CARE HOME ADULTS 18-65
Kiver Road (128) 128 Kiver Road Finsbury Park London N19 4PQ Lead Inspector
Ms Franki Solomon Unannounced Inspection 8th February 2006 10:00 Kiver Road (128) DS0000020965.V250835.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 Kiver Road (128) DS0000020965.V250835.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. Kiver Road (128) DS0000020965.V250835.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Kiver Road (128) Address 128 Kiver Road Finsbury Park London N19 4PQ 020 7700 2807 0207 700 0085 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) Centre 404 Ms Rachel Wallis Care Home 3 Category(ies) of Learning disability (3), Physical disability (3) registration, with number of places Kiver Road (128) DS0000020965.V250835.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. This home is registered for up to 3 people with learning disabilities and/or physical disabilities who are under the age of 65. maximum of three bads can be used for either of the above catogories Date of last inspection Brief Description of the Service: Kiver Road is a registered care home for three people with learning disabilities and physical disabilities. The home is a small family-type home, and aims to provide a ‘home for life’. The property is owned by Mosaic Homes, formerly New Islington Housing Association. The registered home is managed by Centre 404, formerly Islington Mencap. Centre 404 provides further services which residents can access, for example a Family Support Service and ‘Clubs’. Kiver Road is managed under the organisation’s Housing section. The home provides 24-hour support and has a staff team of team leader and support workers, managed by the registered manager. The property is a flat on the ground floor of a purpose built building within a close. The home has three bedrooms, laundry room, adapted shower, bathroom, kitchen/diner and lounge. There is a shared garden to the rear. The home is located off Holloway Road in North London, close to public transport and local amenities. Kiver Road (128) DS0000020965.V250835.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the second statutory inspection for the year April 2005 – March 2006. The inspection was unannounced and lasted three hours. Kiver Road is a small family-type home with three residents. Residents were all at their Day Centre and the manager was not on duty at the time of the inspection. There was no “Person-in-Charge” as such. The one support worker agreed to take on the responsibility of “Person-in-Charge” for the purpose of the inspection and both support workers were able to respond well to all enquiries relating to the inspection process. Since almost all of the key standards had been assessed at the last inspection, this inspection was to check on the five requirements and 2 recommendations made at the last inspection, to look round some parts of the building and to examine care plans. The inspector would like to thank the staff for their hospitality and cooperation. What the service does well:
The emphasis of support at Kiver Road is, that ‘Kiver Road’ is the residents’ “home”. Every effort is made to ensure that the home is homely and not institutionalised. Staff indicated that the manager leaves staff to develop skills and experience by devolving many duties and responsibilities to staff, for instance staff were not only encouraged to, but given a free hand to develop the format for such formats as the risk assessment. Management and staff are committed and motivated to ensure the safety and comfort of service users. Both lavatory seats had been broken by particular use. Staff contacted the Occupational Therapist to assess how this problem may be resolved so that residents may be assured of safety and comfort. During inspection staff demonstrated their knowledge, abilities and responsibilities for the support of the residents who have high needs and challenging behaviour. Every effort is made to communicate in a helpful manner with the residents who have limited verbal communication so that residents may feel supported and safe. Kiver Road (128) DS0000020965.V250835.R01.S.doc Version 5.1 Page 6 It was evident that the recording styles are reviewed continuously and improved so that residents’ care plans and risk assessments are clear and understood to be able to provide appropriate support to residents. 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.
Kiver Road (128) DS0000020965.V250835.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 Kiver Road (128) DS0000020965.V250835.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): 2. Staff demonstrate initiative and commitment in their efforts to find out what residents would like to do so that residents may gain the best quality of life. EVIDENCE: Given that residents have limited verbal communication, records, care plans, risk assessments and discussion with staff indicated that every means of communication is used to ensure that residents have a fulfilling life. Kiver Road (128) DS0000020965.V250835.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): The key standards were assessed at the last inspection. EVIDENCE: Kiver Road (128) DS0000020965.V250835.R01.S.doc Version 5.1 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): 17. The home now ensure the health and safety of residents in terms of food eaten by residents. EVIDENCE: Details of food eaten, especially out at cafés and restaurants, are recorded to ensure the health and safety of residents. Kiver Road (128) DS0000020965.V250835.R01.S.doc Version 5.1 Page 11 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. There is a risk to the health and safety of both a resident and staff in terms of manual handling. EVIDENCE: A requirement at the last inspection was for the registered manager to have an Occupational Therapist’s assessment on the number of persons required to assist in manual handling of one resident for a certain task. The assessment was not available at the time of this inspection. The inspector spoke with the registered manager on the phone who said the assessment had been undertaken and that the Occupational Therapist’s assessment and advice was that two support workers are required for assisting one resident into and out of bed, but that funding could not be gained from the Local Authority. The manager advised a copy of the assessment would be sent to CSCI. Both staff and the resident are at risk by this deficiency in manual handling. (At the time of writing this report (21/2/06) the assessment had not been received). A requirement has been made. Kiver Road (128) DS0000020965.V250835.R01.S.doc Version 5.1 Page 12 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The key standards were assessed at the last inspection. EVIDENCE: Kiver Road (128) DS0000020965.V250835.R01.S.doc Version 5.1 Page 13 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 & 27. The home follows a safe security system to ensure the safety of residents. Part of the home’s internal environment looks scruffy and neglected. EVIDENCE: When the inspector rang the bell, staff practised safe measures of security procedures to ensure the safety of the home and residents. Following a requirement made at the last and previous inspections, the repairs to the bathroom are now long overdue and the condition is deteriorating; • The floor in the bathroom has a build up of scale in various areas and under the lavatory • pipes are exposed and not boxed in • bathroom tiles need re-grouting where mould is developing • two non-slip rubber mats are covered in mould and is unhygienic • the lighting in the bathroom is inadequate and makes the bathroom gloomy and dingy Parts of the home’s internal fabric is in poor condition; • there is again damage to the bedroom wall which has been repaired previously, plus additional damage to the t.v. arial socket in the wall
Kiver Road (128) DS0000020965.V250835.R01.S.doc Version 5.1 Page 14 • • walls and doors are scuffed and damaged from the wheelchair in the communal areas in the hallway, the closet door handle has caused damage to the wall. The home’s maintenance log shows that repairs to the walls have been made on several occasions. The repairs seem not to resolve the problem and the registered manager may consider resolution through preventative measures, such as clear plastic on those vulnerable areas. This, so that residents may live freely yet in a homely and pleasant environment which meets minimum standards. The home was clean and free from offensive odour. Kiver Road (128) DS0000020965.V250835.R01.S.doc Version 5.1 Page 15 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 & 35. Clarity of staff roles and responsibilities is of some concern to staff, inspection reports are not always freely accessible to staff or visitors. EVIDENCE: On arrival the inspector asked for the “Person-in-Charge”. This caused some debate and staff said neither the registered manager nor the Team Leader were on duty at the time and explained they were “support workers”, and did not have the designation nor authority to be the “Person-Charge”. The inspector subsequently spoke with the registered manager on the telephone. The manager explained that either the Team Leader or herself are always oncall, also that when she is working from Head Office, she can be at the home within ten minutes by bus or on foot. Kiver Road is a small “family-type” home and the three residents are usually out at the Day Centre during the week. At those times only household duties need to be undertaken at the home and a “Person-in-Charge” is not required at the home. However, support is on a 24-hour basis and there is always a staff member on duty at the home. The inspector asked for the last inspection report. The staff said the report had been brought to a staff meeting but had subsequently been filed away and they were unable to access the report. A recommendation had been made at
Kiver Road (128) DS0000020965.V250835.R01.S.doc Version 5.1 Page 16 the last inspection for the registered manager to develop “robust” measures to make the report available. It is useful for staff to have access to the inspection report at all times so that they may be aware of any progress or shortfalls of the support provided to the residents. The recommendation has been repeated. Kiver Road (128) DS0000020965.V250835.R01.S.doc Version 5.1 Page 17 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The key standards were assessed at the last inspection. EVIDENCE: Kiver Road (128) DS0000020965.V250835.R01.S.doc Version 5.1 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 Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 x ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 1 28 x 29 x 30 3 STAFFING Standard No Score 31 2 32 x 33 x 34 x 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score x x x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 x 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 1 x x x x x x x x x Kiver Road (128) DS0000020965.V250835.R01.S.doc Version 5.1 Page 19 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 19 Regulation YA19 Requirement The Registered Person must ensure the health and safety of both the resident and staff in terms of the manual handling of one resident for certain tasks identified by the Occupational Therapist that 2 workers are required. (page 12 of this report). The Registered Person must ensure that the walls in the bedroom and communal areas are either properly repaired or preventative measures taken to minimise the damage. The Registered Person must take action to have the shower and bathroom refurbished and that lavatory and bathing facilities are appropriate to meet the assessed needs of service users. The Registered Person must ensure that according to minimum standard 24.12 the home has a planned maintenance and renewal programme for the fabric and decoration of the premises.
Kiver Road (128) DS0000020965.V250835.R01.S.doc Version 5.1 Page 20 Timescale for action 29/03/06 2 24 & 27 YA24 15/07/06 This requirement has been re-stated. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard 31 Good Practice Recommendations It is recommended that the Registered Manager develops more robust measures to ensure all persons involved with the home are aware of the Commission’s Inspection reports. This relates to the staff not being able to provide the last inspection report. Kiver Road (128) DS0000020965.V250835.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Camden Local Office Centro 4 20-23 Mandela Street London NW1 0DU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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