Inspection on 08/12/06 for Langthorne Road

This inspection was carried out on 8th December 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 9 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 09/05/06

Langthorne Road 21/03/06

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 8th December 2006 08:20 Langthorne Road DS0000007303.V309460.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 Langthorne Road DS0000007303.V309460.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. Langthorne Road DS0000007303.V309460.R01.S.doc Version 5.2 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.V309460.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th May 2006 Brief Description of the Service: 136 Langthorne Road is a care home offering support, guidance and accommodation to a maximum of five service users who have learning disabilities. The home is privately owned. Service users are encouraged to participate in a range of activities and hobbies of their choice. The home is located in the Leytonstone area, within the London Borough of Waltham Forest. Bus and rail links are nearby, as are local amenities. At the time of the inspection, there were 3 service users accommodated in the home, all of whom were funded by the London Borough of Waltham Forest. Langthorne Road DS0000007303.V309460.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 during one day and was unannounced. This was the second key inspection for the home since April 2006. During the course of this visit, the inspector spoke to two of the service users; he conducted a tour of the premises and viewed various records. He also spoke to the proprietor and one member of staff working in the home. 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? There has been some improvement made in relation to the daily records kept in respect of each service user. Staff spoken to were now familiar with the Adult Protection issues. Staff personnel files have been updated to include all information listen in Schedule 2 of the Care Homes Regulations. Service users have been reviewed since the last inspection, as previously required. Some of the risk assessments have also been reviewed. The registered manager stated that staff working in the home received training relating to medical condition of one of the service users. Langthorne Road DS0000007303.V309460.R01.S.doc Version 5.2 Page 6 Appropriate clinical waste arrangements were now in place. There has been an improvement in recording what food was offered to service users. Medication kept in the home was now appropriately stored. Staff have started receiving more frequent supervision sessions. The responsible person has ensured that the Employer’s Liability Insurance Public Liability cover has been increased to £5 million. Service users’ meetings have restarted. The frequency of staff meetings has also increased, as previously recommended. What they could do better: There were 4 requirements and 1 good practice recommendation, which remain outstanding from the previous inspection reports. These included: - The registered manager must ensure that care staff complete appropriate NVQ training. - The registered manager must ensure that staff files contain evidence that staff have attended mandatory training and any other training relevant to their jobs. - The registered manager must obtain NVQ Level 4 in Care. - The registered manager must ensure that all parts of the home are reasonably decorated. - It is recommended that each service user have an individual missing person’s procedure. In addition, the following requirements were made following this inspection: - The missing lampshade in the hallway must be replaced. - The broken cupboard in one of the service users’ bedroom required repairing/replacement. Langthorne Road DS0000007303.V309460.R01.S.doc Version 5.2 Page 7 - The registered manager must ensure that cracks in the walls in the hallway must be replastered. - The collapsed fence at the back of the garden must be re-erected. - The registered manager must ensure that service users bedrooms include all items listed in Standard 26.2. 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.V309460.R01.S.doc Version 5.2 Page 8 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.V309460.R01.S.doc Version 5.2 Page 9 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): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home meets the needs of the service users living there. EVIDENCE: There have been no changes/updated to the home’s Statement of Purpose and the Service User’s Guide since the last inspection visit. At the time of this inspection, there were 3 service users living in the home and there were 2 room vacancies. There have been no new admissions to the home for a considerable length of time. Standards relating to the home’s admission systems and trial visits to the home, were therefore not assessed during this inspection and will be tested following a new admission to the home. Following the review of documentation, direct and indirect observation, and discussion with the service users and staff working in the home, the inspector was satisfied that the assessed needs of the current service user group were being met. Langthorne Road DS0000007303.V309460.R01.S.doc Version 5.2 Page 10 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, 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some improvement has been made to ensure that service users’ care plans are up to date. The recommendation that each service user has an individual missing persons procedure remains unmet. Confidentiality was maintained. EVIDENCE: Care plans of all 3 service users accommodated in the home were viewed by the inspector. It had been previously identified that some care plans were not being regularly reviewed. Since the last inspection, the registered manager has reviewed individual service users’ care plans. The requirement that daily log books are maintained in respect of each service users has also been met. Service users who spoke to the inspection confirmed that they were able to make informed choices and decisions. Their views were being respected by staff on duty. Those who live in the home said that they were free to make choices around their daily living and were consulted about how the home Langthorne Road DS0000007303.V309460.R01.S.doc Version 5.2 Page 11 should be run. They were also asked to choose colours schemes during recent refurbishment work and helped in choosing furniture in their bedrooms. The service users’ meetings have been restarted, as previously recommended. The inspector checked risk assessments in respect of the service users accommodated in the home and there was evidence that these have been updated. The recommended that each service user has an individual missing persons procedure however remains outstanding. Confidentiality was being maintained and all files were securely stored. Langthorne Road DS0000007303.V309460.R01.S.doc Version 5.2 Page 12 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): 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. 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. Service users enjoyed food in their home. 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. On the day of this inspection, two of the service users were going out for a dress rehearsal for the pantomime performance they were preparing with their drama group. Langthorne Road DS0000007303.V309460.R01.S.doc Version 5.2 Page 13 The home adequately supported service users in attending their places of worship. 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 and visited them on regular basis. At the time of the inspection one of the service users was staying with her mother. Service users said that they enjoyed food served in the home. There were sufficient food supplies in the home, which were appropriately stored. There has been an improvement in recording food offered to the service users, as previously required. Langthorne Road DS0000007303.V309460.R01.S.doc Version 5.2 Page 14 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was meeting personal and healthcare needs of the current service user group. Medication systems were generally satisfactory. EVIDENCE: The home continues to met personal and healthcare needs of the service users accommodated in the home were generally met. The registered manager stated that staff working in the home had received training in relation to the medical conditions of one of the service user, however no certificate and/or confirmation was available to this effect. 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 found to be satisfactory. It was also now appropriately stored. There was a record of medication brought into the home. Record of medication administered to service users was adequately maintained. Langthorne Road DS0000007303.V309460.R01.S.doc Version 5.2 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate complaints systems were in place. Service users were protected from abuse. EVIDENCE: There have been no complaints made to the home since the last inspection. Service users spoken to said that they would raise any complaints with the registered manager. Appropriate complaints policy was in place. The registered manager stated that there have been no accident/incidents since the last inspection. The home had an appropriate adult protection procedure/policy in place. During the course of this inspection, the inspector spoke to one of the members of staff about Adult Protection issues and she was aware of what action to take if abuse is reported or suspected. The registered manager stated that staff working in the home were in the process of doing a distance learning course on Protection of Vulnerable Adults from abuse and some training has been done in the home. Langthorne Road DS0000007303.V309460.R01.S.doc Version 5.2 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, 26, 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The premises have recently been refurbished and extended. As previously required, further work was required to ensure that adequate furnishing and fittings are 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. At the time of this inspection some parts of the building required additional work, such as additional paintwork. The lampshade in the hallway was missing and must be replaced. Cupboard in one of the service users’ bedroom was broken and required repairing/replacement. The registered manager must ensure that service users bedrooms include all items listed in Standard 26.2. Although the home has been opened for several months since the refurbishment, little work has been made to ensure that the service users have been made more personalised and paintwork in some parts of the building still Langthorne Road DS0000007303.V309460.R01.S.doc Version 5.2 Page 17 remained unfinished. This is a repeated requirement and must be met without any further delay. The registered manager must also ensure that cracks in the walls in the hallway must be replastered. At the time of this inspection none of the service users had mobility issues. Standard in relation to specific equipment was therefore not applicable. The fence at the back of the garden has collapsed and must be re-erected. The premises were generally clean and hygienic, however one of the service users bedrooms required vacuuming. The requirement in relation to the clinical waste arrangement has now been met. Langthorne Road DS0000007303.V309460.R01.S.doc Version 5.2 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): 32, 33, 34, 35, 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements have been noted in ensuring that staff personnel files have been brought up-to-date and that staff are appropriately supervised, however further improvements are required to ensure that staff are appropriately trained and that there is evidence that staff have received adequate training. EVIDENCE: Staffing levels continue to be appropriate to meet the needs of the current service user group. 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 1 member of staff has obtained their NVQ Level 2 in Care qualification. 3 staff were in the process of obtaining their NVQ qualifications. The requirement in relation to staff having NVQ qualification has therefore been repeated and must be met without any further delay. Staff personnel files were examined during this inspection and these have now been updated to include the information required by law. Langthorne Road DS0000007303.V309460.R01.S.doc Version 5.2 Page 19 The requirement for the registered manager must ensure that staff files contain evidence that staff have attended mandatory training and any other training relevant to their jobs remains outstanding and has been repeated. Failure to comply with this requirement may result in the Commission considering an enforcement action against the registered persons. No new staff have commenced work in the home since the last inspection visit. Staff meetings have now recommenced and minutes from those were available for inspection. The inspector noted improvement in the frequency of supervision sessions and appraisals offered to staff working in the home. Langthorne Road DS0000007303.V309460.R01.S.doc Version 5.2 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, 42, 43. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is run by a competent manager, however she must ensure that full compliance in meeting the National Minimum Standards and Care Homes Regulations. She must also obtain NVQ Level 4 in Care qualification. Appropriate health and safety checks were in place. EVIDENCE: The registered manager is also the proprietor. She has been managing the home since it was established. The registered manager has the NVQ Level 4 Registered Managers Awards, however she must complete the NVQ Level 4 in Care, as required by law. She demonstrated her awareness of the assessed needs of those accommodated in the home. The inspector received positive comments from both service users and staff in relation to the manager’s conduct and management style. Langthorne Road DS0000007303.V309460.R01.S.doc Version 5.2 Page 21 Based on the observation and discussion with the service users and during previous inspection with the service user’s relative, the inspector was satisfied that she promotes service user’s rights and encouraged them to maintain their rights and independence whenever possible. Service users spoken to stated that staff are always readily available to offer support and guidance. As previously mentioned, service users’ meetings have recommenced. Appropriate quality assurance systems were in place. As the proprietor is also the registered manager, monthly visits from the responsible individual were therefore not required. There has been an overall improvement in record keeping in the home. Appropriate health and safety checks were in place. The responsible person has ensured that the Employer’s Liability Insurance Public Liability cover has been increased to £5 million, as previously required. Langthorne Road DS0000007303.V309460.R01.S.doc Version 5.2 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 x 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 x 26 2 27 x 28 x 29 N/A 30 2 STAFFING Standard No Score 31 x 32 3 33 2 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 2 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 3 3 x 3 3 3 Langthorne Road DS0000007303.V309460.R01.S.doc Version 5.2 Page 23 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 The registered manager must ensure that care staff complete appropriate NVQ training. (Previous timescales of 31/12/05 and 01/06/06 were not met). The registered manager must ensure that staff files contain evidence that staff have attended mandatory training and any other training relevant to their jobs. (Previous timescales of 01/05/06 and 01/06/06 were not met.) The registered manager must obtain NVQ Level 4 in Care. (Timescale not expired at the time of this inspection visit.) The registered manager must ensure that all parts of the home are reasonably decorated. (Previous timescale of 01/08/06 was not met.) The missing lampshade in the hallway must be replaced. The broken cupboard in one DS0000007303.V309460.R01.S.doc Timescale for action 01/04/07 2. YA33 7, 9, 19 Sch 2 01/03/07 3. YA37 9(2)(i) 01/01/07 4. YA24 23(2)(d) 01/03/07 5. 6. YA24 YA26 23(2)(c) 16(2)(c), 01/02/07 01/02/07 Page 24 Langthorne Road Version 5.2 23(2)(c) 7. YA26 23(2)(b) 8. 9. YA24 YA26 23(2)(o) 16(2)(c), 23(2) of the service users’ bedroom required repairing/replacement. The registered manager must ensure that cracks in the walls in the hallway must be replastered. The collapsed fence at the back of the garden must be re-erected. The registered manager must ensure that service users bedrooms include all items listed in Standard 26.2. 01/03/07 01/02/07 15/02/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA9 Good Practice Recommendations It is recommended that each service user have an individual missing persons procedure. (Repeated recommendation.) Langthorne Road DS0000007303.V309460.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection East London Area Office Ferguson House 113 Cranbrook Road Ilford Essex IG1 4PU 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.V309460.R01.S.doc Version 5.2 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!