Inspection on 18/04/05 for Market Street (152)

This inspection was carried out on 18th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 8 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) 12/05/06

Market Street (152) 20/10/05

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 18-65 152 Market Street 152 Market Street East Ham London E6 2PU Lead Inspector Sarah Greaves Unannounced Inspection 18th April 2005 at 17:00pm The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 152 Market Street G57 G06 S22884 Market Street V221956 180405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service 152 Market Street Address 152 Market Street, East Ham, London, E6 2PU Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8470 2535 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 152 Market Street G57 G06 S22884 Market Street V221956 180405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th September 2004 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 ownwd and the proprietor works at the establishment. The home is situated in Newham, close to the shopping facilities, amanities 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. 152 Market Street G57 G06 S22884 Market Street V221956 180405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This statutory unannounced inspection was conducted over one day, commencing at 5pm. The purpose of this visit was to check the home’s compliance with the two requirements and two recommendations issued in the previous inspection report. The home was found to have satisfactorily met the one of the requirements, which was due to be met by 28/02/05. The second requirement was due to be met by 30/06/05; compliance with this requirement will be checked at the next (announced) inspection. The two recommendations for good practice had been met. The inspector spoke to the three service users and the member of staff on duty. Further information was sought from the registered manager via a telephone call during the inspection. The inspector did not meet any relatives/ representatives of service users at this inspection visit. What the service does well: What has improved since the last inspection? The last inspection was very positive; two requirements and two good practice recommendations were issued. The service has consistently presented a robust approach to meeting requirements and recommendations. No specific areas of improvement were noted at this inspection visit; however, via discussion with the registered manager, the inspector was informed of the service’s plans to provide a broader scope of training for staff which will include training in mental health issues. 152 Market Street G57 G06 S22884 Market Street V221956 180405 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 152 Market Street G57 G06 S22884 Market Street V221956 180405 Stage 4.doc Version 1.20 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 152 Market Street G57 G06 S22884 Market Street V221956 180405 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 4 and 5. The service demonstrated good systems to ensure that prospective service users are provided with a satisfactory degree of information prior to moving into 152 Market Street. The home gathered appropriate medical and social information relating to an individual in order to assess whether a person’s needs could be met by the service. EVIDENCE: The inspector viewed the assessment for the most recently admitted service user (admitted after the last inspection in September 2004). This care plan demonstrated that a full multi-disciplinary assessment was undertaken prior to admission. The care plan contained a comprehensively presented contract. Via discussion with the service user and a staff member, the inspector established that the service user visited the home before they moved in. The relevant information to evidence that a trial period was offered was contained within the service user’s file. 152 Market Street G57 G06 S22884 Market Street V221956 180405 Stage 4.doc Version 1.20 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 10. The service needs to ensure that full risk assessments are undertaken for service users. The need for staff to understand terminology within the care plans has been identified. Confidential information was securely stored. EVIDENCE: The inspector viewed two care plans. One of the care plans contained a risk assessment conducted by the placing authority; this risk assessment needed to be expanded upon by the service in order to evaluate a wider scope of actual and potential risks (for example, any risks associated with the service user undertaking food preparation activities within the home). The inspector found a medical diagnosis recorded within a care plan; the care worker on duty did not know what this term meant. Via the reading of the minutes of the Care Planning Approach (CPA) meetings arranged by the local Community Mental Health Trust, the inspector found good evidence to demonstrate that service users were consulted upon their preferences in relation to their ‘home life’. Service users participated in the planning of menus and attended monthly service users/ staff meetings. Confidential information relating to service users was observed to be held in a lockable cabinet, in an office that was kept locked when not in use. 152 Market Street G57 G06 S22884 Market Street V221956 180405 Stage 4.doc Version 1.20 Page 10 152 Market Street G57 G06 S22884 Market Street V221956 180405 Stage 4.doc Version 1.20 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 standard(s) 12, 13, 15 and 17. The service users were encouraged to take part in activities which facilitated personal development and engagement within their local community.The service demonstrated a collaborative approach (in conjunction with Health and Social Services) to promoting the involvement of service users in educational, recreational and community- based activities. Service users were encouraged to retain links with relatives and friends. A more methodical approach to the consistent provision of a varied selection of food items must be undertaken. EVIDENCE: Through the reading of the care plans and via discussion with service users and staff, the inspector was informed of the activities undertaken by the service users. One of the service users was a volunteer in a local church charity and regularly attended church. The inspector noted the difficulties encountered by staff in consistently engaging service users in meaningful community activities. Appropriately, these difficulties were discussed in the regular CPA meetings and advice was sought from health and social services professionals. Specific information has not been recorded in this report in order 152 Market Street G57 G06 S22884 Market Street V221956 180405 Stage 4.doc Version 1.20 Page 12 to maintain the confidentiality of service users. One of the care plands detailed the arrangements for a service user to spend short breaks with relatives. The care plans viewed by the inspector demonstrated that contacts with family members and friends were encouraged. The inspector could not look at a full record of visitors since the last inspection as a ‘Visitors Book’ had been destroyed. The inspector was disappointed by the narrow choice of food items within the home. Although a ‘main’ shopping trip was planned for the next day, the registered manager must ensure that a daily monitoring of food items is undertaken and prompt appropriate taken to address any shortages. On the day of the inspection, there was no fresh fruit in the home although this was addressed by a staff member who purchased bananas. Very limited food items were available for service users to help themselves to (for example, there was white bread but no wholemeal bread, crackers, crisps, rice cakes, savoury or sweet biscuits). 152 Market Street G57 G06 S22884 Market Street V221956 180405 Stage 4.doc Version 1.20 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 standard(s) 19 and 20. The home’s commitment to meeting the health needs of service users was generally satisfactory. The registered manager must regularly audit medication records. The need for all staff to be trained in first aid (since this is a small home, all staff undertake solitary late/overnight shifts) has been identified. EVIDENCE: The care plans viewed by the inspector demonstrated that the health needs of each service user were addressed at the regular Care Planning Approach meetings. Staff escorted service users to health appointments, if necessary. The inspector noted that a service user was not registered with a General Practitioner; the service had fully documented that a good level of support and encouragement had been offered to the service user to promote their compliance with registering. The member of staff on duty was not trained in first aid even though they had worked at the home for approximately a year and took sole charge of the home at times. The medication administration records were generally well maintained; however, examples of a medication not being signed for were found. 152 Market Street G57 G06 S22884 Market Street V221956 180405 Stage 4.doc Version 1.20 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 standard(s) 22 and 23 The home had a robust complaints procedure and ensured that the views of service users are listened to and acted upon. The service users were protected from abuse through the home’s use of a comprehensive Adult Protection procedure and related training for staff. EVIDENCE: The service possessed an appropriately written complaints procedure and Adult Protection procedure. The inspector noted at the previous inspection that staff had received applicable training in Adult Protection. There have been no complaints received by the CSCI since the last inspection. The documentation relating to complaints investigated by the home was clear and straightforward. 152 Market Street G57 G06 S22884 Market Street V221956 180405 Stage 4.doc Version 1.20 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 standard(s) 24, 25, 26, 27, 28 and 30. The premises were homely, comfortable and clean. Some new furniture for the service users bedrooms was required. The dignity and hygiene needs of the service users must be addressed via the provision of appropriate hand-washing facilities in the bathroom. The service was not assessed for the provision of specialist equipment as none of the service users required this. EVIDENCE: The home was found to be clean and tidy at the time of the inspection. There were no offensive odours detected and items that required safe storage (COSSH products, such as cleaning fluids) were observed to be appropriately maintained. The inspector noted that the carpet on the stairs was frayed and needed replacing , and the sofa in the communal lounge displayed exposed metal buttons. A requirement was issued in the previous inspection report for the registered manager to ensure that a new sofa was provided or the existing sofa was covered in a new fabric by 28/02/05. The inspector noted that this requirement had been met as this damage was recent. The armchair in a bedroom needed to be replaced and a headboard was required on a bed. The inspector spoke to the registered manager on the telephone during the 152 Market Street G57 G06 S22884 Market Street V221956 180405 Stage 4.doc Version 1.20 Page 16 inspection and was satisfied that these matters were in the process of being addressed. The inspector observed that the home were unable to store liquid soap or solid soap for hand-washing in the communal bathroom; the reason for this was explained to the inspector. The home were advised to install an attachment to the bathroom wall that dispenses liquid soap. 152 Market Street G57 G06 S22884 Market Street V221956 180405 Stage 4.doc Version 1.20 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32 and 35. The staff appeared caring and communicated well with service users; however, the support to service users would be improved via the provision of specific training for staff related to relevant mental health issues. EVIDENCE: At the point of the inspector’s arrival, the home was staffed by a person who was not employed to work at the home. The person found in sole charge of the home stated that they were ordinarily employed to work at a supported living unit owned by service’s proprietor and that they were covering for an hour to enable a permanent care worker from 152 Market Street to attend a training course. A permanently employed member of staff arrived at the premises soon after the inspector’s arrival. The staffing rota did not evidence that this alteration had been made. The permanent member of staff was not scheduled on the rota to be required to work at the time of the inspection as their swap of shift with a colleague had not been recorded. The worker from the supported living unit had not signed in the visitors book; a friend of the worker was also in the premises but had not signed in the visitors book. The permanent member of staff stated that they were undertaking an NVQ level 2 in Care and had attended training in topics including medication administration, manual handling, health and safety and break-away techniques. The registered manager was in the process of arranging specialist training for staff in mental health issues. 152 Market Street G57 G06 S22884 Market Street V221956 180405 Stage 4.doc Version 1.20 Page 18 152 Market Street G57 G06 S22884 Market Street V221956 180405 Stage 4.doc Version 1.20 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42. The home demonstrated good practices to ensure the safety of the service users; however, attention was required in the specfic areas of food safety and maintennce of first aid equipment. EVIDENCE: The inspector checked the following health and safety practices; (1) Portable Electrical Appliances testing (2) Food temperatures (3) Freezer and refrigerator temperatures and (4) Labelling of opened food items (5) Storage of COSHH items and (6) First Aid equipment. Meat was found in the freezer that was not labelled with any information (product, expiry date). The first aid box contained items which had expired. 152 Market Street G57 G06 S22884 Market Street V221956 180405 Stage 4.doc Version 1.20 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x x 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 2 2 2 N/A 3 Standard No 11 12 13 14 15 152 Market Street x 3 3 x 3 Standard No 31 32 33 34 35 36 Score 2 3 x x 2 x Version 1.20 Page 21 G57 G06 S22884 Market Street V221956 180405 Stage 4.doc 16 17 x 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 2 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x 152 Market Street G57 G06 S22884 Market Street V221956 180405 Stage 4.doc Version 1.20 Page 22 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 YA6 Regulation 15 Requirement The registered manager must ensure that the care plans contain appropriately detailed and comprehensive risk assessments. The registered manager must ensure that service users are provided with a choice of varied food items. The registered manager must ensure that the applicable bedrooms are provided with (1) headboard for bed and (2) new armchair. The registered manager must ensure that the service users are provided with soap for handwashing, which must be stored in the communal bathroom. The registered manager must ensure that the sofa is repaired. The registered manager must ensure that policies and procedures are written per accordance to Appendix 2 of the National Minimum Standards. The registered manager must ensure that all opened food items are labelled wih the date of opening. Timescale for action 30/06/05 2. YA17 16(2) 31/05/05 3. YA26 23(2) (e) 15/06/05 4. YA27 13(4) 15/06/05 5. 6. YA28 YA40 23(2)(i) 12 30/06/05 30/06/05 7. YA42 13(4) 15/05/04 152 Market Street G57 G06 S22884 Market Street V221956 180405 Stage 4.doc Version 1.20 Page 23 8. 9. YA42 13(4) The registered manager must ensure that all opened food items are labelled 15/05/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations 152 Market Street G57 G06 S22884 Market Street V221956 180405 Stage 4.doc Version 1.20 Page 24 Commission for Social Care Inspection 4th Floor, Gredley House 1-11 Broadway, Stratford London E15 4BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 152 Market Street G57 G06 S22884 Market Street V221956 180405 Stage 4.doc Version 1.20 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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