CARE HOME ADULTS 18-65
Maple House 78 Aldborough Road South Seven Kings Ilford Essex IG3 8EX Lead Inspector
Helen Fontaine Unannounced Inspection 24 October 2005 03:00 Maple House DS0000025909.V260853.R01.S.doc Version 5.0 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 Maple House DS0000025909.V260853.R01.S.doc Version 5.0 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. Maple House DS0000025909.V260853.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Maple House Address 78 Aldborough Road South Seven Kings Ilford Essex IG3 8EX 020 8590 7082 020 8550 0666 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Alan Philp Mrs Pamela Philp Mrs Pamela Joan Philp Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Maple House DS0000025909.V260853.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Moderate to high level of disability. To include named people as they reach 65 years of age, subject to the home being able to demonstrate that they are still able to meet their needs. 22nd March 2005 Date of last inspection Brief Description of the Service: Maple Lodge is a residential home for Adults with a Learning Disability. The home is situated in a residential road in Seven Kings in the London Borough of Redbridge, with easy access to the local park, shops, places of worship and transport. The nearest shopping facilities are Seven Kings High Road, Ilford Shopping Centre and Newbury Park. Each Service User has a single bedroom, individually decorated to a high standard, with personal items that reflects their individual character and interests. The home is part of the Alpam Homes organisation, which operates two other similar residential care homes in the London Borough of Redbridge and also has its own day centre, which Service Users attend daily, as well as using the Chadwell Day Centre. Maple House DS0000025909.V260853.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection took place in accordance with the annual inspection programme for this home. The previous inspections took place in February and March 2005 and were on an unannounced basis, where two Requirements were identified. Both of the Requirements remain and have been repeated over several inspections and two additional Requirements and one Recommendation was made at this inspection. A tour of the home was undertaken, where a number of the Service Users were seen and communicated with. A number of documents were seen and a member of staff assisted with the inspection, which was very much appreciated. The Manager was not present during the inspection and therefore a number of documents were not available for inspection. This must be addressed, as statutory records must be available for inspection at all times. What the service does well: What has improved since the last inspection? What they could do better:
Over the last three inspections for over a year, the same Requirements are made with extensions for dates to be completed. These are for the Service Users’ Guide to be in accordance with regulations and standards, and for a business plan to be made available. However, they are still not met and the Registered Provider does now need to meet these Requirements as a matter of urgency. Maple House DS0000025909.V260853.R01.S.doc Version 5.0 Page 6 Unmet requirements impact upon the welfare and safety of service users. Failure to comply by the revised timescale will lead to the Commission considering enforcement action to secure compliance. An additional Requirement was given at this inspection, as fire doors were found to be wedged open. The home does need to make sure that it does not place its Residents at risk and needs to make sure that appropriate equipment for this is used. The Manager was not present for this unannounced inspection and there were no facilities to access some of the records needed for the inspection. A system must be put in place for all statutory records to be available for inspection at all times. It is suggested that the Manager discusses with the Manager of the home next door, about holding each other’s keys for access of documents when necessary. 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. Maple House DS0000025909.V260853.R01.S.doc Version 5.0 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 Maple House DS0000025909.V260853.R01.S.doc Version 5.0 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 and 2 No documents were available to assess these standards; this means it was not possible to establish if appropriate assessments were undertaken or appropriate information provided to service users, prior to them moving into the home. EVIDENCE: The Support worker assisting with the inspection was not able to find any assessments prior to moving into the home. The Support Worker said that these were locked in the cupboard and the Acting Manager had the keys. The Service Users’ Guide was not available for inspection, to establish if all elements as outlined in regulations and the national minimum standards were included. It is essential that this is made available, as it has been a requirement from several inspections and the Commission for Social Care Inspection may take enforcement action, if it is not addressed within the new timescale set. Maple House DS0000025909.V260853.R01.S.doc Version 5.0 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 the following standard(s): 6, 7 and 9 Care plans reflect the assessed and changing needs of the Service User. Staff assist Service Users to make decisions about their lives and take risks as part of an independent lifestyle. EVIDENCE: During the inspection Service Users files were looked at and two Residents’ care plans reflected their changing needs. One care plan had issues around continence and the plan for assisting the Service User to become fully continent. The review documented that the incontinence problem had improved and the current support was to continue. The care plan also covered the areas of: Communications, Activities in the home, safe environment, Eating/Taking food, Interactions with other Residents. Each of the care plans were very different, being personalised to the needs of each Service User. Another care plan looked at covered the area of Personal Care. This documented that improvements had been made, but there was a need for continuing support and advises staff to be tactful. It documented a bath each morning and encouragement for the service user to take pride in their appearance and help with washing their hair. Each care plan was signed by the Service User and had regular and planned reviews.
Maple House DS0000025909.V260853.R01.S.doc Version 5.0 Page 10 One Service User was risk assessed to go out independently in the community and it was observed that this Service User went to the shop to get an item for the staff. The risk assessment identified that the Service User was to tell staff the route they would take and expected time of arrival back at the home. There was also a section about personal safety, crossing the road and vulnerability to exploitation. Maple House DS0000025909.V260853.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Service Users take part in activities and are able to meet with their own age and peer group. There are leisure activities and being part of the local community is encouraged. The home encourages Service Users to have contact with family and friends and their rights and responsibilities are recognised. Service users do have a healthy and enjoyable diet and thoroughly enjoy their mealtimes. EVIDENCE: All the Service Users in the home do have a number of activities and leisure pursuits to access and enjoy. During the inspection a number of the Service Users came back from their day centre and some of the Service Users had remained. The Support worker said that they do have a choice and could stay at the home if they wished. Service Users from the two homes do have regular contact with each other; one Resident from the home next door was at the home during the inspection. One Service User does go out independently and during the inspection, went to the local shop to buy something for the staff. Another Service User at the
Maple House DS0000025909.V260853.R01.S.doc Version 5.0 Page 12 home was making tea and coffee and provided the Inspector with a cup of coffee when they arrived. Later the Service User was assisting the staff, to put crockery away after the washing up had been done. Service Users do have contact with family and friends; care plans looked at had documented the regular contact with family. Service Users from the home attend a day centre run by the service providers and another day centre where they meet friends they have known for a long time. Service Users receive a healthy and varied diet, the fridges and freezers looked at during the inspection were well stocked. During the inspection the Staff were preparing the Residents tea, they were asked what they wanted and given choices. Menus were looked at and as an example showed there was spaghetti on toast or soup and for dinner there was chicken, potatoes and vegetables. Maple House DS0000025909.V260853.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Service Users receive personal support in a way they prefer and their physical and emotional needs are met. Service Users do not administer their own medication, but are protected by the homes policies and procedures. EVIDENCE: The care plan lays out the way Service User prefer their personal support to be given. One Service User’s care plan documents that staff are to respect the Service user’s dignity and privacy at all times and assist the Service user to be suitably dressed. The Service Users file documented that their ongoing health and emotional needs are being met. One Service User has an ongoing health problem that is contributing to their incontinence. On the Service Users file is a Redbridge PCT booklet in picture format completed, which documents their medical information. The home’s medication policy and procedure is in place, Medication Administration records (MAR sheets) were looked at and were fully completed. All medication is in bubble packs; no Service User in the home is currently selfmedicating. Maple House DS0000025909.V260853.R01.S.doc Version 5.0 Page 14 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 and 23 Service Users views and concerns are listened to and are acted on and they are protected from abuse, neglect and self-harm. EVIDENCE: Service Users’ files looked at had a section on concerns and complaints and the policy was in pictorial form, which included the contact details of the Commission for Social Care Inspection. Residents meetings were seen as an area where concerns could be bought up and one agenda item was headed “Likes and Dislikes,” there were no dislikes. Minutes of Staff meetings were looked at as another area where concerns may be highlighted, had documented one concern about a Service User shouting. The staff-training folder was looked at; there was a policy on whistle blowing, complaints and the grievance policy. Maple House DS0000025909.V260853.R01.S.doc Version 5.0 Page 15 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 and 30 The Service users live in a homely environment that is clean and hygienic, but fire doors were wedged open which places service users at risk. EVIDENCE: During the inspection a tour of the building was undertaken and the home was clean and hygienic. Each of the Service Users bedrooms were comfortable and the lounge was very nicely decorated and furnished. It was noted though that the kitchen fire door and the dining room fire door were both wedged open. The staff were in the kitchen and needed to be able to have contact with the Service Users, however appropriate door equipment needs to be in place. Maple House DS0000025909.V260853.R01.S.doc Version 5.0 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 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): It was not possible to inspect these standards, therefore to assess whether staff in the home are appropriate to meet the needs of service users. EVIDENCE: The Acting Manager of the home was not present and staff present during the inspection did not have the keys to access the staff files. All statutory records must be available for inspection at all times. Maple House DS0000025909.V260853.R01.S.doc Version 5.0 Page 17 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): 43 The Service Users are not benefiting from accountable management, as the business plan is still not available. EVIDENCE: The business plan was still not available for this inspection, as it has not been available for a number of previous inspections. The Registered Providers must make sure that the business plan is available, or the Commission for Social Care Inspection may take enforcement action. Maple House DS0000025909.V260853.R01.S.doc Version 5.0 Page 18 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 1 X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30
STAFFING Score 1 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Maple House Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score X X X X X X 1 DS0000025909.V260853.R01.S.doc Version 5.0 Page 19 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 5 Timescale for action The Service Users Guide must 24/12/05 include all details as described in national minimum standard 1.2 This is repeated from previous inspections. The Registered Person must 24/11/05 ensure the Safety of Service Users and Staff with regard to fire safety; fire doors must not be wedged open. All statutory records must be 12/12/05 available for inspection A business plan must be 24/11/05 available, together with financial information as required. This is repeated from previous inspections. Requirement 2 23(4) 3. 4. YA33YA2 YA43 19, 17(1)(a) 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 39 Good Practice Recommendations The home makes arrangements for keys to be held by Manager of the home next door, allowing access to files for
DS0000025909.V260853.R01.S.doc Version 5.0 Page 20 Maple House inspections and any other professional needing access. Maple House DS0000025909.V260853.R01.S.doc Version 5.0 Page 21 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 Maple House DS0000025909.V260853.R01.S.doc Version 5.0 Page 22 - 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!
