Inspection on 21/03/06 for Langthorne Road

This inspection was carried out on 21st March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found 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 14 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Langthorne Road 15/04/08

Langthorne Road 21/06/07

Langthorne Road 08/12/06

Langthorne Road 09/05/06

Langthorne Road 25/05/05

Langthorne Road 25/02/05

Langthorne Road 07/09/04

Langthorne Road 12/02/04

Similar services:

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Langthorne Road 136 Langthorne Road Leytonstone London E11 4HR Lead Inspector Robert Sobotka Unannounced Inspection 21st March 2006 03:30 Langthorne Road DS0000007303.V248973.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 Langthorne Road DS0000007303.V248973.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. Langthorne Road DS0000007303.V248973.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Langthorne Road Address 136 Langthorne Road Leytonstone London E11 4HR 020 8989 5768 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) Mr Yusuf Oomar Jooma Mrs Rooksanah Jooma Mrs Rooksanah Jooma Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Langthorne Road DS0000007303.V248973.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th May 2005 Brief Description of the Service: 136 Langthorne Road is a residential care home offering support, guidance and accommodation to a maximum of five service users who have learning disabilities. The home has recently been rebuilt and extended and as a result the home’s registration has been changed from 3 to 5 service users. The home is privately owned. Service users are encouraged to participate in a wide range of activities and hobbies of their choice. The home is located in the Leytonstone Area, within the London Borough of Waltham Forest. Bus, rail and underground links are nearby, as are local amenities. At the time of this inspection there were 3 service users accommodated in the home and 2 places were vacant. Langthorne Road DS0000007303.V248973.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place in the late afternoon/early evening and was unannounced. As part of the visit, the inspector spoke to all 3 service users accommodated in the home, as well as both proprietors and a member of staff working in the home during this inspection visit. A tour of premises was also conducted. The inspector also viewed various records. The aim of this unannounced inspection was to check the home’s progress towards full compliance with the legislation. What the service does well: What has improved since the last inspection? What they could do better: The inspector identified that there was some outstanding work to be done in relation to premises to complete the recent building works. The home’s garden must also be tidied up. Appropriate clinical waste disposal systems must also be in place. The home’s statement of purpose and the service user’s guide must be amended/updated to reflect the recent change of registration. Langthorne Road DS0000007303.V248973.R01.S.doc Version 5.1 Page 6 Care plans and risk assessments must be updated and kept under review. The registered manager must ensure that daily logbooks kept in respect of each service user are improved and recorded daily. The registered manager must ensure that staff personnel files include all information listed in Schedule 2 of the Care Homes Regulations. This is a repeated requirement and must be met without any further delay. It is also required that the registered manager/proprietor obtains evidence in a form of training certificates to demonstrate that staff have attended relevant training. All staff working in the home must be familiar with the Adult Protection issues. It is recommended that individual missing persons procedures are drawn up for each service user accommodated in the home. 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. Langthorne Road DS0000007303.V248973.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 Langthorne Road DS0000007303.V248973.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, 5. The home’s statement of purpose and the service user’s guide required review/updating. The home was meeting the needs of the service users accommodated at Langthorne Road. EVIDENCE: The home’s statement of purpose and the service user’s guide required updating/review to reflect the recent changes of registration. There were 3 service users accommodated in the home and there were 2 beds vacant at the time of this inspection. There have been no new admission to the home for a number of years; standards relating to the home’s admission systems could not therefore be assessed. These will be looked at during the next inspection visit. Following discussion with the service users and staff working in the home, direct and indirect observation and review of documentation, the inspector was satisfied that the home was meeting needs of the current service user group. Each service user had a costed contract, which included statement of terms and conditions in place. Langthorne Road DS0000007303.V248973.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. Further work was required to ensure that both individual care plans and risk assessments were kept under review. Service users are encouraged to make decisions about their lives and take responsible risks as part of their independent lifestyle. EVIDENCE: As part of this visit, the inspector viewed care plans of all 3 service users accommodated in the home. It was identified that some care plans have not been reviewed. Quality of care plans also varied. This required improvement. The requirement issued during the last inspection visit that daily log books are maintained was partly met, however log books viewed by the inspector did not contain entries for up to a week prior to this inspection. The requirement has therefore been repeated and must be met without delay. Throughout this visit, the inspector observed service users being able to make informed choices and decisions. Their views were being respected by staff on duty. Service users spoken to said that they were free to make choices around their daily living and were consulted about how the home should be run. They were also asked to choose colours schemes during recent refurbishment work. Langthorne Road DS0000007303.V248973.R01.S.doc Version 5.1 Page 10 Risk assessments were also looked at. It was noted that only some risk assessments have recently been reviewed. It is therefore required that the registered manager ensures that risk assessments are reviewed on regular basis. It is also recommended that each service user has an individual missing persons procedure. Langthorne Road DS0000007303.V248973.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. Those who lived in the home are encouraged and supported to become part of the local community and develop and maintain friendships and family links. EVIDENCE: Following discussion with the service users and review of their care plans and records of activities offered to those who lived in the home, the inspector was satisfied that those who live in the home were supported and encouraged to take part in appropriate leisure activities. Each care plan viewed contained a weekly timetable. During the course of inspection service users told the inspector about activities they enjoyed. These included: drama classes, literacy classes, First Aid and Independent Living Skills classes, painting, trips to cinema, pubs etc. Those who lived in the home said that they enjoyed going on annual holidays. The home adequately supported service users in attending their places of worship. Langthorne Road DS0000007303.V248973.R01.S.doc Version 5.1 Page 12 Those living in the home were supported and encouraged to maintain appropriate friendships and family links. Service users spoken to confirmed that they had good relationship with their family and friends. Langthorne Road DS0000007303.V248973.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 home was meeting personal and healthcare needs of the current service user group, however the registered manager must ensure that where identified, staff working in the home receive adequate training in relation to medical conditions of any service users. EVIDENCE: The inspector was satisfied that the personal and healthcare needs of the service users accommodated in the home were generally met, however where it has been identified that additional training is required for staff to meet the needs of personal care needs of the service user, this must be provided. The inspector discussed this issue with the registered manager in more detail during the course of this inspection. Files examined showed that each service user was registered with a General Practitioner and that those accommodated in the home were supported and encouraged to utilise community health resources. All service users had “Health Action Plan” in place, which was incorporated into their care plan. Medication systems were also checked and were found to be satisfactory. There was a record of medication brought into the home. Record of medication administered to service users was adequately maintained. Langthorne Road DS0000007303.V248973.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23. Service users were generally protected from abuse, however staff required refresher course about Adult Protection issues. The Commission was not always informed about significant events in the home. EVIDENCE: There have been no complaints to the home since the last inspection. The registered manager stated that there have been no accident/incidents since the last inspection. During the course of this visit, the registered manager informed the inspector an event, which should have been reported to the Commission. It is therefore required that the Commission is informed about any events listed in Regulation 37 of the Care Homes Regulations. The home had an appropriate adult protection procedure/policy in place. During the last inspection visit, one member of staff did not have sufficient knowledge of adult protection issues. Member of staff working in the home at the time of this inspection confirmed that she had not received adult protection training. The requirement in relation to Adult Protection has therefore been repeated and must be met without any further delay. Langthorne Road DS0000007303.V248973.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 30. The premises have recently been refurbished and extended. Further work was required to ensure that adequate furnishing and fitting were in place. EVIDENCE: The home has recently been refurbished and extended. Two additional bedrooms have been added. Four out of five bedrooms have now en-suite facilities. In addition there is one bathroom located on the first floor. Service users spoken to stated that they were happy with the refurbished bedrooms and the new layout of the house. At the time of this inspection some parts of the building required additional work. The registered manager stated that she had purchased some new furniture and she was awaiting delivery of those. The registered manager must ensure that service users bedrooms include all items listed in Standard 26.2. At the time of this inspection no service users had physical disabilities. Standard in relation to specific equipment was not applicable. The home’s rear garden required tidying up. Langthorne Road DS0000007303.V248973.R01.S.doc Version 5.1 Page 16 The premises were clean and hygienic. The home required clinical waste disposal to be set up. The registered manager must ensure that appropriate clinical waste arrangements are in place. Langthorne Road DS0000007303.V248973.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35. Appropriate staffing levels were in place. The homes recruitment practices and staff training required improvement. EVIDENCE: The inspector viewed the duty rosters, which showed that there is a member of staff on duty at all times. The registered manager works from Monday till Friday between 9am and 6pm. There is a member of staff working in the late afternoon/early evening. The home has a sleep-in cover in place. The registered manager stated that 3 of the staff were in the process of obtaining their NVQ training. The requirement in relation to staff having NVQ qualification has therefore been repeated. As part of this inspection, staff personnel files were examined. Some of the files viewed did not contain all information required by law. This is the second inspection when this issue had been raised. The requirement that the registered manager must ensure that staff personnel files include all information listed in Schedule 2 of the Care Homes Regulations has therefore been repeated and must be met within set timescales. Failure to meet the requirement and result in the Commission issuing an enforcement notice. Langthorne Road DS0000007303.V248973.R01.S.doc Version 5.1 Page 18 Additionally, the registered manager must ensure that staff files contain evidence that staff have attended mandatory training and any other training relevant to their jobs. Langthorne Road DS0000007303.V248973.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 41. Some of the records kept in the home required improvement. EVIDENCE: As mentioned in other parts of this report, it was identified that some of the record kept in the home required improvement. These included: - The home’s statement of purpose and the service user’s guide. - Care Plans, - Risk assessments, - Individual service user’s daily logbooks, - Staff personnel files, - Record of staff training. It is also required that the registered manager informs the Commission of any important events listed in Regulation 37 of the Care Homes Regulations. All other standards were not assessed during this visit, as they were met during the last inspection. They will be retested on the next occasion. Langthorne Road DS0000007303.V248973.R01.S.doc Version 5.1 Page 20 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 2 2 x 3 3 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 2 27 3 28 2 29 x 30 2 STAFFING Standard No Score 31 x 32 2 33 3 34 2 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 x 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 x x x x x 2 x x Langthorne Road DS0000007303.V248973.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 YA32 Regulation 13(1)(c) Requirement Timescale for action 01/06/06 2. YA6 3. YA23 4. YA34 5. YA1 The registered manager must ensure that care staff complete appropriate NVQ training. (Previous timescale of 31/12/05 was not met). 17 The registered manager must ensure that daily logbooks kept in respect of each service user are improved and recorded daily. (Previous timescale of 01/08/05 was not met.) 18(1)(c)(i), All staff working in the home 13(6) must be familiar with the Adult Protection issues. (Previous timescale of 15/08/05 was not met.) 7, 9, 19 The registered manager must Sch 2 ensure that staff personnel files include all information listed in Schedule 2 of the Care Homes Regulations. (Previous timescale of 15/08/05 was not met.) 4, 5, 6. The home’s statement of purpose and the service user’s guide must be amended/updated to reflect the recent change of registration. Copy of both documents should be forwarded to the Commission. DS0000007303.V248973.R01.S.doc 15/04/06 01/05/06 15/04/06 01/04/06 Langthorne Road Version 5.1 Page 22 6. 7. YA6 YA9 15 17, 4(c) 8. YA32YA19 18(1)(c)(i) 9. YA26 16(2)(c) 10. 11. YA28 YA30 23(2)(o) 13(3) 12. YA35YA33 7, 9, 19 Sch 2 The registered manager must ensure that care plans are kept up-to-date and under review. The registered manager must ensure that risk assessments are kept up-to-date and kept under review. Staff working in the home receive adequate training in relation to medical conditions of any service users. The registered manager must ensure that service users bedrooms include all items listed in Standard 26.2. The home’s rear garden requires tidying up. The registered manager must ensure that appropriate clinical waste arrangements are in place. The registered manager must ensure that staff files contain evidence that staff have attended mandatory training and any other training relevant to their jobs. 15/04/06 15/04/06 15/04/06 15/04/06 01/06/06 01/04/06 01/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA9 Good Practice Recommendations It is recommended that each service user has an individual missing persons procedure. Langthorne Road DS0000007303.V248973.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford London E15 4BQ 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 Langthorne Road DS0000007303.V248973.R01.S.doc Version 5.1 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. 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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