Inspection on 25/07/05 for Lower Clapton Road (Flat 1)

This inspection was carried out on 25th July 2005.

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 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lower Clapton Road (Flat 1) 08/01/08

Lower Clapton Road (Flat 1) 09/10/06

Lower Clapton Road (Flat 1) 15/05/06

Lower Clapton Road (Flat 1) 13/04/05

Lower Clapton Road (Flat 1) 25/10/04

Lower Clapton Road (Flat 1) 24/05/04

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Ashlong House

Norbury Crescent (30)

Edenvale

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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 Flat 1, 219 Lower Clapton Road Flat1, 219 Lower Clapton Road Hackney London E5 8EH Lead Inspector Sandra Jacobs-Walls Announced Inspection 13 April 2005 at 10:00am th 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. Flat 1, 219 Lower Clapton Road G56 G06 S10272 Flat 1 Lower Clapton Road V211913 130405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Flat 1, 219 Lower Clapton Road Address Flat 1, 219 Lower Clapton Road, Hackney, London, E5 8EH 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 8986 1876 020 8986 1876 info@hilt.org.uk Hackney Independent Living Team Ms Jennifer Johnson Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Flat 1, 219 Lower Clapton Road G56 G06 S10272 Flat 1 Lower Clapton Road V211913 130405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th October 2004 Brief Description of the Service: Lower Clapton Road (Flat 1) offers support, personal care and accommodation for a maximum of four service users who have learning difficulties. Some of the current service users are physically disabled and are living with complex health conditions. The home is situated within a modern small complex of flats at a busy intersection near Clapton Pond within the London Borough of Hackney. The home has good bus links and is within walking distance of local shops, and amenities including a post office. Hackney Independent Living Team, (HILT) manages the home, which is a voluntary sector provider of care services. Flat 1, 219 Lower Clapton Road G56 G06 S10272 Flat 1 Lower Clapton Road V211913 130405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was conducted on April 13 2005. The home’s registered manager and a senior member of staff assisted with the inspection process. At the time of the inspection, four service users were accommodated, two service users were present a during the inspection, but due to their significant learning disability and communication issues, the inspector had limited opportunity to obtain a real sense of their wishes and opinions. The inspection included the review of two service user files, review of relevant policies and procedures, review of staff personnel files and interviews with staff members. As a result of the inspection findings, 12 requirements were made, of which 4 are repeat requirements. The inspector would like to thank all service users and staff who co-operated and contributed to the inspection What the service does well: What has improved since the last inspection? The home’s manager made an application to CSCI and is now the home’s registered manager. Staff had managed to address most of the issues highlighted at the last inspection. There was evidence of newly implemented Flat 1, 219 Lower Clapton Road G56 G06 S10272 Flat 1 Lower Clapton Road V211913 130405 Stage 4.doc Version 1.20 Page 6 policies and practices, particularly in relation to medication information and issues of confidentiality. The home is also in the process of developing active personal planning systems to further enhance service users’ sense of independence. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Flat 1, 219 Lower Clapton Road G56 G06 S10272 Flat 1 Lower Clapton Road V211913 130405 Stage 4.doc Version 1.20 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 Flat 1, 219 Lower Clapton Road G56 G06 S10272 Flat 1 Lower Clapton Road V211913 130405 Stage 4.doc Version 1.20 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 and 5 The home’s current service users have lived at the home since the 1990’s; there had been no new admissions to the home for several years, therefore standards relating to practice with regard to prospective service users could not be assessed. The home provided detailed information about the home’s services, but must amend information relating to the home’s complaints procedure. Each service user had an individual written agreement on file. EVIDENCE: The home’s Statement of Purpose and Service User Guide was reviewed. Both documents contained comprehensive information about services offered by the home; the service user guide contained pictorial information so that the information is readily accessible to prospective service users. Information about the home’s complaints procedure will need to be amended to better facilitate service user users participation in all stages of the procedure. Currently the procedure advises service users to contact service managers in writing only. This is not possible for any of the home’s current service users. The home must also develop and implement an admissions policy. The two service user files reviewed contained tenancy agreements Flat 1, 219 Lower Clapton Road G56 G06 S10272 Flat 1 Lower Clapton Road V211913 130405 Stage 4.doc Version 1.20 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 standard(s) 6, 7, 8, 9and 10. Staff of the home made good efforts to keep service users involved in care planning and the decision making process. Staff consulted with service users using a number of differing communication methods and risk assessments are in place. Service user information is kept confidential. EVIDENCE: Files reviewed indicated that service users and family members, as appropriate were invited to participate in the reviewing process and contributed to service user care plans. Care plans seen were relevant and current. Pictorial cues and objects of reference systems were used by staff to assist service users indicate choice and decisions. General and specific individualistic risk assessments were evident on file, some focused on manual handling issues, the management of aggression of some service users and risks associated with significant medical conditions such as Parkinson’s disease and severe diabetes. Since the last inspection the registered manager had developed and implemented an effective confidentiality policy. Flat 1, 219 Lower Clapton Road G56 G06 S10272 Flat 1 Lower Clapton Road V211913 130405 Stage 4.doc Version 1.20 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16 and17 Most service users have opportunities for personal development and to participate in appropriate activities; this however was not seen to be the case for one service user, whose file was reviewed. All service users have good access to the local community and engage in leisure pursuits. Service users have appropriate personal and family relationships and their rights are respected. Meals offered by the home were varied and nutritionally balanced. EVIDENCE: The home made good use of HILT’s Occupational services, enlisted to design, escort and encourage service users participation in numerous activities largely within the local community. Despite this provision however, the inspector reviewed the individual file for one service user, who appeared not to participate in a range of meaningful activities on a regular basis. The registered manager acknowledged this was in need of improvement. Service users frequently accessed local shops and amenities and would visit the local pub and restaurants. Staff escorted service users to local parks, to Covent Garden, cafes, theatre trips, to a local church etc. Service users were encouraged to participate in hobbies and leisure activities of their choosing, Flat 1, 219 Lower Clapton Road G56 G06 S10272 Flat 1 Lower Clapton Road V211913 130405 Stage 4.doc Version 1.20 Page 11 one service user was said to obtain immense pleasure from listening to spiritual music on her own in her room. Most service users shared a close relationship with family members, the mother of one service user saw her son on a daily basis either at her home or at the unit. Another service user went out with his father every Saturday. Management of the home are assisting the HILT organisation develop policies and practices with regard to issues of (service user) sexuality. The inspector saw weekly menus. Meal planning is explored with service users at the weekly residents meeting; choices offered take into account the individual dietary needs of service users. Flat 1, 219 Lower Clapton Road G56 G06 S10272 Flat 1 Lower Clapton Road V211913 130405 Stage 4.doc Version 1.20 Page 12 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, 20 and 21 Service users receive personal support in accordance to their indicated preferences; their physical and emotional health needs are well met. The home’s medication policies and practices are adequate. The home manages well issues of service user illness and ageing. EVIDENCE: Files reviewed indicated that some service users had very significant medical conditions and were physically disabled. Documentation seen on file was very comprehensive and explicit in outlining the personal care needs of service users and how specifically individual service users wished these tasks to be performed. Guidance to staff seen was clear and sensitively written. Good attention was paid to the healthcare needs of service users, files contained detailed information regarding the management of diabetic conditions and the impact of Parkinson’s disease, both conditions were relevant to two service users. The medication and relevant information for one service user was reviewed, the inspector noted that practice and procedures were safe, well monitored and in line with the home’s written procedures. Flat 1, 219 Lower Clapton Road G56 G06 S10272 Flat 1 Lower Clapton Road V211913 130405 Stage 4.doc Version 1.20 Page 13 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 and 23 The home has a comprehensive complaints procedure that is in need of further development to ensure that any potential complaint is appropriately acted upon. Service users are protected from abuse, neglect and self-harm. EVIDENCE: The home’s complaints log was reviewed, the home had no recorded complaints during the previous year. The home’s complaints procedure is available in pictorial and audio forms to make access easier. However, the literature available to service users must be amended since currently service users can only alert the home’s service manager of complaints via written form. This is inappropriate as none of the home’s current service users are able to write. There have been no incidents of suspected or actual abuse of service users during the past year. The home has in place comprehensive adult protection procedures, which is complemented by written local adult protection protocols of referring statutory agencies. Flat 1, 219 Lower Clapton Road G56 G06 S10272 Flat 1 Lower Clapton Road V211913 130405 Stage 4.doc Version 1.20 Page 14 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) 24,25,26,27,28,29 and 30 The home at the time of the inspection was clean and hygienic. Service user bedrooms promote their independence and suit their needs and lifestyles. As do shared space. The home’s toilet and bathrooms provide sufficient privacy and meet individual needs and specialist equipment is available to maximise service user independence. The home’s general maintenance is in need of considerable repair and refurbishment to increase service user comfort and safety. EVIDENCE: The inspector participated in a tour of the home’s premises led by the home’s registered manager. The home’s premises were clean and hygienic. Four service user bedrooms were seen, all were clean, appropriately furnished and contained the personal effects of service users such as photographs, art work, stuffed animals, flowers etc. In the bedrooms of service users who are physically disabled, appropriate adaptations were in place, such as hoists, shower seats and grab rails. Disability equipment was also evident in the home’s toilets and bathrooms. Some repair and maintenance work highlighted at the previous inspection had been completed. The inspector noted however that in some areas of the home, plastering was incomplete, and additional Flat 1, 219 Lower Clapton Road G56 G06 S10272 Flat 1 Lower Clapton Road V211913 130405 Stage 4.doc Version 1.20 Page 15 metal strips were needed to address scrapes to the walls made by the manoeuvring of service user wheelchairs. The home’s hallway was in need of general painting and redecoration. The building’s owner, Newlon must promptly and effectively respond to maintenance issues if the safety and welfare of the home’s service users are to be maximised. Flat 1, 219 Lower Clapton Road G56 G06 S10272 Flat 1 Lower Clapton Road V211913 130405 Stage 4.doc Version 1.20 Page 16 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) 31,32,33,34,35 and 36. Staff roles and responsibilities are clearly defined. The staff group are well established, with a good mix of skills that meet well the needs of service users. The home’s recruitment policies are robust, however, all staff personnel records must contain full information as required and evidence regular staff supervision is being conducted to ensure the protection of service users. Training opportunities for staff are adequate. EVIDENCE: The inspector reviewed the personnel files for four members of staff. For one staff member, the file seen did not contain documentation that confirmed proof of identity as was required. Individual staff supervision for most staff was consistent, however it was noted that particularly for night staff there were significant gaps in the frequency of individual staff supervision sessions. These must be held frequently and in line with the home’s written policies. Sessions must be documented. The registered manager produced a training needs analysis of the staff group following completion of most staff appraisals within the year. The training analysis from seen indicated training provided and needed by staff. Some staff members were completing NVQ courses or participating on Learning Disability Award Framework as part of the home’s induction process. Flat 1, 219 Lower Clapton Road G56 G06 S10272 Flat 1 Lower Clapton Road V211913 130405 Stage 4.doc Version 1.20 Page 17 Flat 1, 219 Lower Clapton Road G56 G06 S10272 Flat 1 Lower Clapton Road V211913 130405 Stage 4.doc Version 1.20 Page 18 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) 37,38,39,40,41,42 and 43 The home is well run and the management team are generally effective from which, service users benefit. The home will need to improve upon its monthly monitoring visits; service users rights and best interests will be improved once the home’s complaints procedure is amended and an admission policy is developed. The health, safety and welfare of service users are generally promoted and protected, although improvements to the home’s environment will further enhance this. Service users benefit from competent and accountable management of the service EVIDENCE: The management team of the home is generally well qualified, competent and experienced to run the home efficiently. However, HILT senior management staff will need to consistently conduct monthly monitoring visits and supply both the home and the Commission with subsequent monitoring reports; the inspector was aware that very few reports had been forwarded to the Commission as required. Managers at the home were unable to produce all Flat 1, 219 Lower Clapton Road G56 G06 S10272 Flat 1 Lower Clapton Road V211913 130405 Stage 4.doc Version 1.20 Page 19 past monthly reports. Service users rights will be further improved upon revision of the home’s complaints procedure and the welfare of service users will also be enhanced once the home’s environment is improved. The home currently has no admissions policy or procedure. The home must also supply the commission with information that confirms the home’s financial viability. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 x x x 3 Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Flat 1, 219 Lower Clapton Road Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 1 3 2 3 3 3 3 Standard No G56 G06 S10272 Flat 1 Lower Clapton Road V211913 130405 Stage 4.doc Score Version 1.20 Page 20 LIFESTYLES Standard No 11 12 13 14 15 16 17 Score 3 2 3 3 3 3 3 31 32 33 34 35 36 3 3 3 2 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 2 2 3 2 2 Flat 1, 219 Lower Clapton Road G56 G06 S10272 Flat 1 Lower Clapton Road V211913 130405 Stage 4.doc Version 1.20 Page 21 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA1 Regulation 6 Requirement The registered manager must ensure that the homes Statement of Purpose and Service User Guide is amended to include revised information regarding the homes complaints procedure The registered manager must ensure that all service users have access to a range of meaningful activities available during the day The registered manager must ensure that the homes complaints procedure is appropriately revised in order to faciitate service users participation in all stages of the procedure The registered manager must ensure that the broken shower seat is replaced The registered manager must ensure the homes hallways are re-painted The registered manager must ensure that all plastering to service users bedrooms is completed. (Previous timescale 31/12/04 not met) The registered manager must Timescale for action 15/05/05 2. YA12 16(2)(n) 31/05/05 3. YA22 22(2) 31/05/05 4. 5. 6. YA24, 42 YA24 YA24 23(2)(c) 23(2)(d) 23(2)(b) 31/05/05 01/08/05 15/06/05 7. YA26 23(2)(b) 15/06/05 Page 22 Flat 1, 219 Lower Clapton Road G56 G06 S10272 Flat 1 Lower Clapton Road V211913 130405 Stage 4.doc Version 1.20 8. YA34, 42 19(1)(b) 9. YA36 18(2) 10. YA39 26(4) 11. YA40 12(1)(A) 12. YA43 25 ensure that where necessary, strip metal wall protectors are in place in service user bedrooms The registered manager must ensure that staff personnel files evidence all required information as per Schedule 2 of the Care Homes Regulations. (Previous timescale 30/11/04 not met) The registered manager must ensure that staff receive regular 1:1 supervision that is documented The registered person must ensure that monthly monitoring visits are consistently conducted and that subsequent reports are promptly made available to staff in the home and the Commission. (Previous timescale 30/11/04 not met) The registered manager must develop and implement an admissions policy. (Previous timescale of 30/11/05 not met) The registered manager musr supply the Commission with information that confirms the homes financial viability 31/05/05 31/05/05 31/05/05 31/06/05 31/05/05 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. Refer to Standard Good Practice Recommendations Flat 1, 219 Lower Clapton Road G56 G06 S10272 Flat 1 Lower Clapton Road V211913 130405 Stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection 4th Floor, 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 Flat 1, 219 Lower Clapton Road G56 G06 S10272 Flat 1 Lower Clapton Road V211913 130405 Stage 4.doc Version 1.20 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. 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!