CARE HOMES FOR OLDER PEOPLE
Median Road Median Road 25 Median Road Hackney London E5 OPE Lead Inspector
Sandra Jacobs-Walls Unannounced Inspection 10:30 6 March 2006
th X10015.doc Version 1.40 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 Median Road DS0000033815.V284239.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 Older People. 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. Median Road DS0000033815.V284239.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Median Road Address Median Road 25 Median Road Hackney London E5 OPE 020 8356 4768 020 8985 3960 cbarrett@gw.hackney.gov.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) London Borough of Hackney Cecile Barrett Care Home 37 Category(ies) of Dementia (28), Old age, not falling within any registration, with number other category (28), Physical disability (9) of places Median Road DS0000033815.V284239.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 6th July 2005 Brief Description of the Service: 25 Median Road is a local authority run home for elders who do not require nursing care. The home offers support, personal care and accommodation for a maximum of 37 service users. It offers four distinct services; long term residential care, intermediate care, respite care and services to those recently discharged from hospital and assessed as having no immediate need for hospital care (Delayed Discharge Programme). The home is in the process of reducing its long term residential care provision in order to offer more beds to service users admitted via the delayed discharge policy. It is the service’s long term plan to eventualy phase out long term provision and offer services to slightly younge elders than the registration category currently permits. A variation to the home’s current services will need to be applied for. The home is situated in Clapton within the London Borough of Hackney, in very close proximity to the local general hospital. Bus links are good and local shops and amenities are located nearby. Median Road DS0000033815.V284239.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection of 25 Median Road took place on the morning of March 6 2006. The sole purpose of the inspection was to review the home’s progress in addressing outstanding requirements (3) made at the previous inspection that was conducted in July 2005. The inspection process included discussion wuth the registered manager and other staff and the review of five service users files. The inspector would like to thank all staff and service users who contributed and co-operated with the inspection. It was noted at this inspection that all outstanding requirements had been addressed satisfactorily and no additional requirements or recommendations were made. What the service does well: What has improved since the last inspection?
As noted previously the home provides a very high standard of care to service users; this level of care has been successfully maintained. The inspection findings evidence that all outstanding requirements had been met, so those areas identified as being problematic at the previous inspection, namely evidencing service user contracts, appropriate recording of medication information and the appropriate vetting of staff have now been resolved. Median Road DS0000033815.V284239.R01.S.doc Version 5.1 Page 6 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. Median Road DS0000033815.V284239.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Median Road DS0000033815.V284239.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Each servcie user has a written contract/statement of terms and conditions of the home. EVIDENCE: The previous inspection had highlighted the needs for service user files to evidence written agreements/contracts. The inspector reviewed five service user files, all of which evidenced written agreements. Median Road DS0000033815.V284239.R01.S.doc Version 5.1 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medication. EVIDENCE: The previous inspection had highlighted the need for staff to pay greater attention to the recording of information on MAR cheets. On this occasion, the inspector reviewed the medication information in detail for five service users. Information seen was clear and comprehensive, there was evidence of staff members countersigning records in every instance. Key codes on MAR sheets were apropriately used and where changes to medication regimes had been recommended, documentation and instructions were clear. Median Road DS0000033815.V284239.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): No standards under this heading was assessed during the inspection. EVIDENCE: Median Road DS0000033815.V284239.R01.S.doc Version 5.1 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): No standards under this heading was assessed during the inspection. EVIDENCE: Median Road DS0000033815.V284239.R01.S.doc Version 5.1 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): No standards under this heading was assessed during the inspection. EVIDENCE: Median Road DS0000033815.V284239.R01.S.doc Version 5.1 Page 13 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 Service users’ needs are supported and protected by the home’s recruitment policy and practices. EVIDENCE: The previous inspection had included the review of a number of staff files, some of which failed to evidence key information such as proof of identity. The registered manager commented that since the last inspection the department’s Human Resources team had conducted a review of all staff files and requested staff supply all required documentation. Staff personnel files are maintained off site at the service’s head office in Hackney. The registered manager confirmed that all staff had provided information as required and that she satisfied that staff files contained full information as required. Median Road DS0000033815.V284239.R01.S.doc Version 5.1 Page 14 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): No standards under this heading was assessed during the inspection. EVIDENCE: Median Road DS0000033815.V284239.R01.S.doc Version 5.1 Page 15 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X X Median Road DS0000033815.V284239.R01.S.doc Version 5.1 Page 16 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. Standard Regulation Requirement Timescale for action 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 Median Road DS0000033815.V284239.R01.S.doc Version 5.1 Page 17 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
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