Inspection on 30/05/07 for Maplestead Road

This inspection was carried out on 30th May 2007.

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

Other inspections for this house

Maplestead Road 20/02/07

Maplestead Road 13/12/05

Maplestead Road 01/07/05

Maplestead Road 03/03/05

Maplestead Road 02/09/04

Maplestead Road 29/03/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Maplestead Road 36 Maplestead Road Dagenham Essex RM9 4XR Lead Inspector Lea Alexander Key Unannounced Inspection 30th May 2007 11:00 DS0000027907.V341689.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 DS0000027907.V341689.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. DS0000027907.V341689.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Maplestead Road Address 36 Maplestead Road Dagenham Essex RM9 4XR 0208 595 7645 0208 595 7645 jade@outlookcare.org.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Outlook Care Ms Jadesola Ezerioha Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places DS0000027907.V341689.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To include 2 named people over 65 years of age. Date of last inspection 20th February 2007 Brief Description of the Service: Maplestead Road is a large house that provides residential accommodation for up to six adults with mental health needs, and at the time of this inspection four people were living at the home. It is the aim of the home to promote independence, and to work with people who use the service to improve their daily living skills. The service is provided by Outlook care who lease the property from the local authority. The home is well equipped, homely and comfortable. There is a large wellmaintained garden at the rear of the home, complete with built in barbeque. The house comprises of six bedrooms and two bathrooms arranged over the ground and first floors, a communal lounge, a kitchen diner, WC and office. The home is situated in a residential area and is in walking distance of local shops and has easy access to local bus routes. There is unrestricted parking outside of the home. DS0000027907.V341689.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One Inspector carried out this inspection over the course of a day. This was the Inspectors first visit to the home. The Inspector spoke with the Registered Manager, with care staff on duty and with the four people who use the service. The Inspector also toured the premises, sampled personal files for people living at the home, personnel files for staff and a range of other documentation relating to the running of the home. The home also completed the Commissions “Annual Quality Assurance Assessment” form, and this was used in the inspection process. The Inspector would like to thank staff and people who use the service for their assistance in carrying out this inspection. What the service does well: People who are living in the home told the Inspector that they were “very happy here” and felt “very settled” living in the home. Prospective people who use the service have their needs assessed before moving in. Individuals are involved in decisions about their lives and participate in planning the care and support they receive. People who use the service are able to make choices about their life style and supported to participate in appropriate community activities. The health and personal care that people receive is based on their individual needs. There is an effective complaints procedure and people who use the service are able to express their concerns, have their rights protected and are safeguarded from abuse. The home is well laid out, safe and comfortable. Staffs are trained, skilled and employed in sufficient numbers, and a qualified competent Manager manages the home effectively. The home promotes individual equality and diversity through the use of comprehensive person centred individual plans. At present the home provides a service to three white British women and one white British man. The homes care staff are from a range of backgrounds including white and black British, making the staff group representative of the local community. Two of the homes seven-care staff is male. DS0000027907.V341689.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. DS0000027907.V341689.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 DS0000027907.V341689.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home understands the importance of having sufficient information when choosing a care home. Admissions to the home are not made until a needs assessment has been completed. EVIDENCE: There have been no new admissions to the home since the last inspection in February 2007. The Inspector sampled the personal files and for two people who use the service. This evidenced that the home had obtained carried out its own assessment prior to residents moving in. The home has also produced a statement of purpose and service users guide that are available to current and prospective residents. DS0000027907.V341689.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 excellent. This judgement has been made using available evidence including a visit to this service. People who use the service are involved in developing individual plans that are person centred, celebrate the individual and their life experiences, and focus on strengths and preferences. EVIDENCE: By sampling personal records and discussion with the Registered Manager, people who use the service and care staff the Inspector evidenced that the home has comprehensive person centred plans that cover all aspects of personal, social and healthcare needs. The plans seen by the Inspector were drawn up with the involvement of people who use the service and are easy to follow. The plans included information on life history and residents current situation with sections including “things that I need help with”, “how I like to be helped”, “places I like to go” and “how I like to spend my week”. This style DS0000027907.V341689.R01.S.doc Version 5.2 Page 10 of individual plan also clearly addresses and promotes residents rights to make decisions about their lives. There were also separate detailed plans available addressing individual needs in areas such as personal care, privacy and independence and activities of daily living. The available records evidenced that individual plans were reviewed at least every six months or as needs change. The records sampled by the Inspector also included risk assessments for activities identified in the individual plan, including use of public transport, the risk of falls and cooking. Individual plans for people who use the service include a section titled “my money”. Plans sampled by the Inspector detailed what support people who use the service need to manage their money. The Inspector sampled the homes records of financial transactions. Each person who uses the service has secure finances that are held in the Managers office. The Registered Manager advised that people who use the service could access this at all times. Each time a transaction takes place a record is completed detailing the date and amount of each withdrawal or deposit, and this is then signed by the resident and a staff member. DS0000027907.V341689.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. People who use the service have the opportunity to develop and maintain important personal and family relationships, and the practise of staff promotes individual rights and choices. EVIDENCE: People who are currently using the service range in age from middle through to retirement age. The Registered Manager and care staff identified that as a result of their mental health issues some people who use the service experienced difficulties in motivating and sustaining structured activities. At the time of this inspection no residents were attending day services. One person who uses the service had previously been employed two days per week, but had recently retired upon reaching age 66. The Registered Manager advised that some people who use the service attend a mental health forum DS0000027907.V341689.R01.S.doc Version 5.2 Page 12 and a women’s group on an “ad hoc” basis. All of the people who use the service are encouraged to develop and practise skills relating to the activities of daily living. During the course of the inspection the Inspector observed on a number of occasions care staff encouraging people who use the service to make choices about how they would spend their time and engaging them in activities such as snack and meal preparation. Each of the personal files sampled included a record of activities that the resident had engaged in. Sampling of individual plans, activity sheets and discussion with residents, care staff and the Registered Manager evidenced that everyone living in the home participates in shopping for the home and also meal preparation and household chores. The home also organises occasional day trips, the most recent occurring approximately three weeks prior to this inspection. Two people who use the service usually go out in the community independently on a daily basis. They visit family they have locally and local shopping centres and amenities. The other two people who use the service have extended family members who either visit or phone regularly. The home has a weekly meeting during which people who use the service decide what meals they would like prepared for the upcoming week. The Inspector viewed the homes log of meals provided and this evidenced that a range of varied and nutritious meals are provided. People who use the service commented that “meals are lovely” and that they “enjoyed the food very much”. DS0000027907.V341689.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. People who use the service are supported and encouraged to be independent for their personal care needs and have access to a range of healthcare services. There is an appropriate medication policy and evidence of good medication administration practises. EVIDENCE: Discussion with people who use the service, care staff and the Registered Manager evidenced that residents require prompts and reminders but are independent in carrying out personal care tasks. This was reflected in the individual plans sampled by the Inspector. The Inspector sampled the personal records for two people who use the service. These evidenced that a healthcare planner and appointments log is regularly maintained. This details the appointment attended, the outcome and any follow up actions. Recent healthcare appointments attended included GP, Physiotherapist, Occupational Therapist and Acupuncturist. DS0000027907.V341689.R01.S.doc Version 5.2 Page 14 The Registered Manager informed the Inspector that none of the people currently living in the home is self-medicating or taking any controlled drugs. The Inspector sampled the homes medication policy. This is a corporate Outlook care document that includes guidance on the storage, administration and disposal of medicines. The Inspector sampled the Medication Administration Records (MAR) and actual medication available for two service users. The MAR sheet was found to be in order and the medications seen corresponded with the MAR sheet. DS0000027907.V341689.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. The home has an open culture that allows residents to express their views and concerns in a safe and understanding environment. EVIDENCE: The home has a corporate Outlook Care complaints procedure. This includes the process and timescales within which the home aims to deal with complaints. The Inspector also sampled the homes complaints log. This contains an easy to read summary of the homes policy and procedure as well as completed complaints forms. The most recent complaint related to one resident complaining about the noise another resident was making. During discussions with people who live in the home one person who uses the service told the Inspector that they were “very satisfied” with how the home had dealt with a complaint they had made in the past. There have been no adult protection allegations since the previous inspection in February 2007. The home implements a corporate Outlook Care protecting adult’s policy and procedure. This includes definitions and possible indicators of abuse and gives clear guidance to staff on the procedure to follow should they have any concerns. The policy also makes appropriate reference to local multi agency adult protection procedures. DS0000027907.V341689.R01.S.doc Version 5.2 Page 16 The member of staff spoken to by the Inspector demonstrated a good understanding of adult protection issues and their responsibilities. DS0000027907.V341689.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well lit, clean and tidy and smells fresh. Residents have their own bedrooms and there is a range of communal space. EVIDENCE: Entrance to the home is through a hallway that contains a payphone and the homes registration certificates. On the ground floor there is a communal lounge with a range of comfortable seating, this is a homely room with pictures on the wall, a TV and stereo. The communal kitchen and dining area are also on the ground floor. The kitchen is bright and airy with views over the rear garden. There is a fitted kitchen and a large dining table and chairs. There is also a separate pantry cupboard that was found to contain a good variety of fresh fruits and vegetables as well as canned and dry ingredients. The fridge was well stocked, and appropriate items date labelled. A large chest freezer is also sited in the kitchen. There is access to the rear garden from the kitchen DS0000027907.V341689.R01.S.doc Version 5.2 Page 18 and to the Managers office. One residents bedroom and a large bathroom with tub, walk in shower, WC and hand basin are also on the ground floor. Access to the first floor is via a staircase. A further five residents bedrooms, a separate WC and a further bathroom are located on the first floor. The home was found to be comfortable, homely and generally well maintained. Good standards of hygiene were found throughout and the environment was free from offensive odours. DS0000027907.V341689.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. 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. Staffs take external qualifications beyond the basic requirements and are regularly supervised. People who use the service have confidence in the staffs that care for them. However, pre employment procedures must include a “POVA” check for all staff. EVIDENCE: During the course of the inspection staff were observed to be accessible to and approachable by residents. One resident described staff as “very friendly and helpful” and said that they were “treated very well” another said that staff were “very helpful and chatty”. In addition to the Registered Manager the home has a vacant Deputy Manager post and seven care workers. Six of the care workers have obtained NVQ level 3. Outlook Care has a centralised Human Resources Department that manages the recruitment process. Records relating to staff recruitment were available on site, and the Inspector sampled two personnel files. This evidenced that DS0000027907.V341689.R01.S.doc Version 5.2 Page 20 the home obtains proofs of identity and two satisfactory references as part of the recruitment process. Outlook Care also obtains its own enhanced level Criminal Records Bureau (CRB) check. The CRB’s seen by the Inspector were dated 2004, and the Registered Manager advised that the organisation does not currently have a policy regarding timescales for renewing the CRB checks of existing staff. The Inspector also noted that the CRB for one staff member was annotated as “not requested” against the Protection of Vulnerable Adults (POVA) register. The Registered Manager advised the Inspector that Outlook care have developed a process to include residents in staff selection. This includes asking service users to submit any questions they have for prospective employees. The Registered Manager advised that in addition to a corporate Outlook Care induction, new staffs are also given an induction to the home. Training records for the personnel sampled evidenced that training on mental health awareness, suicide and self-harm, risk management, women and mental health and motivating residents had all been attended in the last 12 months. Sampling of supervision records evidenced that staff have received a minimum of six supervisions in the previous twelve months, and that these sessions had been recorded. Discussions with care staff evidenced that they receive a copy of their supervision notes. DS0000027907.V341689.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. 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 Manager has the required qualifications and is competent to run the home. EVIDENCE: The Registered Manager has obtained NVQ level 4 and the Registered Managers Award. In addition to visits from the Responsible Individual and other monitoring measures, the Manager has also developed an Annual Development Plan. This published document is available to any interested party and includes information from service users and their families on the homes performance. DS0000027907.V341689.R01.S.doc Version 5.2 Page 22 The Inspector sampled a range of health and safety records maintained in the home. Copies of accident and incident forms were available, and those sampled by the Inspector were found to be in order. A monthly record of water temperatures is maintained, and the recorded temperatures were within acceptable parameters. Weekly fire alarm call point tests are recorded as being carried out, along with regular fire evacuation drills that include timings. Fridge and freezer temperatures are recorded daily, and these were again found to be within acceptable limits. During the site inspection it was found that medication-requiring refrigeration is stored in the general refrigerator. The Inspector noted that at the time of the inspection this was not locked. DS0000027907.V341689.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 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 2 X DS0000027907.V341689.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No. 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 16 & 23 Requirement To maintain the environment the home must attend to the following issues: (i) (ii) (iii) Secure loose tiles in the upstairs bathroom. Secure the loose kickboard and draw fronts in the kitchen. Clean or replace soiled carpets in some service users bedrooms. Timescale for action 30/08/07 2. YA34 19 To ensure residents safety, the 30/07/07 home must ensure that a “POVA” check is requested as part of the CRB. To ensure the safety of people who use the service the medicines box stored in the fridge should be locked. 30/07/07 3. YA42 13 & 23 DS0000027907.V341689.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA34 Good Practice Recommendations To promote resident safety, the organisation should consider developing a policy addressing the timescales for renewal for existing staff members CRB checks. DS0000027907.V341689.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 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 DS0000027907.V341689.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!