Inspection on 08/01/08 for Lower Clapton Road (Flat 1)

This inspection was carried out on 8th January 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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

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

Lower Clapton Road (Flat 1) 25/07/05

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

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

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

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 Lower Clapton Road (Flat 1) Flat 1 219 Lower Clapton Road Hackney London E5 8EH Lead Inspector Brenda Pears Unannounced Inspection 8th January 2008 2:00 Lower Clapton Road (Flat 1) DS0000010272.V356930.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 Lower Clapton Road (Flat 1) DS0000010272.V356930.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. Lower Clapton Road (Flat 1) DS0000010272.V356930.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lower Clapton Road (Flat 1) Address Flat 1 219 Lower Clapton Road Hackney London E5 8EH 020 8986 1876 020 8986 1876 lcr1@hilt.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) Hackney Independent Living Team Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Lower Clapton Road (Flat 1) DS0000010272.V356930.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th October 2006 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. Hackney Independent Living Team, (HILT) manages the home, which is a voluntary sector provider of care services. 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. Lower Clapton Road (Flat 1) DS0000010272.V356930.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken on the 8th January 2007 and started at 2.00pm. The focus of this inspection was on the previous requirements, on the core national minimum standards and on the quality of life for those living in the home. The methods used to complete this inspection consisted of a review of records, discussions were undertaken with the acting manager, interaction with one person living in the home. A tour of the building was carried out and observations of staff and routines in the home all inform the outcomes in this report. At the time of this inspection there were three people in the home and one visitor. At the time of this inspection there were three people in the home being supported. A regular member of agency staff assisted with the main body of this inspection and the senior member of staff on shift then took over to assist with the completion of this inspection. What the service does well: What has improved since the last inspection? What they could do better: Lower Clapton Road (Flat 1) DS0000010272.V356930.R01.S.doc Version 5.2 Page 6 Ongoing redecoration and dealing with minor repairs quickly would ensure the environment is continually in an acceptable condition. 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. The summary of this inspection report can be made available in other formats on request. Lower Clapton Road (Flat 1) DS0000010272.V356930.R01.S.doc Version 5.2 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 Lower Clapton Road (Flat 1) DS0000010272.V356930.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): No judgement made at this time. There have been no new admissions into the home since the last inspection, therefore this area was not directly inspected at this time. All those currently living in the home have been living there long term. EVIDENCE: Lower Clapton Road (Flat 1) DS0000010272.V356930.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Choices are made by individuals regarding all activities and how each day will be spent, supporting autonomy and choice on a daily basis. EVIDENCE: Care plans are in place for each person and these are updated as needs, or a person’s health, changes. Personal care plans are appropriately stored and locked. Those living in the home are treated appropriately with due consideration for privacy and respect. This was confirmed by observations at this time and also through discussions with one family visitor. Daily records are kept up to date reflecting how each day is spent and what events have impacted on daily lives. Each person makes their own choice as to whether they participate in Lower Clapton Road (Flat 1) DS0000010272.V356930.R01.S.doc Version 5.2 Page 10 household chores, activities or outings. All activities are undertaken following the completion of risk assessments and this ensures the correct staffing support is provided. This was confirmed through a review of files and through discussions undertaken at this time. Relatives are an important part of the support for each person and are also included in the development of care plans. A sampling of files showed that all areas of care are recorded and up to date including communication needs, money policy and procedures, menu plans and full risk assessments. Lower Clapton Road (Flat 1) DS0000010272.V356930.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. 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. All needs and support are met by the home. Family and friends are encouraged to maintain contact, ensuring the well being of those living in the home. EVIDENCE: All relationships that are important to service users are encouraged and constant contact supported. Events in the home are undertaken with involvement and support from friends and family. This was confirmed by a review of records and also through discussions. The home was found to be clean and odour free with a relaxed atmosphere. Two people were in the lounge and one person who uses a wheelchair was relaxing in various areas and joining in with conversations. Lower Clapton Road (Flat 1) DS0000010272.V356930.R01.S.doc Version 5.2 Page 12 Everyone was introduced to the inspector and told why the inspection was taking place. Staff fully included those living the home at all times and stopped discussions to ensure everyone was attended to and supported. Independence and mobility are encouraged and hobbies or activities that are enjoyed are fully supported. The home continues to provide support and care in a safe and relaxed environment. Access to the local community is through the occupational team run by HILT as well as outings and programmes developed in the home. One person was enjoying a family visit and the visitor explained that contact has been maintained since the person moved into the home. It was explained that staff do ‘look after people well and ‘provide a good service’. Records clearly showed meals that have been eaten, preferences and clear descriptions of individual needs. Lower Clapton Road (Flat 1) DS0000010272.V356930.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. 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. All needs and preferences are clearly recorded on person centred plans and medication is appropriately stored, ensuring the health, safety and well being of those living in the home. EVIDENCE: Health professionals provide support that ensures staff fully meet the care needs for each individual. All service users have access to appropriate healthcare professionals and visits are recorded. Records clearly state appointments made and outcomes of all health support that is given. Full reviews are undertaken and the home has support from the local GP and other healthcare professionals. All appropriate equipment is used in the home to ensure people are fully mobile and their needs are being met. Lower Clapton Road (Flat 1) DS0000010272.V356930.R01.S.doc Version 5.2 Page 14 All medication was seen to be in order and appropriately stored. Records were correctly completed and up to date. Staff confirmed that medication is dispensed only by staff who are fully trained. Lower Clapton Road (Flat 1) DS0000010272.V356930.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. 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. Service users are protected and supported by procedures and staff training in the home. EVIDENCE: The complaints procedure is up to date and the previous inspection found adult protection procedures to be appropriate. Discussions with a visitor at this time confirmed there is a good relationship with family and friends that encourages discussions at all times. It was also confirmed that the home is run in an open and inclusive manner and there would be no hesitation in visitors speaking about any concerns. Respect and consideration is demonstrated for the needs of others by both staff and service users. Those living in the home have an allocated key worker, enabling everyone to have one to one discussions. This does not making things too formal, while encouraging comments and discussion about all issues in the home. Any matters concerning individuals are taken seriously and appropriate support is given. Lower Clapton Road (Flat 1) DS0000010272.V356930.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,27,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home was found to be clean, bright and providing a safe and comfortable environment, however, the repairs to some areas of piping require urgent completion. EVIDENCE: The home was found to be clean and odour free with a relaxed atmosphere. Rooms are personalised and very much an individual space. The environment has previously been adapted to accommodate the changing needs of one person, particularly in the shower room following an assessment by the occupational therapist. There is currently a problem with some previous repairs undertaken to pipe work in the bathroom. These pipes urgently need to be repaired as it is also Lower Clapton Road (Flat 1) DS0000010272.V356930.R01.S.doc Version 5.2 Page 17 affecting a room occupied by one person. The floor has been patched over and staff have stated they regularly check this for safety. The current situation, while safe, is not providing a homely and comfortable room for this person. Staff explained that this work is to be completed and on completion, the flooring will also be replaced. The kitchen area was found to be clean and orderly and fridge temperatures are regularly taken. There is some damage to the walls in the staff room and the hallway needs repainting where scrapes have occurred due to wheelchair use. The hallway also needs protection to prevent repeated damage occurring following redecoration as this area is in constant use. Lower Clapton Road (Flat 1) DS0000010272.V356930.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported and protected by the staff training, recruitment and the supervision process. EVIDENCE: Training and service user needs are at the centre of all plans and service delivery in the home. All CRB and POVA checks are in place prior to any new person starting work in the home, which ensures the full safety of service users at all times. The previous inspection found that generally all staff information was held at the HILT head office, including CRB disclosure forms. However, a senior member of staff confirmed that files in the home do now contain copies of all appropriate recruitment paperwork. While agency staff do not have access to staff files, it was later confirmed that the senior member of staff on duty does have access at all times. Staff do have regular training that covers all core areas of support. There is also an induction programme in place that is completed by any new members of staff. Staff confirmed they have ongoing refresher training, supervision and Lower Clapton Road (Flat 1) DS0000010272.V356930.R01.S.doc Version 5.2 Page 19 appraisals and they felt they could discuss any matters or problems openly. Any agency staff required in the home are the same regular staff, this ensures that staff are known to those receiving support and are also aware of practices in the home. There is a handover period between each shift and there were three staff on duty during the morning, two staff on the afternoon shift and one waking night staff on the day of this inspection. Rotas identify when additional staff are required for specific outings or activities. Staff confirmed they have refresher training and this has included manual handling, first aid and awareness of abuse. Staff meetings are regularly undertaken and minutes are on file to ensure all staff read the outcomes. Staffing levels are set after an assessment of daily needs is undertaken. Depending on the daily activities, the rota then reflects the service user support that is required. Staff work together to support service users and are fully aware of their roles and responsibilities, ensuring continuity and teamwork. Lower Clapton Road (Flat 1) DS0000010272.V356930.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home continues to work in an open manner to ensure the well being and safety of service users. EVIDENCE: As stated above, the registered manager is responsible for making sure all requirements are met and this includes appropriate information on staff files in the home. The health and well being of service users is considered at all times and staff expressed a thorough knowledge of service user needs. Any change in the Lower Clapton Road (Flat 1) DS0000010272.V356930.R01.S.doc Version 5.2 Page 21 personal or physical needs of service users is clearly recorded and procedures drawn up to ensure appropriate and full support at all times. Observations and discussions with staff and a visitor at this inspection, confirm that routines and practices ensure the well being of people receiving support. Regular monthly audits are undertaken by the organisation and these are also accompanied by action plans to addresss any areas needing attention. Staff are appropriately trained to enable the full support of those living in the home. The routines and daily activities are dictatated by those living in the home who are at the centre of the care provided. Lower Clapton Road (Flat 1) DS0000010272.V356930.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 X 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 2 26 X 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X 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 3 X 3 X X 3 x Lower Clapton Road (Flat 1) DS0000010272.V356930.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 YA24 Regulation 23(2)(b) Requirement All damaged areas to be repaired, particularly in personal rooms where damage impacts directly on the quality of life for that person. (Brought forward from the last inspection as not yet fully completed) Timescale for action 31/05/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Lower Clapton Road (Flat 1) DS0000010272.V356930.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Lower Clapton Road (Flat 1) DS0000010272.V356930.R01.S.doc Version 5.2 Page 25 - 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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