Inspection on 16/11/05 for Monica Close (8 and 9)

This inspection was carried out on 16th November 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Monica Close (8 and 9) 03/07/06

Monica Close (8 and 9) 07/07/05

Monica Close (8 and 9) 24/01/05

Monica Close (8 and 9) 21/06/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Monica Close (8 and 9) 8 and 9 Monica Close Radlett Road Estate Watford Hertfordshire WD24 4GZ Lead Inspector Jeffrey Orange Unannounced Inspection 16th November 2005 08.30 Monica Close (8 and 9) DS0000019471.V266039.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 Monica Close (8 and 9) DS0000019471.V266039.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. Monica Close (8 and 9) DS0000019471.V266039.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Monica Close (8 and 9) Address 8 and 9 Monica Close Radlett Road Estate Watford Hertfordshire WD24 4GZ 01923 250561 01923 250561 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) Walsingham Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Monica Close (8 and 9) DS0000019471.V266039.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th July 2005 Brief Description of the Service: 8 & 9 Monica Close is registered to provide care and accommodation for up to 6 adults, under the age of 65, with a learning disability. The home is managed by Walsingham and comprises two semidetached houses, each of which can provide accommodation for three adults with learning disabilities. The home is situated in a quiet residential neighbourhood in Watford close to the many amenities of the town centre and within easy reach of public transport. Monica Close (8 and 9) DS0000019471.V266039.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection started at 08.30 a.m. giving an opportunity to observe the early morning routine and to talk to each of the current residents as they prepared for the day’s activities. As the acting manager was unexpectedly absent, the staffing comprised the acting deputy and one care support worker. There are currently additional pressures on the service caused by the changing care needs of one of the residents. General care outcomes observed were good, although the preferred pattern of care for the most challenging resident was difficult to sustain with the staff numbers on duty. The standard of record keeping, particularly in respect of recent changes in two resident’s very complex and challenging care needs was good, with full and comprehensive details of revisions to care plans and action plans. Where key standards were assessed during the inspection of the 7th July 2005 these have not all been assessed again on this occasion and reference should be made to the report of that inspection for details. What the service does well: What has improved since the last inspection? The standard of medication records in particular have improved and the rear garden was well kept and tidy on this occasion. Monica Close (8 and 9) DS0000019471.V266039.R01.S.doc Version 5.0 Page 6 Staff recruitment and secondments from other homes has improved the stability and consistency of the staff team, which has benefited the residents and the staff team and has worked through to an all round better standard of record keeping. There have been some decorative and soft furnishing improvement to number 9 Monica Close. 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. Monica Close (8 and 9) DS0000019471.V266039.R01.S.doc Version 5.0 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 Monica Close (8 and 9) DS0000019471.V266039.R01.S.doc Version 5.0 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): 1,2,4 Despite some recent changes and challenges this remains a relatively stable resident group and there have been no recent admissions to the home. The policies and procedures for assessment that are in place, together with a close working relationship between the home and the placement authorities should ensure that only someone whose needs can be met appropriately and satisfactorily at Monica Close would be considered for admission and this process would include several opportunities to visit the home and meet staff and residents. EVIDENCE: Existing resident’s files include evidence of a robust and thorough assessment process with a regular pattern of review in place. There is substantial evidence on files of close working relationships with social workers and other health and social care professionals, all of whom would be involved in decisions about admissions to the home, as appropriate. The manager and operations manager worked together with a range of health and social care professionals during a recent period of increasing challenge in respect of one resident, whose care needs they felt they could no longer adequately and appropriately meet, this process was well documented and handled in a thoroughly professional manner. Monica Close (8 and 9) DS0000019471.V266039.R01.S.doc Version 5.0 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): 6,8 Residents are encouraged and enabled to exercise choice and express preferences in respect of care and all aspects of life at Monica Close. In one case it was evident that what may be temporary pressures on staff were affecting their ability to fully deliver all aspects of the current care action plan. EVIDENCE: Residents were again seen to be preparing drinks, “packed lunches” and cleaning their rooms, under appropriate, discreet supervision and again the staff’s relationship with residents was seen to be very supportive and not directive. Walsingham have devised a series of records, in appropriate formats, which provide evidence of genuine consultation with residents and their inclusion in decision-making and there is also evidence of the involvement of advocates contained in the care plan documentation. One resident, who cannot currently attend structured day care services was not at all times receiving care fully compliant with his very full and thorough care action plan, drawn up to reflect his changing care needs and challenging behaviour. Monica Close (8 and 9) DS0000019471.V266039.R01.S.doc Version 5.0 Page 10 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): 11,14, 17 Residents are encouraged and enabled to develop their interests and participate in a range of social, leisure and learning activities based on their own goals and preferences. “I am going shopping for stuff to make a Christmas cake this afternoon” was what one resident told the inspector. EVIDENCE: Care plans included evidence of a range of different activities being undertaken by residents, together with a variety of contacts with families and friends in the community. This is not a static programme or process and there is evidence that changes in venue and activity have taken place recently. Care plans include evidence of the involvement of dieticians with residents and there are books of menus in appropriate and accessible formats available for residents to choose from. Monica Close (8 and 9) DS0000019471.V266039.R01.S.doc Version 5.0 Page 11 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): 19,20,21 The standard of medication recording and practice has improved since the previous inspection. The health needs of residents both physical and emotional are assessed, reviewed and wherever possible met in a way that reflects their expressed preference. Resident’s wishes in the event of their death are sensitively discussed and recorded. EVIDENCE: Medication records were spot checked and found to be in order. The home has regular medication audits and monthly stock checks and records of these were seen. Details of recent medication training was seen and proposed NVQ training in medication discussed. Care plans include details of residents’ wishes with respect to their deaths and some have funeral plans in place. Care plans include ample evidence of the involvement of a range of health professionals with residents in line with their emotional and physical needs. Monica Close (8 and 9) DS0000019471.V266039.R01.S.doc Version 5.0 Page 12 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): 23 Residents are well protected from abuse, neglect and self-harm by a thorough and robust system of policies, procedures and staff training. EVIDENCE: Very full and thorough records of recent multi-disciplinary procedures in relation to two residents, provide evidence that policies, procedures and staff training are appropriately put into practice as the circumstances require. Monica Close (8 and 9) DS0000019471.V266039.R01.S.doc Version 5.0 Page 13 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): 24,28,30 Overall the home provides a safe and hygienic environment for residents, however there are some areas of concern that the operations manager and deputy manager are aware of. EVIDENCE: There is some remedial work required to repair a water damaged ceiling in one lounge and there is a persistent problem of the smell of urine which suggests that the bathroom and toilet in number 8 may need some exploratory work to trace and rectify the cause and this should be dealt with as a matter of some priority. Monica Close (8 and 9) DS0000019471.V266039.R01.S.doc Version 5.0 Page 14 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): 33,35,36 The staff team are provided with training and supervision, which enable them to effectively support and care for the home’s residents. In order to fully comply with personal goals and specific action plans and strategies, drawn up to meet the care needs of some of the more complex and challenging residents, additional staff resources may be required. EVIDENCE: Those staff present confirmed details of recent training and supervision and confirmed that they felt well supported by their managers and Walsingham. One resident, who is currently not able to attend structured day care services is providing the service with a particular challenge. The action plan and goals in respect of this individual are comprehensive and well documented, however on the day of the inspection, it was evident that staff are not always able to put this into action. Monica Close (8 and 9) DS0000019471.V266039.R01.S.doc Version 5.0 Page 15 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): 37,38,42,43 Recent additions to the staff and management team have improved the consistency of the provision of both management and care in the home, which has benefited residents and the staff team alike. EVIDENCE: The standard of medication recording for example has improved. Less agency staff are now being employed. Services users were observed to be at ease and were being encouraged to exercise control over their daily routine in an appropriate way. Monica Close (8 and 9) DS0000019471.V266039.R01.S.doc Version 5.0 Page 16 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 4 X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X 3 X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X 3 X 2 LIFESTYLES Standard No Score 11 3 12 X 13 X 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X 2 X 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Monica Close (8 and 9) Score X 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 X X X 3 3 DS0000019471.V266039.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA30 Regulation 23 Requirement Action must be taken to address and remedy the persistent problem with odour in the bathroom of number 8 Monica Close. The ceiling affected by water damage must be repaired. Staffing levels must be adequate at all times to meet the care needs of all service users as set out in their current care plan documentation. Timescale for action 30/01/06 2 3 YA24 YA33 23 18(1)(a) 30/01/06 16/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Monica Close (8 and 9) DS0000019471.V266039.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Monica Close (8 and 9) DS0000019471.V266039.R01.S.doc Version 5.0 Page 19 - 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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