Inspection on 27/09/05 for Mawney Road

This inspection was carried out on 27th September 2005.

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

Mawney Road 08/08/06

Mawney Road 24/02/06

Mawney Road 23/02/05

Mawney Road 21/07/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Mawney Road 89 Mawney Road Romford Essex RM7 7HX Lead Inspector Mr Roger Farrell Unannounced Inspection 27 September 2005 15:45 Mawney Road DS0000027864.V254980.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 Mawney Road DS0000027864.V254980.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. Mawney Road DS0000027864.V254980.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Mawney Road Address 89 Mawney Road Romford Essex RM7 7HX 01708 741388 01708 741 388 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) Milbury Care Services Limited Mrs Brenda Netto Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Mawney Road DS0000027864.V254980.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd February 2005 Brief Description of the Service: 89 Mawney Road is a care home that provides accommodation and help with daily living for six people who have profound learning disabilities, most of whom do not communication using words. Opened in 1994, all six residents moved in during the first year. It is run by ‘Milbury Care Services Limited’ (which is part of the ‘Paragon Healthcare Group’), a company who run about two hundred and fifty care homes nationwide. This house is on large corner plot in a residential neighbourhood, set well back from one of the main roads that run into Romford town centre. Positive points are good living space – including large shared rooms, and each person having their own big bedroom; a well maintained and equipped garden; and a car park that makes it easy for residents who need wheelchairs outside to use the home’s minibus. Residents enjoy a safe and homely environment, supported by an experienced manager who leads a caring and stable staff team. Mawney Road DS0000027864.V254980.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 27 September 2005, between 3.30 and 7pm. The manager, Brenda Netto returned to the home and assisted with the inspector’s checks until 5pm. She gave an update on the service, including - the health of residents, notably the two people who have had medical difficulties; the introduction of a new deputy and other staff arrangements; and building and equipment improvements, including those set as requirements in the last report. After she had left, the senior support worker took the lead in helping the inspector. Other checks at this visit included looking at the service users’ files; observing staff assist residents, including serving the evening meal and giving medication; making sure staff know what to do if there is a complaint or concern; and looking around the building, including bedrooms. Residents who live here are not able to give opinions on the service they receive. The inspector appreciates those relatives and other visitors who sent comments and questionnaires ahead of his last announced visit. Some of these views are quoted in this report, such as a visiting tutor who commented – “I have always fond the home to be welcoming and friendly. Residents are well cared for. I am in the home for a half day at a time and have never had cause for concern in what I have observed. I feel this home is definitely one of the better ones I visit.” The inspector is grateful for the cooperative way the manager, senior support worker, and other staff responded to his enquiries, and for the welcome he receives. Mawney Road DS0000027864.V254980.R01.S.doc Version 5.0 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Mawney Road DS0000027864.V254980.R01.S.doc Version 5.0 Page 7 The inspector finds there is little he needs to tell the manager to improve to make sure the service and facilities meet with the standard covering care homes. He has set a requirement saying that the medical tracking sheets be brought back into use. The main elements of the care plans need to show that they have been reviewed at least once a year. He also advised that where residents pay for replacements such as new beds, that such agreements are covered in review records. 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. Mawney Road DS0000027864.V254980.R01.S.doc Version 5.0 Page 8 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 Mawney Road DS0000027864.V254980.R01.S.doc Version 5.0 Page 9 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. The use of pictures and photos show good efforts to help make main documents understandable. There have been no vacancies for over ten years, but there are guidelines that say how a new person would be helped move in if a vacancy occurred. EVIDENCE: There is a ‘statement of purpose’ folder, which the manager has kept up-todate. This contains all items that need to be included. One resident is 82, and needs some assistance moving around indoors. She has a large bedroom on the ground floor, and there are good adapted bathing facilities. How this person’s needs are met is covered in the statement of purpose. There is also a well-produced pictorial‘ service users’ guide’ which makes good use of photos and contains comments by service users. The manager and some other staff had worked with residents in their former setting, and this provided helpful continuity. Current files have carried forward some assessment schedules used as part of the move-ins, but these are of little use these days given changing patterns of need. Should a vacancy occur, the manager said assessment and transition would be carried out in accordance with the company’s policy and procedures, copies of which were available. This says that staff would work closely with the prospective resident’s family or other representative; include trial visits and stays; and a review meeting would be held after the initial settling-in period. Mawney Road DS0000027864.V254980.R01.S.doc Version 5.0 Page 10 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, 8 and 9. There are well- arranged service user files giving details of individual needs and he support needed. The team has little turnover, meaning that staff have a good understanding of each person’s abilities, preferences and special needs. EVIDENCE: There are a range of service user files. This includes the ‘Individual Personal Plan (IPP) files’; the individual ‘Personal Diaries’ with three good entries made each day; The ‘Goal Sheet File’; and the ‘Daily Monitoring Sheets File’. The main components, such as the detailed ’Individual Planning Review,’ incorporating the ‘goal setting and monitoring’ elements – are comprehensive. Overall, the system provides good detail on individual practical support with day-to-day support needs, including specialist areas. The manager needs to make sure that the main files in the office are kept up-to-date with the working files kept downstairs. For instance, a couple of ‘IP Reviews’ could not be located, the explanation being that these may be with the social worker following recent reviews. Before announced visits questionnaires are circulated. Comments from relatives unanimously express satisfaction with the service. One person wrote – “My brother…has a severe learning difficulty and therefore I am consulted about any major issues concerning his life as well as many minor ones. These I know are implemented as my wishes.” Other comments included – “It’s Mawney Road DS0000027864.V254980.R01.S.doc Version 5.0 Page 11 excellent. It is a lovely place with a good staff team.”; “People always look well dressed. There’s plenty of patience.” Milbury’s policies say there is a commitment to seeking the views of residents. However, current residents are unable to take part in discussions about how the home is run. Nevertheless, staff are aware of how each person expresses their preferences. The inspector stressed that it is important to get the agreement of a service user’s family or social worker before they make major purchases, such as specialist furniture and funeral plans. For instance, one resident has paid for the installation of a whirlpool cabin. The inspector was shown the order for this equipment signed by this person’s brother. The service users’ files have a section covering risk assessments, and where appropriate ‘behavioural management plans’. These covered such areas as using the stairs; seizures; and use of the vehicle. All residents require support for all activities away from the building. Each person’s file has a completed ‘missing person form’ with a photo attached. Mawney Road DS0000027864.V254980.R01.S.doc Version 5.0 Page 12 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): 0. These standards were not covered at this visit. They were all scored as met in last year’s main report, including the steps taken to link in with families. EVIDENCE: Mawney Road DS0000027864.V254980.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. There are good standards of care and health monitoring. One example is how a resident scared of medical settings is helped. He is due to have a further operation. When he was in hospital last year staff maintained a bedside presence. His relative wrote – “{My brother} has finally had a much needed operation this year. The staff were persistent in seeing he had all the treatment and aftercare he needed.” EVIDENCE: All residents need assistance regarding their personal care, two to a lesser degree. Three residents use wheelchairs away from the house. One person at times now needs to use a wheelchair indoors. However, at this visit this person was moving around with support from staff. The five residents seen were well presented, and bedrooms had good stocks of well cared for personal clothing. The women are helped to attend a local hairdresser. In addition to looking at a range of practice files, the inspector asked the manager to describe the increasing support needs of two residents. One person is growing increasingly frail, mainly due to her heart condition. Consideration was being given to seeking a second opinion on whether further treatment is possible, that person’s sister is being kept involved. Mawney Road DS0000027864.V254980.R01.S.doc Version 5.0 Page 14 One other resident’s periods of distress are being linked to dental problems. In the past he has needed extra arrangements due to his fear of medical settings. Plans are being made to support him have a dental operation. This will again involve staff being with him throughout his hospital admission. Descriptions of the support residents receive from all health care professionals are positive. This includes the GP practice where all residents are registered. In last year’s report the way health sections in the practice files were set out was commended. This included the ‘The OK Health Check List’; the health care plan; medical letters and forms; and the health profile pictorial booklets completed by the community nurses. However, at this visit it was found that the tracking sheets for GP visits and contacts with other practitioners were not being kept up to date. Other health monitoring sheets kept in the office, rather than with the working files have also lapsed, such as the weight charts. This is a step backwards, therefore a requirement has been made on this matter. None of the residents are capable of holding their own medication. Medication is provided by Boots in their monitored dose cassettes, with printed recording sheets. Medication is kept in a purpose built cabinet in the smaller downstairs office. The supplying pharmacist visits and checks the arrangements every three months and leaves a report of her findings. The medication file contains good simple guidance on the medication used. There is an extra auditing for one drug packed in the blister packs that is classified as controlled. All observations made at this visit were satisfactory. One alternative therapist who visits the home previously commented – “The quality of care at the home is excellent. The staff are always friendly and helpful and I know I will always be made welcome.” Mawney Road DS0000027864.V254980.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. There is sufficient awareness, and guidance to make sure the right steps are taken if there is a complaint or concern. EVIDENCE: The company’s guidance and procedure on making complaints are available. Duty staff were able to locate the ‘The Milbury Complaints Book’. There is also a pictorial version of a complaints procedure attached to the service users guide. There has been one entry over recent months – a complaint from a neighbour that was dealt with amicably. Last year the inspector had the opportunity to talk to the family who had made a complaint. He was told – “We are satisfied that the matter was dealt with appropriately from the start”. There is an up-to-date policy and procedure on responding to allegations and suspicions of abuse. This makes reference to ‘No Secrets’ and the need to follow the local guidelines, a copy of which is available. In the past appropriate action was taken following a worker raising a concern. All staff had been given a copy of the ‘General Social Care Councils’ Code of Practice. Mawney Road DS0000027864.V254980.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 and 30. This house has plenty of space, including large single bedrooms. High standards of cleanliness and safe arrangements are found at all visits. Staff have helped make this a comfortable and homely setting for residents. The manager and team are also alert to introducing aids and adaptations to help those with mobility needs. EVIDENCE: There is wide ramp access with sturdy support rails at the back of the house. There is also ramped access to the front door. The combined space of the kitchen/diner and large lounge considerably exceed the minimum levels. The communal rooms are well decorated and furnished. The inspector looked at all bedrooms. These are all big, ranging in size from 16.4sqm to 21.5sqm. They are all well equipped and show good levels of individuality, reflecting the tastes and interests of each resident. This includes the person whose behaviour results in higher wear and tear. Residents have been helped purchase better quality furniture and fittings. In some instances this includes specialist models, such as a lift and massage electric bed. The manager said that in all instances these purchases had been agreed with a family member or other representative. There is good attention to safety, such as radiator covers; wash-hand basins have thermostatic safety valves; and Mawney Road DS0000027864.V254980.R01.S.doc Version 5.0 Page 17 first floor window openings are restricted. All have suitable locks, but no resident is able to use a key at present. The bathrooms are also large, there being one on the ground floor, and two on the first floor. The ground floor bathroom has a fixed electric chair hoist. There is ceiling tracking in this bathroom, but this is not needed at present. As with other parts of the house, staff have added homemaking touches and there is a consistently good attention to detail. There is a well maintained garden with features such as swing benches; raised flower beds; a vegetable area; and plenty of seating including a delightful ivy clad pagoda covering the outside dining area. A whirlpool cabin was installed last year. This was paid for by one resident following an inheritance. All but one resident is said to use this regularly. Mawney Road DS0000027864.V254980.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 34 and 35. This is a well-established team, with strong leadership and a stable core of support workers. The manager, deputy, and senior have relevant qualifications, and the team are on target to achieve the expected quota of NVQs. A comment sent by one visiting alternative therapist was – “I am always made to feel very welcome by the staff at Mawney Road. Their conduct is always professional at all times.” EVIDENCE: The staffing complement is - manager; deputy; 1 senior support worker; 9 support worker posts, including night hours. Total care hours, including nights is 479, including 20 hours of the manager’s time. The normal pattern of cover is – Three people on each of the early and late shifts (7am to 9.30pm, with a 1.5hr overlap period between 1.30 and 3pm); night cover being one person awake, and one on sleeping-in. There is relatively low staff turnover. Since the last main inspection a new deputy has stared. The only other person to join the team transferred in from another Milbury home. Vacancies are covered by staff doing voluntary overtime, and there are a couple of regular bank workers. Mawney Road DS0000027864.V254980.R01.S.doc Version 5.0 Page 19 Staff files have a handy checklist at the front saying when the necessary documentation was received. They contain all the required vetting evidence, including two references and documents that confirm identity. There is a separate record of CRB certificates. The deputy has an NVQ level 3. Four staff have achieved NVQ at level 2, with three support workers due to commence this award. Mawney Road DS0000027864.V254980.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 0. These standards were not covered at this visit. EVIDENCE: Mawney Road DS0000027864.V254980.R01.S.doc Version 5.0 Page 21 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 3 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 3 3 X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Mawney Road Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000027864.V254980.R01.S.doc Version 5.0 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 Make sure that there is a record that each element of service users’ care plans are reviewed at least once a year. Timescale for action 28/11/05 2 YA6 15 3 YA7 15 It is advised that the medical 28/11/05 tracking sheets for each type of practitioner are reintroduced, and as appropriate, monitoring sheets such as weight charts are kept up-to-date. Double check that there is 28/11/05 documentation that confirms consent for residents’ own money to be spent on items such as new personal furniture. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Mawney Road DS0000027864.V254980.R01.S.doc Version 5.0 Page 23 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 Mawney Road DS0000027864.V254980.R01.S.doc Version 5.0 Page 24 - 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. 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