Inspection on 16/02/06 for Longbridge Road (144)

This inspection was carried out on 16th February 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Longbridge Road (144) 08/02/07

Longbridge Road (144) 06/10/05

Longbridge Road (144) 24/06/04

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 Longbridge Road (144) 144 Longbridge Road Barking Essex IG11 8SP Lead Inspector Mrs Denyse Lillington Unannounced Inspection 16th February 2006 10:00 Longbridge Road (144) DS0000027904.V282162.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 Longbridge Road (144) DS0000027904.V282162.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. Longbridge Road (144) DS0000027904.V282162.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Longbridge Road (144) Address 144 Longbridge Road Barking Essex IG11 8SP 0208 594 6510 0208 594 6510 johngleaves(johng@outlookcare.org.uk) 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) Outlook Care Mr John Barry Gleaves Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Longbridge Road (144) DS0000027904.V282162.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th October 2005 Brief Description of the Service: 144 Longbridge Road is a care home registered to provide care, support and accommodation to 6 adults of both genders aged between 18-65 with learning disabilities. The home is a large semi detached property with five single bedrooms on the first floor and one bedroom with an en-suite and shower on the ground floor. The home is located in a busy residential area of Barking, close to shops, public transport and the A13 and A406. The home employs staff, working a roster, which gives 24-hour cover. Longbridge Road (144) DS0000027904.V282162.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During the inspection the staff and service users were helpful and cooperative with the inspection. All except one service user felt comfortable with talking to the inspector. One of the service users was a newly admitted service user. All the service user comments to the inspector were favourable about the service they were provided with and their lifestyles. The premises were clean and tidy and had a homely appearance. Service users bedrooms were personalised by the service users themselves. All service users had a care plan and risk assessments, although some of the risk assessments needed updating. The manager of another residential home also owned by the same provider was acting as manager of this home and working between the two homes which were located next door but one from each other. This manager was applying to be the manager of 144 Longbridge Road and was in the process of the application with the Commission at the time of the inspection. There were 2 repeat requirements in this report, 3 new requirements made and no recommendations. What the service does well: The service recognises the individuality of the service users in their personal planning. Service users are able to include their details in their own personal plans with the support from the staff where needed. The staff training opportunities were comprehensive and staff were formally supervised and appraised as required. The service users were respected and were part of the community. They were involved in sheltered work, college and social activities in the community as they chose. Longbridge Road (144) DS0000027904.V282162.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Longbridge Road (144) DS0000027904.V282162.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 Longbridge Road (144) DS0000027904.V282162.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): 1,2,3,4,5 The documents were able to provide service users, prospective service users and their representatives with most of the information they need to make a decision about moving into the home. Service users’ needs were fully assessed in their person centred plans. Service users had access to specialist services if they needed them. EVIDENCE: The home’s Statement of Purpose and Service User Guide did not accurately reflect the current situation with the vacant manager post. Both documents needed updating with current information about the service. Since the last inspection, the statement of purpose had been updated to include details of the management structure of the home. However, a manager from another Outlook Care home was overseeing the home whilst her application to become manager was being processed. The statement of purpose was not clear about this and had information about the manager from the other home but did not state that the manager position was vacant and had been for some time. Staff spoken with said that not having a permanent manager put added pressure on the deputy manager and staff. This is something Outlook Care need to address in the light of the management arrangements for this and the “sister” home. Longbridge Road (144) DS0000027904.V282162.R01.S.doc Version 5.1 Page 9 The manager of 148 Longbridge was applying for the position as manager of 144 Longbridge Road and was in the process of sorting out the application forms at the time of inspection. It had been agreed with Outlook Care and the Commission that the manager of 148 Longbridge Road could do this on a permanent basis if the deputy managers had more supernumery time available. The statement of purpose stated that there were five service users living at the home but at the time of the inspection there were six service users living there. All service users have a person centred planning to ensure that their needs were being met. A copy of the Service User Guide is given to all residents prior to admission and was readily available within the home, as is the last inspection report. Service users receive a written contract of terms and conditions, which was very comprehensive and was also in pictorial form. Service users or their representatives had signed contracts. There was evidence of advocacy meetings in the person centred planning for service users to discuss issues with independent advocates rather than staff. There was a service user who had moved into the home since the last inspection and they had a Care Management Assessment completed as required. The service user guide discussed the option for service users to meet with other service users and staff before making a decision about living at the home and all service users had the opportunity of a trial period at the home before the placement became permanent. Longbridge Road (144) DS0000027904.V282162.R01.S.doc Version 5.1 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): 6,7,9 There is a clear and consistent care planning system in place, which provides staff with the information they need to meet the needs of service users. Service users were supported to take appropriate risks as part of an independent lifestyle, although risk assessments are not always reviewed or updated regularly, which could put service user’s care at risk. Service users are supported to make active choices and decisions throughout their daily living and areas of risk are assessed. Information about service users is kept confidential. EVIDENCE: Since the last inspection there was evidence that one of the service users risk assessment had been reviewed as necessary. The other service user risk assessments had not been reviewed. Service users person centred plans were written by service users, with support from staff where required. These plans set out clearly the assessed needs of Longbridge Road (144) DS0000027904.V282162.R01.S.doc Version 5.1 Page 11 the service users and changing needs and personal goals were reflected in the plans. The service users told the inspector that they were able to make decisions about their life and choices. The service users were observed to make choices about what they wanted to do on the day of inspection and confirmed with the inspector that they were able to make choices and live a lifestyle that suited them. Longbridge Road (144) DS0000027904.V282162.R01.S.doc Version 5.1 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): 12,13,15,17 Service users are provided with the support to maintain their independence and in areas of personal development according to their needs and wishes. Service users are engaged in community life; enjoy a range of leisure activities and a varied and nutritious diet. EVIDENCE: Some of the service users spoke with the inspector and were able to discuss the activities and opportunities that they enjoyed and participated in. Service users were part of the community and participated in activities that were age appropriate. One service user told the inspector that they belonged to a local gym, which they enjoyed and another service user said they received visits from their family. Some service users attended college and supported work. Service users chose whether or not they attended church and details of their wishes were recorded in their person centred plans. Longbridge Road (144) DS0000027904.V282162.R01.S.doc Version 5.1 Page 13 Staff supported service users independence where necessary, by managing finances if required and assistance with cooking and general housework in the home. Some of the activities service users were involved in included attending cooking classes, coffee at the café when out swimming, walk in the park and gardening. All service users were provided with the option of a holiday outside the home, which they choose and plan. Family and friends can visit anytime of the day and service users were encouraged to go out with their families and develop personal relationships. The home menu records showed that service users were supported in preparing their own meals or have the option to have their meals provided by the home, which are varied and healthy. A daily log of nutritional intake for individual service users was kept. Longbridge Road (144) DS0000027904.V282162.R01.S.doc Version 5.1 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 Service users are supported with personal care needs in the way they prefer and require. Their physical and emotional needs are met. Medication administration is not robust enough and could put service users at risk. EVIDENCE: All service users had a detailed plan of their daily routine including what support was needed in relation to personal hygiene. Personal support takes account of individual preferences and was provided in private. The service users choice of dress and appearance was respected. All service users had a designated key worker. Service users were supported to attend appointments with treatment by health care professionals. Care records showed that service users health was monitored and prompt referrals were made. The home kept a record of medication ordered and received as evidenced by the inspector. These records were dated and signed by staff. The amount of medication received was recorded as well as dosage. Longbridge Road (144) DS0000027904.V282162.R01.S.doc Version 5.1 Page 15 None of the service users at the time of inspection were able to self medicate, so staff members supported service users with handling their medication. The inspector randomly checked the medication record sheets against the blister packs held for service users. Gaps in the recording were identified. A message was left in the record sheets for a member of staff to sign the dates they had not completed. The inspector found other gaps in the recording however that had not been picked up by the staff. The homes manager must introduce a more robust system for checking medication administration. It is recommended that this is a specific area of close scrutiny for future Regulation 26 visits for this home. Longbridge Road (144) DS0000027904.V282162.R01.S.doc Version 5.1 Page 16 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 The home provides a satisfactory complaints system and service users views are listened to and acted upon. EVIDENCE: The home had a comprehensive complaints policy and procedure. The home’s complaints logbook was seen where all complaints where logged clearly. The log identified that relatives, friends or visitors felt comfortable in making complaints. Staff responded promptly and complaints were actioned appropriately. These standards had not changed since the last inspection and met minimum standards. Longbridge Road (144) DS0000027904.V282162.R01.S.doc Version 5.1 Page 17 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): 24,27,30 Service users live in a comfortable, homely and safe environment. Décor, furnishings and fittings are of a good standard and provide a homely and pleasant living environment enhancing service users comfort. The home was clean but infection control at the home was inadequate. EVIDENCE: The premises were comfortable, bright, airy, clean and free from offensive odours. Furnishings and fittings in communal areas were of good quality, domestic and unobtrusive. The home provided a lounge, a dining and kitchen area. There was a communal assisted bathroom and shower room, and additional toilets. The bathroom/toilet upstairs did not have any soap or hand washing supplies or toilet roll on the day of inspection, increasing the risk of infection. The staff at the home explained that this was due to the needs of one service user who felt they had to remove anything that was in the bathroom/toilet, but that they recognised that this must be addressed for the comfort of all service users living at the home and the control of infection issues. The grounds around the home were well maintained and were equipped with suitable garden furniture. Longbridge Road (144) DS0000027904.V282162.R01.S.doc Version 5.1 Page 18 Some of the service user bedrooms were seen during the inspection. All rooms were fitted with a hand basin, were comfortable with adequate furnishings and were also personalised by service users. Service users had their own toiletries and towels on their vanity units. Emergency call points were in place and all specialist equipment for those service users in need was in place. On the day of inspection the communal shower was not in operation due to an electrical fault, which had been reported to East Thames by the staff. Longbridge Road (144) DS0000027904.V282162.R01.S.doc Version 5.1 Page 19 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): 31,36 Staff were aware of their and other’s job roles and responsibilities, providing clarity of roles to service users. There is a good match of qualified staff offering consistency within the home. Recruitment processes were robust to ensure the protection of people living at the home. The staff group receive adequate training to meet the needs of service users. Staff received supervision on a regular basis. It was evident from the activities in the home that the staff were highly motivated and committed to the service user group. EVIDENCE: One member of staff told the inspector that they had been working at the home for 10 years and enjoyed it. This member of staff was to receive refresher fire safety training on the day of inspection. Another member of staff stated that they enjoyed working at the home and the staff were supportive of one another. They stated that they received regular supervision. Staff records seen identified members of staff were being supervised regularly. A supervision programme for all members of staff was in place highlighting booked supervision dates. Longbridge Road (144) DS0000027904.V282162.R01.S.doc Version 5.1 Page 20 Staff received an annual appraisal. The GSCC Code of Conduct was covered in the induction training programme and copies were available in the home. Discussions with staff indicated that they were aware of their roles and responsibilities. Staff were observed to respect service users and were accessible and approachable. The staff team had established professional relationships with therapists, care managers, GP’s, etc. The staff team consisted of permanent and agency staff. Agency staff were used to cover any vacant posts, sickness and annual leave. On inspecting the homes recruitment procedure, two staff files were viewed. These files were complete with all relevant checks required by the regulations. The files included a comprehensive completed application form, two good references, medical check, copies of ID, and a photograph of the applicant. The home employs a successful applicant once a Criminal Bureau and POVA check has been completed and received by the home. Training was organised for all staff on an on-going basis. Training certificates staff had attained were seen to evidence this. Longbridge Road (144) DS0000027904.V282162.R01.S.doc Version 5.1 Page 21 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): 37,39,42 The systems for Service User consultation are good with evidence that Service User views are sought and acted on. Residents are safeguarded by the home’s record keeping policies. Robust quality assurance systems ensure service users and their representatives are heard and acted upon. EVIDENCE: The home did not have a registered manager in post. The registered manager of 148 Longbridge Road was also acting as manager for 144 Longbridge Road. The acting manager had no set days to work at 144 Longbridge Road and was working between the two homes as required. One member of staff spoken to considered that not having a permanent manager put pressure on the deputy manager and staff team. The quality assurance system included seeking the views of service users by the home holding monthly meetings. The minutes included ways in which Longbridge Road (144) DS0000027904.V282162.R01.S.doc Version 5.1 Page 22 issues raised will be actioned by the management team. Records of quality assurance surveys were also seen, which are sent out yearly to service users. The results of surveys are published and discussed with staff and service users in meetings. Stakeholder evaluation surveys were also given to Stakeholders on a yearly basis. Reports regarding monthly visits in accordance with Regulation 26 visits had been received by CSCI, which were comprehensive and considered the quality of the service for which they were responsible. During the inspection all service users care plans were kept in a secured place when not in use. Documentation seen was completed appropriately. Service users could access their records if they wished. Longbridge Road (144) DS0000027904.V282162.R01.S.doc Version 5.1 Page 23 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 3 3 3 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 2 28 X 29 X 30 2 STAFFING Standard No Score 31 3 32 X 33 X 34 X 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 x Longbridge Road (144) DS0000027904.V282162.R01.S.doc Version 5.1 Page 24 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 YA1 Regulation 4 Requirement The Registered Person must produce an up to date Statement of Purpose reflecting the current manager of the home or vacancy situation. (Previous timescales of 24/09/04 and 6/1/06 partly met). All risk assessments must be reviewed regularly and amended accordingly. This is a repeat requirement and did not meet the timescale of 6/12/05. Medication record sheets must be signed appropriately by staff and the homes manager must introduce a more robust system for checking medication administration. The communal bathroom/toilet must have a supply of toilet rolls and soap/hand washing liquid. The communal shower must be repaired and in good working order. Timescale for action 16/04/06 2. YA9 13 (4) (b) (c) 24 16/03/06 3 YA20 13 16/02/06 4 5 YA30 YA27 13 16 16/02/06 28/02/06 Longbridge Road (144) DS0000027904.V282162.R01.S.doc Version 5.1 Page 25 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 20 Good Practice Recommendations It is recommended that medication administration is a specific area of close scrutiny for future Regulation 26 visits for this home. Outlook Care needs to address staff comments regarding the management arrangements for this and the “sister” home. 2 37 Longbridge Road (144) DS0000027904.V282162.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford 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 Longbridge Road (144) DS0000027904.V282162.R01.S.doc Version 5.1 Page 27 - 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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