Inspection on 14/06/05 for Longbridge Road (148)

This inspection was carried out on 14th June 2005.

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 no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Longbridge Road (148) 01/02/07

Longbridge Road (148) 17/10/05

Longbridge Road (148) 11/03/05

Longbridge Road (148) 22/07/04

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 (148) 148 Longbridge Road Barking Essex IG11 8SP Lead Inspector Rhona Crosse Unannounced Inspection 14 June 2005 09:20 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 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 Stationary 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 (148) G55_S0000027905_Longbridge Road (148)_V232569_140605_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Longbridge Road (148) Address 148 Longbridge Road, Barking, Essex IG11 8SP Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8594 7913 Outlook Care Ginnette Commons CRH Care Home 5 Category(ies) of LD Learning disability (5) registration, with number of places Longbridge Road (148) G55_S0000027905_Longbridge Road (148)_V232569_140605_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. To include one named person with mental health needs. Date of last inspection 11 March 2005 Brief Description of the Service: The home provides 24 hour care for 5 people with learning disabilities. Accommodation is in 5 single bedrooms. The home is in a residential area of Barking near Barking Park, close to local shops and the town centre. There is a bus stop outside the home. Parking is restricted in the side streets so a parking permit for visitors has to be provided from the home and has to be displayed in the car. Longbridge Road (148) G55_S0000027905_Longbridge Road (148)_V232569_140605_Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced so the home did not know the inspector was coming. The manager was not at the home as she was on sick leave. The staff member in charge of the home at the time of the inspection assisted with the inspection and dealt with all areas of the inspection very well. Statutory records were easily accessible and up to date. The home was well organised. 4 service user’s were at home when the inspector arrived. One service user had been escorted to the local hospital for tests and returned later in the morning. All service users were appropriately dressed for the time of year. What the service does well: What has improved since the last inspection? What they could do better: The home requires some maintenance. The upstairs bathroom floor has lifted and this allows water to get underneath the flooring. This floor requires resealing or replacing. The downstairs shower room has a build up of stains on the floor. This will require an industrial cleaner to remove the staining. The seal around the sink in this room requires replacing so that water cannot get between the wall and the vanity unit. The plug was missing from the wash hand basin this must be replaced. The lounge carpet and downstairs hall Longbridge Road (148) G55_S0000027905_Longbridge Road (148)_V232569_140605_Stage 4.doc Version 1.30 Page 6 carpet is very stained and requires a deep clean. If the staining cannot be removed after deep cleaning then these carpets must be replaced. A wallpaper border has been picked off in places by the service user. The border requires replacing. An audit of medication took place. The rectal Stesolid that is to be administered in the event of a prolonged seizure is recorded on a separate sheet in the medicines folder, (this is not a regularly used medication and was last dispensed in 2003 the expiry date for this medicine is November 2005). However the record does not make reference to how many tablets are left for administration. This should be recorded on the chart when the medicine is checked. The date recorded of the last check was 18/5/05. 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 (148) G55_S0000027905_Longbridge Road (148)_V232569_140605_Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Longbridge Road (148) G55_S0000027905_Longbridge Road (148)_V232569_140605_Stage 4.doc Version 1.30 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 standard(s) 1, 2, 3, 4 and 5 This standard is well managed with information and procedures in place to assist service users and relatives to know what service the home can provide. Assessments undertaken prior to admission ensure that any new service users’ needs are able to be met and that any new service user ‘fits’ in with the current people living at the home. Currently there are no vacancies at this home. EVIDENCE: The home has a Statement of Purpose and a Service Users Guide to enable service users and relatives to know what service the home provides. Pictorial information is provided to enable service users who cannot read to have some understanding of what is being provided. There are no vacancies at the home. However prior to any admission a proposed service user would visit the home several time to see if they liked the home and if they fitted in with the current service users living there. Visits would at first be short visits, then progress to the service user taking a meal, an overnight stay and a weekend stay. The length of the process would depend on the individual needs of the service users. From observation of service users’ files an assessment of the needs of the service users is always made prior to them being admitted to the home, this will include all the care needs, likes and dislikes the person has. A licence Longbridge Road (148) G55_S0000027905_Longbridge Road (148)_V232569_140605_Stage 4.doc Version 1.30 Page 9 agreement (contract) is then provided by the company once the placement is made a permanent after the first review. Although there were blank copies of both the written and pictorial licence agreement there was no signed copies of the agreements in the service users file. It is recommended that a copy is held on the service user’s file. Longbridge Road (148) G55_S0000027905_Longbridge Road (148)_V232569_140605_Stage 4.doc Version 1.30 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 standard(s) 6, 7, 8, 9 and 10 These standards are well managed with information being update and readily available. EVIDENCE: From an inspection of service users’ files it was seen that each service user has a ‘Person Centred Plan’. This care plan identifies the needs, likes and dislikes of each service user. Pictorial information is provided for each person to show the areas that are written about them. One service user knew which was his file. Service users are able to make decisions about how they spend their time and this was observed in practice during the inspection visit. From observation of the daily life within the home and discussion with staff it was seen that service users take part in the daily life of the home and carryout specific jobs that they like to do around the house. There is a rota for cleaning with staff support. After lunch one service user loaded the dishwasher as this was part of his programme of household duties for the day. Another service user likes to deal with the laundry. All service users clean their own rooms with support. Longbridge Road (148) G55_S0000027905_Longbridge Road (148)_V232569_140605_Stage 4.doc Version 1.30 Page 11 Service users have risk assessments if there is an activity or particular action that may take place that could place them or other service users at risk (this may be behavioural problems or being able to self medicate or travel on public transport as an example). Due to the abilities of the service users currently living at the home it is difficult to establish if they are aware and understand information that is held about them or would understand if any confidence was kept or whether it was broken. However from observing staff assisting service users during the inspection it was clear that service users felt able to make their needs known and these were respected by staff. Longbridge Road (148) G55_S0000027905_Longbridge Road (148)_V232569_140605_Stage 4.doc Version 1.30 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 standard(s) 11, 12, 13, 14, 17. These standards are well managed with good participation in activities and use of the local shops and community services. Although daily living skills are practiced every day there is no documentation or monitoring to show how well these are met, or evidence that future goals are being set for service users. This should be addressed. EVIDENCE: Each service user has a person centred plan which tells staff what they are able to do. A weekly plan details what activities that each service user would take part in on any one day. Whilst skills maintenance is undertaken on a daily basis, there are no means of documenting or monitoring how well these tasks are achieved or future goals set to encourage service users to reach/exceed their potential. This is something that the home should look at as they should be able to show a year on year improvement in the life skills of service users. However from talking to staff it was clear that the service users have been able to increase their abilities over the years. The home needs to be able to document this achievement. Longbridge Road (148) G55_S0000027905_Longbridge Road (148)_V232569_140605_Stage 4.doc Version 1.30 Page 13 There is a great deal of individual activities planned on a weekly basis and a record is kept of all activities undertaken. These activities range from trips out for personal shopping, food shopping for the home. outings to the local park, meal in cafes and restaurants in the community, church visits (this is a church for people with learning disabilities), college courses for art and craft, trips out on public transport to the YMCA to use their sports facilities, beauty therapy and aromatherapy all take place. Trips to the Cinema are undertaken (this is dependent on the films being shown), visits to a local ‘sensory room’ on a planned basis for relaxation therapy. Holidays are discussed with service users and the holiday the majority wish to go on is then planned and booked. A holiday is booked this year for July. All service users will be going on this holiday. Service users are able to choose the meals they eat. Usually on a Saturday everyone sits down and the menu for the week is chosen. Each service user is able to make a choice of a meal, one for each day so that everyone gets a chance to have their favourite meal (which some may also help to prepare). A record of the meal choices made is recorded daily. ‘Healthy’ eating is promoted with fresh fruit and where necessary an individual eating guidelines are recorded (to enable some weight loss for one service user). Service users are able to participate in the local community and an advocacy service is also provided by an outside agency. This agency assisted service users who wished to vote at the last election to do this. The advocate has changed so this information must be updated on files. Links with relatives are encouraged at trips home are supported weekly. There were no relatives or friends visiting the home at the time of the inspection. Longbridge Road (148) G55_S0000027905_Longbridge Road (148)_V232569_140605_Stage 4.doc Version 1.30 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 standard(s) 18, 19 and 20 These standards are well managed with documentation to show that great care is taken with health care for all service users. 2 service users are able to self medicate and this is monitored closely. EVIDENCE: It was observed from documentation that service users are well supported with their personal hygiene tasks dependent on their abilities. These are identified in their ‘Person Centred Plan’ and reference to these is recorded in each service users ‘daily diary’ (daily record of how they sent their day). Same gender care is provided (the staffing rota takes this into consideration and no males provide personal care to female service users). From documentation held about GP and other health care professionals visits these were well documented and the reasons for the referrals and diagnosis was well documented showing a clear picture of the outcome of visits. 2 service users are able to self medicate (a weekly amount of medication is held by each service user, (this weekly medication is dispensed by the pharmacy to the home). A lockable drawer is provided in the bedroom for medication to be held safely. Service users are continually assessed to ensure that they continue to be able to self medicate. Medication for other service users was appropriately signed and the monitored dosage system Longbridge Road (148) G55_S0000027905_Longbridge Road (148)_V232569_140605_Stage 4.doc Version 1.30 Page 15 corresponded with the signatures recorded. However a ‘when necessary’ medication was observed to be held by the home but there was no corresponding amount documented. All medication held must be recorded on the medication administration sheet and the amount of medication carried forward each month onto the new medication administration sheet. The home must be able to show a clear audit trail of any medication received into the home. Longbridge Road (148) G55_S0000027905_Longbridge Road (148)_V232569_140605_Stage 4.doc Version 1.30 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 standard(s) 22 standard 23 will be inspected at further inspections. These standards were well managed. EVIDENCE: From the inspection of complaints received by the home it was seen that these are well documented with the action taken to ensure that a similar situation does not arise again. It is recommended that the home record whether the complainant is happy with the outcome of the homes investigation. Service users’ finances were inspected, receipts corresponded with the expenditure documented. Money paid into building society accounts corresponded with records held by the home. Longbridge Road (148) G55_S0000027905_Longbridge Road (148)_V232569_140605_Stage 4.doc Version 1.30 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 standard(s) 24, 25, 26, 27, 28 and 30. None of the current service users require any specialist equipment therefore standard 29 does not apply to this home. The home in general was clean and tidy with service users participating in keeping the home to a good standard. Some areas require attention. Once these requirements are met the home will be in good order. EVIDENCE: The majority of the home was clean and free from odours. All bedrooms were individually decorated and had different furniture and lots of personal possessions were displayed. A vacuum cleaner was stored in a bedroom, this must be stored elsewhere. No equipment should be stored in service users bedrooms. However here are some areas within the home that require attention. The flooring in the upstairs bathroom requires re-sealing to the floor as the flooring has become loose around the edges at the end of the bath and water will get under this. The downstairs shower room has staining on the floor around the W.C. that requires removing. The sink in this room needs the seal between the vanity unit and the wall reapplied as this has perished. There was no plug for the wash hand basin in this room, this must be replaced. The carpet in the Longbridge Road (148) G55_S0000027905_Longbridge Road (148)_V232569_140605_Stage 4.doc Version 1.30 Page 18 lounge and downstairs hallway is badly stained and requires a ‘deep’ clean. If the stains cannot be removed then these carpets will have to be replaced. In one bedroom the service users has picked of the wallpaper border in several places. The border should be replaced as this spoils the decor in this bedroom. Longbridge Road (148) G55_S0000027905_Longbridge Road (148)_V232569_140605_Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) All of the above standards will be inspected at further inspections. EVIDENCE: The manager was not at the home at the time of this inspection due to sick leave, therefore these standards were not inspected at this inspection but will be inspected at further inspections. Longbridge Road (148) G55_S0000027905_Longbridge Road (148)_V232569_140605_Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 was inspected. Standard 39 will be insepcted at further inspections. The information required to allow standard 42 to be met was readily available. This ensures that the safety of service users is being met. EVIDENCE: Health and safety was well documented. The annual Gas safety certificate was dated 18/3/05. Fire drills are taking place and the last drill was recorded as taking place on 17/3/05 the fire alarm system was serviced on 9/6/05 fire extinguishers received their annual check in June 2004 and this is due to be undertaken again. The emergency lighting test was carried out on 24/6/04. The last fire officers visit to the home was dated 22/4/04 and a fire risk assessment of the building was dated 22/9/04. There was also a risk assessment should a fire happened Longbridge Road (148) G55_S0000027905_Longbridge Road (148)_V232569_140605_Stage 4.doc Version 1.30 Page 21 in the home’s mini bus this was dated 5/9/04 The fire alarm call point checks are being tested weekly and a record is kept of these. The Legionella test (annual test) is dated 20/5/04. The 5 year electrical check of the premises was dated 28/6/03 and is current. The electrical portable appliance test an annual test was dated 30/3/05. Hot water temperatures are being taken and recorded, where there were problems found action was recorded to put this right. Fridge and freezer temperatures are being taken on a daily basis. The kitchen was found to be clean and well organised. Longbridge Road (148) G55_S0000027905_Longbridge Road (148)_V232569_140605_Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 2 3 2 2 N/A 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Longbridge Road (148) Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x G55_S0000027905_Longbridge Road (148)_V232569_140605_Stage 4.doc Version 1.30 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 12(b) Requirement Create a recording/monitoring sheet to record the skills being maintained and set goals for future achivement to enable the home to evidence a year on year improvment of service users potential. Record on the medication administration sheet the anount of Stesolid held in the home. This should be carried forward each month onto the next medication administration sheet to show a clear audit trail of medication held. Repair/replace the torn wall paper border in one bedroom. Remove the vacum cleaner from the service users bedroom and store elswhere. Repair/reseal the flooring in the upstairs bathroom Clean the staining on the flooring around the W.C. pan in the downstairs shower room. Replace the seal between the wall and the vanity unit in the downstairs shower room. Replace the missing plug from the wash hand basidn of the downstairs shower room. Timescale for action 30/8/05 2. YA20 13(2) 14/6/05 and ongoing action. 3. 4. 5. 6. 7. 8. YA25 YA25 YA27 YA27 YA27 YA27 23(2)(d) 23(2)(l) 23(2)(b) 23(2)(d) & 13(3) 23(2)(b) 23(2)(b) 30/7/05 14/6/05 30/7/05 30/7/05 30/7/05 27/6/05 Longbridge Road (148) G55_S0000027905_Longbridge Road (148)_V232569_140605_Stage 4.doc Version 1.30 Page 24 9. YA28 23(2)(d) Deep clean the lounge and downstairs hall way carpets as they are very stained. If the stains cannot be removed the these carpets will require cleaning. Clean by 30/7/05 replace if necessary by 30/9/05. 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. 2. Refer to Standard YA5 YA13 Good Practice Recommendations It is recommneded that a copy of the licence agreement is held on each service users file. Ensure the name of the new advocate is added to the files. Longbridge Road (148) G55_S0000027905_Longbridge Road (148)_V232569_140605_Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection 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. 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