Inspection on 16/01/07 for Kitchener Road 83

This inspection was carried out on 16th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kitchener Road 83 07/02/06

Kitchener Road 83 26/07/05

Kitchener Road 83 08/11/04

Kitchener Road 83 19/07/04

Kitchener Road 83 23/02/04

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 Kitchener Road 83 London N17 6DU Lead Inspector Caroline Mitchell Key Unannounced Inspection 16th January 2007 10:45 Kitchener Road 83 DS0000031156.V322920.R01.S.doc Version 5.2 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 Kitchener Road 83 DS0000031156.V322920.R01.S.doc Version 5.2 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. Kitchener Road 83 DS0000031156.V322920.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kitchener Road 83 Address London N17 6DU 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) 020 8808 6931 Mr Edward William Marcus Kamrul Hassan-Shiblee Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Kitchener Road 83 DS0000031156.V322920.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th February 2006 Brief Description of the Service: 83 Kitchener Road is a privately run home for adults (aged 18-65) who have a learning disability. The home is an ordinary house, similar to its neighbours in a residential area of Tottenham north London. The stated aims of the home is to provide care to people who have a learning disability (usually mild to moderate) or service users with an autistic spectrum disorder including some users who may have complex behavioural problems. Priority is given to maintaining privacy, dignity, independence, security, civil rights, choice and fulfilment. Accommodation in the home is provided in three single rooms, one on the ground floor (with an en-suite shower and toilet facility) and two on the first floor (each equipped with a hand basin and sharing a bathroom and two toilets nearby). A sleeping in room and office are also provided on the first floor. Service users also have access to a lounge area, diner/conservatory, and rear garden area. Service users resident in the home are supported to use nearby community facilities to meet education and recreational needs including local transport networks, leisure facilities and shops in close proximity to the home. The fees are around £1,400 to £1,500 for each placement per week, and service users are expected to pay separately for items such as toiletries, hairdressing and clothes. Following “Inspecting for Better Lives” the provider must make information available about the service, including inspection reports, to service users and other stakeholders. Kitchener Road 83 DS0000031156.V322920.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on an unannounced basis and took around four hours to complete. The inspector spent time with the registered manager, two support workers and two of the service users. The inspector toured the building and a number of the written records that are kept in the home were inspected. What the service does well: 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. The summary of this inspection report can be made available in other formats on request. Kitchener Road 83 DS0000031156.V322920.R01.S.doc Version 5.2 Page 6 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 Kitchener Road 83 DS0000031156.V322920.R01.S.doc Version 5.2 Page 7 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ needs are assessed prior to them moving to the home. They are able to visit the home and have overnight stays prior to making the decision to move in. Service users are provided with a written contract with the home. EVIDENCE: The inspector reviewed the written records for one service user, who had moved into the home around one year ago. They showed that a full assessment had been provided to the home prior to the service user’s admission, so that the home was clear about the service user’s needs. The service user had visited the home on numerous occasions; had overnight stays and the staff from the home had visited him in his previous placement, prior to him moving in. The inspector also noted that included in the written records of the service user, there was a contract setting out what the service user can expect from the home. Kitchener Road 83 DS0000031156.V322920.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service user plans and risk assessments have been further developed and service users are supported to take risks as part of an independent lifestyle. Service users are encouraged to make decisions that are relevant to their lives although there are some restrictions placed on service users and there is room for improvement in the documentation of one particular restriction. EVIDENCE: At the previous inspection there were pockets of good practice and some people had individual plans and risk assesments in place, whilst other’s needed to be worked upon. At this inspection the inspector reviewed the written records for all three service users and each person had good quality needs assesments and individual plans in place. There were also some good quality risk assesments for each service user, which are relevant to their particular needs, behaviours and interests and set out the interventions necessary to minimise the risks. Kitchener Road 83 DS0000031156.V322920.R01.S.doc Version 5.2 Page 9 The inspector noted that for the most part the routines in the home do encourage freedom of movement, freedom of choice and independence. This was emphasised in the service user plans and risk assessments and was also demonstrated in the decisions made by service users in their regular meetings. There were service users who were subject to some minor restrictions to their personal freedom. These restrictions were not unreasonable and were related to risks to peoples’ health or the overall safety of all in the home. In most case they were clearly documented, and part of a multidisciplinary approach. In the cases of locking the fridge in the kitchen, although the issue was touched upon in some risk assessments or care plans, the issue was not quite so clearly recorded, and a requirement is made in respect of this. It is worth noting that there is a second fridge in the conservatory ensuring that service users do have access to controlled amounts of food that is safe to eat uncooked. Kitchener Road 83 DS0000031156.V322920.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The daily routines in the house do generally promote independence, individual choice and freedom of movement. Service users are provided with a rich and varied social life by the home with range of, leisure activities being offered. Staff support service users to participate in activities, the local community and support service users to maintain family links. The food provided is culturally appropriate and healthy, and offers variety and choice. EVIDENCE: Service users are encouraged to be involved in the tasks of daily living e.g. making their own breakfasts and tidying their rooms. The service user plans detail support to be provided in order to maintain and develop social, emotional, communication and independent living skills as part of weekly timetables. Kitchener Road 83 DS0000031156.V322920.R01.S.doc Version 5.2 Page 11 One service user independently visits a number of Turkish cafes in the local area on a regular basis, and all three service users enjoy seeing their family regularly. Records for the month prior to the inspection reflected that service users went out for meals, for regular walks, and shopping. Within the home, Greek and Turkish TV channels are installed on the televisions. The registered manager has introduced a very clear method of summarising what has happened in service users’ lives each month so it is easy to monitor their quality of life in terms of what activities they are supported with, their home life, and the contact they have with their families. This is a useful quality assurance tool. The inspector noted that the menu takes into account the needs and preferences of the service users, and reflects their cultural backgrounds, providing meals from Afro-Caribbean, Greek and Turkish origins. There is evidence that a dietician has recently been involved with supporting two of the service users around their diet. Kitchener Road 83 DS0000031156.V322920.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personal care and the healthcare needs of service users are assessed and recognised and that procedures are in place to address them. The service users are protected by the home’s policy and procedure for the receipt, recording, storage, handling, administration and disposal of medicines. EVIDENCE: The inspector also noted that care plans set out the kinds and levels of support needed by service users in the area of their personal care, and emphasise promoting service users’ independence. The service users are from a range of ethnic backgrounds and their plans reflect this. The registered manager told the inspector that Turkish one of the service user’s first language, and there are Turkish speaking staff in the team. He added that, one service user is from a Greek background and speaks English. It is an advantage that there are Greek speaking staff in the team, as it helps in communicating with this service user’s family. Service users are registered with different local GPs and the registered manager has very good monitoring records in place that shows clearly when they were supported to access medical practitioners as the optician, dentist, Kitchener Road 83 DS0000031156.V322920.R01.S.doc Version 5.2 Page 13 dietician, community nurse and psychiatrist. The monitoring record also highlighted when service user’s reviews were undertaken, and where these were due, the registered manager had written to the placing authority requesting they be arranged. The inspector briefly reviewed the arrangements for the storage, administration and recording of medication in the home. The medication was kept appropriately in a locked cabinet and the temperature monitored. Records included medication received and medication returned to the pharmacist. The Boots system is used; there was evidence that staff members had been provided with appropriate training in the administration of medication and the records were well ordered, up to date, and accurate. To improve his compliance with taking his medication, one service user has recently been prescribed liquid medication. However, his service user plan and risk assessment haven’t kept pace with this, and a requirement is made in relation for this to be addressed. Kitchener Road 83 DS0000031156.V322920.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are clear and effective complaints, adult protection and whistle blowing procedures and service users are safeguarded from abuse and neglect. EVIDENCE: The complaints procedure was clearly written, I has been made available in Greek, for one service user. One complaint, from a service user’s relative, had been recorded since the previous inspection, and records indicated that it had been responded to appropriately. The registered manager has put together an information pack for staff regarding adult protection and this includes the homes adult protection procedure (including whistle blowing), and a copy of the local authority’s adult protection policy, body maps and alerter forms. There was evidence that staff members had been provided with training in adult protection along with evidence that the manager has gone to some lengths to ensure that staff are clear about the procedures and their responsibilities in relation to protecting vulnerable adults. Kitchener Road 83 DS0000031156.V322920.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s premises are suitable for its stated purpose and meet service users’ individual and collective needs in a comfortable and homely way. The premises are kept clean and hygienic throughout. EVIDENCE: The inspector looked around the home and saw two of the three service user’s bedrooms. The home is an ordinary house in keeping with the local community. It is comfortable, bright and cheerful and there is sufficient and suitable light in each room. Furnishings and fittings in the home are of good quality, and domestic in character. The front and rear gardens are well maintained and the registered manager explained that a gardener is sometimes used to do the heavier gardening work. The standard of décor is generally quite good, although the registered manager agreed that the décor in some rooms is beginning to look a bit tired, particularly in the lounge. The manager and the care staff all told the inspector, independently of each other, that it is the intention of the registered Kitchener Road 83 DS0000031156.V322920.R01.S.doc Version 5.2 Page 16 person to re-decorate when the weather improves and to provide new floor covering in the lounge. The inspector has not made any requirements in relation to these issues, as they are in hand. Kitchener Road 83 DS0000031156.V322920.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an effective staff team with sufficient numbers and complementary skills to meet service users’ needs and operates a robust recruitment procedure. Service users benefit from a staff team who are provided with good training and supervision and who are clear about their roles and responsibilities. EVIDENCE: The inspector saw the rota for the week of the inspection and this indicated that there were a minimum of two staff on duty for each morning and evening shift, and one person sleeping-in over night. At the previous inspection the registered person was required to ensure that all applicants provide an explanation of why they left each post, where previously employed with children or vulnerable adults. It is also necessary to ensure that applicants provide a written explanation of any gaps in their service. The registered person was also required to ensure that a recent photograph of each staff member is included in the individual personnel records of all staff working in the home. At this inspection the inspector reviewed the personnel records of the two staff who have most recently started work in the home and found all necessary pre-employment checks had been undertaken and that the application form had been improved. Kitchener Road 83 DS0000031156.V322920.R01.S.doc Version 5.2 Page 18 The inspector noted that each staff member had been provided with written terms and conditions of employment and a job description, additionally there was evidence of a very good quality induction process. One of the staff members that the inspector spoke to confirmed that they had been provided with all of the necessary core training prior to their induction at the home, and that they had spent around two weeks shadowing an experienced staff member prior to working directly with service users. Records reflected that they had been supervised closely throughout this period and allowed time to become confident before starting work with service users. A good quality staff handbook also helps to ensure that staff are clear about their role and responsibilities in the home. Staff have recently had an annual appraisal. Their training needs have been identified, and planned for in the schedules of in-house and external staff training. These schedules provide a very comprehensive programme of training that is relevant to the needs of the service users. The two staff who spoke to the inspector said that the manager was both supportive, and clear about the standards expected. Kitchener Road 83 DS0000031156.V322920.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A competent manager runs the home. Service users benefit from support that seeks their views and monitors their welfare. The service users and staff are protected by a proactive approach to health and safety in the home. EVIDENCE: A manager has been appointed to the home and has been registered with the Commission. He comes across as experienced, committed and very well organised. The registered manager has improved the administrative and quality assurance systems in the home and introduced a number of good practice improvements such as self-assessment and 360° appraisal. The registered manager showed the inspector evidence of the progress that he has made in introducing continuous management self-assessment against the national standards into the home. He also has a quality assurance plan in Kitchener Road 83 DS0000031156.V322920.R01.S.doc Version 5.2 Page 20 place, that he is working to. In terms of consultation, there was evidence that service user meetings and staff meetings are held regularly in the home and any quality issues that arise are taken seriously and acted upon. The inspector observed no obvious health and safety hazards at the time of the inspection. The registered manager ensures that health and safety is properly monitored by means of a monthly walk around audit. The inspector saw the format for this and noted that, as with all of the monitoring records introduced by the registered manager, it was clear, concise and accessible. Good, well ordered records of the necessary safety checks certificates were also available and seen by the inspector and an environmental risk assessment is in place. There was a fire risk assessment and an emergency plan in place. Kitchener Road 83 DS0000031156.V322920.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 3 5 3 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 4 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 4 X 4 X X 4 X Kitchener Road 83 DS0000031156.V322920.R01.S.doc Version 5.2 Page 22 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. Standard YA7 YA16 Regulation 13(4) Requirement The registered person must ensure that, where there are restrictions to service users’ personal freedom, these are clearly documented as part of their risk assessment, and these issues are monitored at each review as part of a multidisciplinary approach. The registered person must ensure that one service user’s individual plan and risk assessment are updated to reflect that they are prescribed liquid medication. Timescale for action 28/02/07 2. YA20 13(4) 28/02/07 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 Kitchener Road 83 DS0000031156.V322920.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Kitchener Road 83 DS0000031156.V322920.R01.S.doc Version 5.2 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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