Inspection on 12/05/06 for Market Street (152)

This inspection was carried out on 12th May 2006.

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 no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Market Street (152) 21/01/08

Market Street (152) 20/10/05

Market Street (152) 18/04/05

Market Street (152) 27/09/04

Market Street (152) 19/04/04

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

CARE HOME ADULTS 18-65 Market Street (152) 152 Market Street East Ham London E6 2PU Lead Inspector Sarah Greaves Unannounced Inspection 12th May 2006 02:00p Market Street (152) DS0000022884.V293514.R01.S.doc Version 5.1 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 Market Street (152) DS0000022884.V293514.R01.S.doc Version 5.1 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. Market Street (152) DS0000022884.V293514.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Market Street (152) Address 152 Market Street East Ham London E6 2PU 020 8470 2535 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) Mrs Grace Antwi-Nyame Ms Dorothy Mensah Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Market Street (152) DS0000022884.V293514.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12 January 2006 Brief Description of the Service: 152 Market Street is a residential home for people with mental health problems and is registered for up to three service users. The home is privately owned and the proprietor works at the establishment. The home is situated in Newham, close to the shopping facilities, amenities and transport links available at High Street North. The home comprises of a single bedroom and a communal lounge on the ground floor, and two bedrooms on the first floor. The home occupies an ordinary domestic property in a residential street. Market Street (152) DS0000022884.V293514.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken in one day. The inspector spoke to two service users and the registered manager; there were no personal or professional visitors in the care home at the time of this inspection visit. The inspector checked the service’s compliance with the requirements issued at the previous inspection on the 12th January 2006, and assessed the service’s performance in the key National Minimum Standards for Care Homes for Young Adults. The inspector read two care plans, looked at policies and procedures, toured the premises and checked the contents of the medication cabinet. What the service does well: What has improved since the last inspection? What they could do better: Market Street (152) DS0000022884.V293514.R01.S.doc Version 5.1 Page 6 Four requirements and one recommendation have been issued in this report. The home needs to ensure that more detailed food records are maintained and undertake a full redecoration of the bedrooms. The home’s training plan must evidence that staff receive on-going training in mental health care and ‘refresher’ training in Adult Protection. One requirement has been issued in relation to health and safety monitoring. 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. Market Street (152) DS0000022884.V293514.R01.S.doc Version 5.1 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 Market Street (152) DS0000022884.V293514.R01.S.doc Version 5.1 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): 1,2 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The service provides prospective and existing service users with good information about the home. Service users needs are appropriately assessed. EVIDENCE: Requirements were issued in the previous inspection report for the service to make amendments to the Statement of Purpose and the Service User’s Guide. The inspector read both of these documents and found that they were now presented in a comprehensive and detailed style. At the time of this inspection there were two service users residing at the home and there was one vacancy. The inspector read the care plans of both service users, which included pre-admission assessments conducted by the placing authorities. These assessments were accompanied by a needs assessment undertaken by the home. Each service user was issued with a contract by the home, which was written in a clear manner. Market Street (152) DS0000022884.V293514.R01.S.doc Version 5.1 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users benefit from an individualised approach to identifying and planning their care and support needs. Service users are assisted to make choices and take responsible risks. EVIDENCE: The care plans read by the inspector were found to be detailed, up-to-date and relevant to the needs of the individuals. As identified at previous inspections, the home works closely with the medical, health and social care professionals involved in the welfare of the service users. The care plans viewed by the inspector demonstrated that the information attained at Care Planning Approach (CPA) meetings and statutory reviews was appropriately used in order to plan new objectives for service users. Service users have stated that they do not want to participate in formally arranged group meetings within the home; therefore, the registered manager documented key discussions conducted individually with service users on a regular basis. The inspector looked at a sample of these ‘one-to-one’ discussion sessions and noted that the topics of discussion promoted the involvement of service users in decision- making about their health, advocacy, Market Street (152) DS0000022884.V293514.R01.S.doc Version 5.1 Page 10 menu choices, community activities and therapeutic employment. One of the service users spoke to the inspector about their aspirations for the future, which clearly corresponded with the aims of their care plan. The risk assessments devised by the home reflected the discussions held at the service users CPA meetings and statutory reviews. The home was pro-active in raising any issues of concern at these forums in order to gain an inclusive plan of how to manage identified risks, taking into account the views of service users, their representatives and relevant professionals. Market Street (152) DS0000022884.V293514.R01.S.doc Version 5.1 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users are encouraged to pursue fulfilling activities and develop/maintain external relationships. Service users choose food that they enjoy; however, the home must improve upon its detailed recording on menus. EVIDENCE: The inspector spoke to the registered manager and one of the service users about involvement in community and social activities. Service users stated that they liked to go out shopping and to local restaurants. There were no expressions of interest in attending places of worship. One of the service users attended a day centre group twice a month and enjoyed gardening at the home. The gardening activity was encouraged by the home through the payment of an occupational allowance. The care plans and minutes for the CPA meetings demonstrated that the home actively sought to broaden the social interests of individuals, although it was acknowledged that service users do not presently feel motivated to attend the activities offered by local mental health services. Via discussion with service users and the registered manager, the inspector was informed that contact with family members was encouraged. Service users Market Street (152) DS0000022884.V293514.R01.S.doc Version 5.1 Page 12 stated that they maintained external relationships through telephone calls, making visits and receiving visitors. The minutes of the regular individual discussions with the service users demonstrated that they were consulted about their food preferences. The inspector looked at the weekly menu plan, which clearly evidenced that the meals provided were based upon the preferences of both service users. The home had previously involved the relative of one of the service users to show staff how to prepare particular favourite dishes. Service users were also invited to undertake the weekly grocery shopping with staff. The inspector noted that sometimes the menu did not fully reflect the content of the meals, for example, there was insufficient information recorded regarding the vegetables served with the main course. The registered manager stated that fresh fruits and vegetables were offered daily but service users were reluctant to eat this food, which was confirmed to the inspector by one of the service users. Market Street (152) DS0000022884.V293514.R01.S.doc Version 5.1 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users are supported to meet their identified health care and personal care needs. Medication is safely managed. EVIDENCE: The service users did not require assistance with their personal care; however, the care plans appropriately identified whether encouragement or guidance was required to promote personal hygiene. Via discussion with the registered manager, no issues of concern regarding service users access to community and hospital based health care was identified. The general health care needs of the service users were also regularly discussed and reviewed at the CPA meetings. The inspector checked the home’s storage of medication and the medication administration records, which were efficiently maintained. The home’s medication policy has been reviewed at previous inspections and noted to be satisfactorily written. Market Street (152) DS0000022884.V293514.R01.S.doc Version 5.1 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users are protected by appropriate policies, procedures and staff training. EVIDENCE: The inspector read the home’s complaints procedure, which was written in accordance to the guidance of the National Minimum Standards. At the time of the inspection, there were no recent complaints. The inspector viewed documentation to demonstrate that service users were informed about their entitlement to make complaints and how to access advocacy support. The inspector looked at the home’s Adult Protection procedure. This document was written in accordance to current Department of Health guidance. Staff had undertaken Adult Protection training within the past two years; however, the registered manager was advised of the necessity to ensure that staff received ‘refresher’ training in this topic every two years and to contact the local social services to find out whether relevant training could be offered. Market Street (152) DS0000022884.V293514.R01.S.doc Version 5.1 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): 24,26 and 30 Quality in this outcome area is average. This judgement has been made using available evidence including a visit to the service. Service users are provided with suitably maintained communal areas; however, their bedrooms need to be improved upon. EVIDENCE: The home was observed to be tidy, homely and comfortable. The inspector observed that the bedrooms would benefit from being re-decorated and refurbished; the communal areas had been more recently decorated. The premises were clean and free from any offensive odours. Standard 29 is not applicable to the home. Market Street (152) DS0000022884.V293514.R01.S.doc Version 5.1 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): 32,34,35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users are supported by trained staff that are safely recruited and regularly supervised. However, staff should be provided with more training related to the care needs of the service users. EVIDENCE: The inspector looked at two randomly selected staff files. Both members of staff had attained a National Vocational Qualification in Care at Level 2; the registered manager confirmed that all care staff at the home now possessed this qualification. The training records for staff demonstrated that staff had received mandatory training and some specific training in mental health care issues. The inspector recommended that staff should be offered on-going training in mental health care topics relevant to the needs of the current service users. The registered manager evidenced that she was due to meet with a training company to explore further training options for staff. The two staff files checked by the inspector demonstrated that the home undertook safe recruitment practices as stipulated by the National Minimum Standards and Regulations. The supervision records seen by the inspector established that staff received a good quality of formal ‘one –to-one’ supervision once every two months. Market Street (152) DS0000022884.V293514.R01.S.doc Version 5.1 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): 37,39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users benefit from a competently managed service and their views are regularly sought. The environmental safety needs of the service users are generally appropriately addressed; however, the home must adopt a more rigorous approach to the monitoring of the hot water temperatures. EVIDENCE: The inspector found that the home was well managed. The three requirements issued at the last inspection had been met within the specified timescales and service users spoke favourably of the support that they received. Care plans and other documents were found to be up-to-date. A requirement was issued in the previous inspection report for the home to develop upon its existing quality assurance systems. The registered manager produced written evidence that she undertook ‘spot checks’ of care plans, records and care practices. The home also produced quality assurance surveys for service users and their representatives. The inspector noted that the statutory reviews by the placing authorities contained positive references regarding the support provided to service users. Market Street (152) DS0000022884.V293514.R01.S.doc Version 5.1 Page 18 The inspector checked the following health and safety records, which were all found to be satisfactory; (1) Landlord’s gas safety (2) Portable electrical appliances testing (3) Electrical installations inspection by a competent person (4) Refrigerator and freezer temperatures and (5) Fire drills and testing of fire equipment. The home had a temperature regulator for hot water; weekly hot water temperature checks were advised to ensure the safety of this system. The home possessed valid public liability insurance. Market Street (152) DS0000022884.V293514.R01.S.doc Version 5.1 Page 19 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 3 2 3 3 X 4 X 5 3 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 3 25 X 26 2 27 X 28 X 29 N/A 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 3 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 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 X Market Street (152) DS0000022884.V293514.R01.S.doc Version 5.1 Page 20 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA17 Regulation 17(2) Requirement The Registered Manager must ensure that the records of food provided for service users are recorded in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory, in relation to nutrition and choice. The Registered Manager must ensure that the bedrooms are re-decorated. The Registered Manager must ensure that staff are provided with on-going training in mental health care. The Registered Manager must ensure that the hot water temperature is checked and recorded weekly. Timescale for action 30/06/06 2. 3. YA26 YA35 23(2)(d) 18(1)(c) 31/10/06 30/09/06 4. YA42 13(4) 30/06/06 Market Street (152) DS0000022884.V293514.R01.S.doc Version 5.1 Page 21 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 YA23 Good Practice Recommendations The Registered Manager should incorporate Adult Protection training into the home’s training plan at least once every two years. Market Street (152) DS0000022884.V293514.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection East London Area Office 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. 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