicated their involvement in compiling the care plan. Appropriate risk assessments were documented. However, in the samples seen, it was not evident that six-monthly reviews of the care plans had been carried out. Two residents’ case files were sampled. Care reviews, which should be carried out by care managers from the local authority, had not taken place for more than a year. A requirement is made for this to be addressed. Juliana Close 46 DS0000010456.V287863.R01.S.doc Version 5.1 Page 10 The daily diaries of service users, contained evidence of when service users took decisions about their lives; for example, choosing the colour scheme of their rooms. Two-weekly meetings between staff and residents are held when activities are discussed and residents are supported to choose meals. Issues to do with the running of the home are discussed at residents’ meetings where residents are supported by staff to put forward their views. All the residents need considerable support by staff and the types of activities they can do independently is limited. However, the case files seen, contained risk assessments that covered a broad spectrum of activities in the home and in the community; for example, safety in the bathroom and travelling in the home’s vehicle. Juliana Close 46 DS0000010456.V287863.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): 11, 12, 13, 14, 15 & 17 The residents are well integrated with the local community and they have a lifestyle that reflects their individual needs and aspirations. Meals are well balanced and nutritious, which the residents are able to choose. EVIDENCE: Juliana Close 46 DS0000010456.V287863.R01.S.doc Version 5.1 Page 12 The manager stated that residents’ personal care is always provided by care staff of the same gender and the staff rota indicated that there is always male and female staff on duty. The inspector observed that the bathroom door was locked while a resident was being supported by staff. At the time of the first visit, four of the residents were at day centres. Their records showed that communication skills programmes were being provided for them, along with other activities. On the second visit, all the residents were at the home as it was the Easter holiday when the day centres were closed. The residents’ daily records show that they frequently access the local community facilities; for example; residents assist with food shopping, go out for meals in local pubs and restaurants and use leisure centres for swimming etc.. An outside entertainer provides a music session every week. The inspector was shown a newspaper article, which covered a protest campaign by one of the residents from the home, who successfully stopped the planned closure of a local education facility for people with learning disabilities. The resident, who was well supported by the staff, is highly commended for this initiative. There were records of residents being visited by relatives, and of going home for weekends, and there are procedures in place for residents to express their sexuality appropriately. The menus showed a good variety of nutritious meals and residents are supported in planning the menu at fortnightly residents’ meetings. A resident who has diabetes and another who is overweight, are provided with appropriate diets on the advice of the dietician. The service provides support for a non-practising Jewish resident who does not currently require any specific diet. A record of a Jewish resident was seen, indicating that they were nonpractising and did not require specific food. There was evidence that this had the approval of the person’s relatives. Juliana Close 46 DS0000010456.V287863.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 The personal care of residents is provided discreetly and with dignity and their general healthcare needs are being met. There is a recurrent problem of poor recording of the administration of medicines, which potentially puts residents health and safety at risk. EVIDENCE: The inspector was informed that no female residents receive personal care from male staff, and the staff rotas showed that female staff are always on duty. The staff group is multi-racial. Case files contained records of appointments with psychiatrists and psychologists as appropriate, and individual physical and emotional needs were well documented. All residents are 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. Juliana Close 46 DS0000010456.V287863.R01.S.doc Version 5.1 Page 14 A resident who had a history of falls had been referred to a hospital specialist by the G.P. However, at the time of the inspection, there had been no recent incidents of falls. No residents were able to self-medicate. Old stock medication had been returned to the pharmacy. Medication was stored safely. However, there were several gaps in the records where staff had failed to sign for the administration of medicines. This problem was also identified at the last inspection. In addition, examples of the staffs’ signatures who are authorised to administer medication were not recorded. These issues could compromise the safety of the residents and requirements are made to address this. Juliana Close 46 DS0000010456.V287863.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 There are good systems to ensure that residents’ complaints are dealt with appropriately and they are protected from potential abuse by appropriate staff training and policies on this subject. EVIDENCE: The last recorded complaint satisfactorily resolved. was received in April 2005, which was The residents who were spoken to, indicated that they were happy in the home and had no concerns. There were records of staff attending training in adult protection procedures, and staff who were spoken to were knowledgeable about the “whistle-blowing” procedure and their roles in relation to protection of the residents from abuse. Juliana Close 46 DS0000010456.V287863.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, 25, 26 & 30 The residents have comfortable bedrooms that reflect their personal tastes and promote their independence. There have been some improvements to the environment of the home, but there are still concerns about cleanliness, which could compromise residents’ comfort and welfare. EVIDENCE: A tour of the premises was carried out internally and externally. This included four residents’ bedrooms which had been decorated to their individual tastes. There were many examples of personal possessions to demonstrate independence. For example, personal music systems, televisions etc. The gardens to the side and rear of the home were particularly attractive with hanging baskets and a newly built raised bed, which makes access easier for users of wheelchairs. There was also a new impressive water feature in the garden, which the manager said had been donated by the local golf club, and arrangements were in hand for an official handover and presentation of the gift to the home. Juliana Close 46 DS0000010456.V287863.R01.S.doc Version 5.1 Page 17 The following issues were identified about which, requirements are made: • • • • The glass doors in the oven in the kitchen were very dirty. A hot water faucet in a toilet was loose. A shower room was out of use because of a problem with the drainage system. This problem was reported to the landlord several times but had not yet been resolved. Some paving slabs at the front of the building were uneven. Requirements are made for these matters to be addressed. Otherwise, the home was clean and tidy at both visits. The inspector was informed that currently, the home was advertising for a cleaner for the home. Juliana Close 46 DS0000010456.V287863.R01.S.doc Version 5.1 Page 18 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, 32, 34, 35 & 36 The residents’ needs are being met by a well-trained, dedicated and competent group of staff. Staff also receive regular supervision. Staff recruitment records in the home are not sufficiently complete to ensure that residents’ best interests are safeguarded. EVIDENCE: Two new members of staff were spoken to and their records were examined. Both staff were able to describe their roles and showed their written induction programmes to the inspector. This covered all areas of care and the various policies and procedures in the home. The rotas showed that there were sufficient staff on duty to meet residents’ needs, and the manager said that she has advertised for a part-time cleaner to allow the care staff to provide more personal support to the residents. There was a written training and development programme for all staff that covered health and safety issues and a broad spectrum of subjects appropriate to the care of the residents. These staffs’ records were not all available for inspection. For instance, in both cases, the application form was missing. Only one file had two references and Juliana Close 46 DS0000010456.V287863.R01.S.doc Version 5.1 Page 19 a Criminal Records Bureau, (CRB) clearance, (although there was an e-mail from the head office stating that the other staff had been cleared). A requirement is made for all records to be available for inspection. There were records of formal, regular supervision, which staff said they found valuable in their work. Juliana Close 46 DS0000010456.V287863.R01.S.doc Version 5.1 Page 20 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, 39, 41 & 42 The home is well managed and there is a good team spirit. Residents’ are able to express their views about the service and their personal finances are well managed. There are good health and safety procedures in place to safeguard residents and staff. EVIDENCE: The current manager has many years experience of managing homes within the Pentahact organisation. The manager has not yet applied for registration with the Commission for Social Care Inspection, and a requirement is made about this matter. The staff were very complimentary about the manager, describing her as being “service user orientated”. They also said that the morale within the team was good. Juliana Close 46 DS0000010456.V287863.R01.S.doc Version 5.1 Page 21 Regular unannounced visits are made to the home by a senior manager and reports are sent to the Commission for Social Care Inspection. The manager stated that Pentahact were currently carrying out a quality assurance audit of all their services, which includes seeking the views of residents and staff. The personal money for two residents was checked and found to balance against the records. Receipts were seen for goods purchased on residents’ behalf. The fire alarm and emergency lighting systems were being serviced during the inspection, and the fire log showed that fire alarms were checked weekly. Juliana Close 46 DS0000010456.V287863.R01.S.doc Version 5.1 Page 22 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 X 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 3 32 3 33 X 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 X LIFESTYLES Standard No Score 11 4 12 3 13 3 14 3 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 3 3 X 3 3 X Juliana Close 46 DS0000010456.V287863.R01.S.doc Version 5.1 Page 23 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 YA6 Regulation 15(2)(b) Requirement The registered person must ensure that all residents have an annual care review by care managers from the placing authority. The registered person must ensure that all residents’ care plans in the home, are reviewed at least six-monthly. The registered person must ensure that staff sign for all administered medication. This requirement is restated from the last inspection. The previous timescale was 28/02/06 Timescale for action 30/06/06 2. YA6 15(2)(b) 31/05/06 3. YA20 13(2) 30/04/06 4. YA24 23(2)(b)(d) The registered person must ensure that: The glass doors in the oven are cleaned. This requirement is restated from the last inspection. The previous timescale was 28/02/06 23(2)(b)(d) The registered person must ensure that: • The hot water faucet in the toilet is repaired. DS0000010456.V287863.R01.S.doc 30/04/06 5. YA24 30/04/06 Juliana Close 46 Version 5.1 Page 24 • • The problem with the drainage system in the shower room is resolved. The uneven paving slabs at the front of the building are repaired. 31/05/06 6. YA34 7, 9, 19 Sch 4 8.1(a) 7. YA37 The registered person must ensure that complete staff records are available in the home for inspection. The manager must apply to the Commission for Social Care Inspection for registration. 31/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Juliana Close 46 DS0000010456.V287863.R01.S.doc Version 5.1 Page 25 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.V287863.R01.S.doc Version 5.1 Page 26 - 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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