Inspection on 02/07/07 for Old Ford Road (69-71)

This inspection was carried out on 2nd July 2007.

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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Old Ford Road (69-71) 14/10/08

Old Ford Road (69-71) 27/04/06

Old Ford Road (69-71) 21/10/05

Old Ford Road (69-71) 19/05/05

Old Ford Road (69-71) 17/11/04

Old Ford Road (69-71) 21/06/04

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 Old Ford Road (69-71) 69-71 Old Ford Road Bethnal Green London E2 9QD Lead Inspector Anne Chamberlain Key Unannounced Inspection 2nd July 2007 10:25 Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 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 Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 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. Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Old Ford Road (69-71) Address 69-71 Old Ford Road Bethnal Green London E2 9QD 020 8980 5631 F/P 020 8980 5631 h4m059fishter@mencap.org.uk H46013@mencap.org.uk Royal Mencap Society 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) vacant post Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th July 2006 Brief Description of the Service: Old Ford Road is a residential care home registered for seven service users with learning disabilities. Currently there are no vacancies. The home is situated in the Bethnal Green area close to central London. It is comprised of two terraced houses interlinked through a shared conservatory, and with a shared garden. Parking in the area is restricted but there are good public transport links. The registered provider of the service is Mencap. Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The last inspection of the service was random and was reported to the providers by letter in August 2006. The inspector has collected a deal of information on the service since the last inspection, mainly through notifications and e-mail discussions with the service manager. The temporary manager of the service completed an Annual Quality Audit Assessment prior to the site visit. The inspector spent a day and a half at the service. She interviewed the manager and deputy manger. She spoke to two residents and two staff members during the course of the inspection. A link resident kind agreed to distribute surveys to the residents. This was done immediately after the site visit. The returned surveys were generally positive about the service. The inspector case tracked three residents. She viewed their case files and log books and the files of their carers. She also viewed the arrangements for the administration of their medication. The inspector toured premises including the garden and one residents bedroom. She also viewed key paperwork and recording. The inspector would like to take this opportunity to thank the residents, staff and manager for their assistance and co-operation with the inspection. This is a summary of what happened when the Inspector, Anne Chamberlain, came to your home on Monday 2nd July and Tuesday 3rd July 2007. Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 6 She : Talked to some of the residents Talked to the manager and carers Looked at residents files and carers files Looked at other paperwork Walked over the house and looked at the garden. What the service does well: Inspecting this service was a pleasure. The temporary manager has an excitement about supporting adults with learning disabilities, which is infectious and has spread to the staff. Keyworkers are looking for opportunities to help residents develop their skills and interests. The systems of the house interlock and staff can see the value of them in supporting the delivery of the service. Staff are taking responsibility for their work. What the home does well Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 7 Keeps people safe Helps people to achieve their goals What has improved since the last inspection? The service has improved significantly since the last inspection. Key documentation like support plans and risk assessments are now in place and in time will be fully standardised and accessible. The atmosphere in the service has changed markedly. The temporary manager, her deputy and a member of staff at the service demonstrated a commitment to the client group. They were truly enthusiastic about broadening life opportunities for residents. Residents at the service are doing more inside and outside of the home. A number of improvements had been achieved by the permanent manager who proceeded the temporary manager. These have been built on. Some of the improvements at the home are works in progress but enough has been achieved to show that things are and will be running in a way which benefits residents. What has got better since the last inspection? Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 8 People are doing more inside and outside of the home. The home is looking much nicer and so is the garden. There is room to play football in the garden now. There is a new TV and a second lounge to sit in. What they could do better: The inspection resulted in six legal requirements and three good practice recommendations. Advice has been given regarding the proposed change in overnight arrangements, and this has been supported by a requirement. Medication administration can be improved by better recording of medication into and out of the home. Complaints must be pursued to resolution and recorded accordingly. Staff training must be brought up to date and the certificate of employers liability must be displayed in the home. Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 9 Staff should do a bit more training. Some of the recording can be improved, like keeping a separate list of medicines which come into and go out of the home. 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. The summary of this inspection report can be made available in other formats on request. Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 10 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 Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Residents experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Good assessment information is held for the residents in the home. New residents would be properly assessed. EVIDENCE: The manager explained to the inspector the process she would go through to assess a prospective resident. She outlined a thorough assessment of need involving the prospective resident, their family and key professionals. The inspector noted on the case files of the three residents tracked, comprehensive assessment information. The temporary manager stated that she will standardise the assessment format and will integrate the information for existing residents so that the files will be uniform. The inspector saw a specimen file which had been made up. The temporary manager stated that over the next few weeks keyworkers will be tasked to get the files of their residents into this format. Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. Residents experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Support plans are well developed, service users are making decisions for themselves and risks taken are well assessed. EVIDENCE: The residents now have standardised support plans. They are written in the first person and reflect the strengths of residents as well as their needs. There was significant evidence on file of reviews of service user needs. However the manager and inspector agreed on the following: The review will have a standardised format. Support plans will be living documents and will be updated following reviews or any significant change. If there are no changes to make on the plan then this will be recorded and the Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 13 date of the review given. If a review is not called by the social worker of the resident within a certain timescale, say a year, then the home will initiate a review and invite the social worker, giving them adequate notice. The review will go ahead whether or not the social worker attends. The temporary manager said she felt that there had been a tendency to offer residents choices which were too open, needing too much initiative from them. She said that at the moment basic choices residents make are when to get up and go to bed, what clothes they want to wear, what food they want to eat, etc. Residents make choices about their activities and had made choices about their holidays, going to various destinations. The temporary manager has a plan for supporting choice. The residents generally have regular scheduled activities like clubs and day centres in their week. The manager plans to create an illustrated schedule for each person (probably a laminated sheet) with the fixed activities. Around this residents can discuss with their keyworkers, on a weekly basis, what they would like to do in the free time they have. The manager also wants to institute a daily planning file for staff so that there is less need for verbal handover and all staff can check what people are supposed to be doing every day. This should eliminate mix ups and ensure that staffing levels are set responsively and residents are properly supported in their activities. The inspector felt that the above will work very well. It will support service users to structure their week and anticipate each days activities. It will help them to plan with their key workers what they would like do and achieve more of their goals. Log books for the three residents case-tracked showed evidence of people doing more stimulating activities. Risk assessment at the service has now been addressed. Currently all the risk assessments are in one file but the manager stated that they will all be filed in the individual files as the files are standardised by the keyworkers. The inspector viewed the risk assessment file and was satisfied that this function is now working well. The file contained up to date, individualised, appropriate and varied risk assessments for the residets, as well as generic risk assessments. The risk assessments bear dates of when they need to be reviewed. Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13, 14,15, 16 and 17. Residents experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents at the home enjoy a range of educational, recreational and social opportunities. Contact with families and friends is supported. Meals are nutritious and mealtimes are enjoyable. EVIDENCE: One resident told the inspector how keen he is to find employment. This person has worked previously but because of an ongoing health condition needs sheltered employment. The temporary manager said that she is going to refer this person to any agencies which might be able to help him find a job or rewarding occupation. In the meantime he is enjoying Poetry in Wood classes and the Bow Road club. Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 15 Residents at the home take part in a range of activities including, day centres, Map Squad, Coburn Centre, Gateway Club, Poetry in Wood classes and discos at the Bubble club. One resident attends church regularly and has strong links there. Currently he is escorted but the temporary manager said she is hoping to access for him, free travel training. This is over a number of sessions and hopefully would enable the resident to attend church independently. Two other residents attend church sometimes. Residents enjoy the cinema and on the night of the inspection there was a cinema trip. Previously the inspector had concerns about one resident who had very little organised for him. She required the home to give him more opportunities to get out for recreation and exercise. Now he likes to play football in the newly cleared garden and he extracted a promise from the temporary manager to have a kick around with him after the inspector had left for the day. On the day of the inspection the resident mentioned had chosen to go over to Walthamstow market. He has recently come back from three days in Eurodisney supported by the deputy manager, which he enjoyed greatly. The inspector is now happy that the resident is doing more although the temporary manager acknowledged that he does not yet have a full programme. The manager said that his keyworker will be organising swimming for him and looking for other opportunities. She also reported to the inspector that previous negative behaviours noted have disappeared. Two residents have been away on individual holidays of their choice and at the time of the inspection three residents were away together. They sent a postcard which was happily received and shared. Residents are supported to maintain contact with their families. One resident sees his Mum twice a week and stays overnight with her. Another has a large family who visit. One resident has no family but is keen to trace family members. The inspector discussed with the temporary manager how this might be approached. Realistically the task might be time consuming and the inspector recommends it be taken forward as a project, and if necessary additional funding sought for staff hours to support it (see recommendations). The temporary manager said she felt there is a lost opportunity for some residents to visit family at their homes. She feels that this would improve the frequency and quality of family contact and stated that she is going to be working on supporting some residents to go to their family homes. The inspector looks forward to hearing how this progresses. Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 16 The inspector happens to know one resident who is fairly new to the home, had respite services locally. She has given the home the details and recommended that if the resident desires it, the keyworker seeks to restore this social link (see recommendations). As previously discussed the temporary manager is planning a system to support the daily lives of service users. In addition they are encouraged to join in the running of the home. Food is ordered on-line and residents are involved in this. Residents have a home based day when they are supported to tidy their rooms, shop for their needs and generally organise themselves. The inspector observed a significant change in the provision of food in the home. Previously some residents have refrigerators in their rooms and they seemed to eat pre-prepared meals every evening. The stock of food held by the house was minimal at that time. The individual refrigerators (apart from one) have been removed to the cellar and the home has good stocks of tinned, packeted and frozen foods. The inspector also noticed fresh vegetables in the kitchen. She noted that during the day a large quantity of minced steak was removed from the freezer and later on in the afternoon appetizing smells were emanating from the kitchen. The temporary manager stated that the home now runs on a basic weekly menu chosen by residents and there is a hot meal provided every evening. If someone wants something different then that is prepared separately. The temporary manager stated that she is planning to download and laminate pictures of food, to use with residents when they are choosing the menus. Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 and 21. Residents experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents receive personal support in the way they prefer, their physical and emotional needs are met and medication is administered safely. Issues of ageing and death have been addressed with residents. EVIDENCE: The inspector felt that support plans, if followed by staff, would ensure that service users receive support in the way which they prefer and require. One resident at the home tends to rise a bit later. On both mornings the inspector was present in the home and was able to observe him as he came in to the office to let the temporary manager know he was on his way to have a bath. After his bath the resident presented himself again so that the temporary manager could admire his clean shaven smart appearance. This resident has taken a long while to settle into a good personal care routine and the inspector Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 18 felt a lot of progress has been made in all aspects of his care. The interaction she observed between the resident, his keyworker and the temporary manager was relaxed and supportive. Residents at the home now have Health Action Programmes (the format coming from the Community Learning Disabilities service), and the inspector observed these in the files she inspected. She noted that they had been signed by residents. The manager stated that all residents had recently had medication reviews with their general practitioners. One resident has needs around his epilepsy which is currently not well controlled. The home is planning to withdraw waking night cover and replace it with sleeping night cover. The inspector was clear that before they do certain precautions must be taken: 1. The specialist nurse for epilepsy who works with the epileptic resident must approve the arrangement. 2. Appropriate risk assessments must be undertaken and all support mechanisms, for example call bells must be considered and if necessary installed. 3. The social workers of any residents who have been placed on the basis of waking night being provided, must be consulted before the change is made (see requirements). The inspector suggested to the manager that this resident might benefit from a tag to wear which states that he is epileptic, to lessen his vulnerability in the community. The manager said she will speak to the specialist nurse about this. One resident has had a chair supplied by his occupational therapist and a rail has been installed for him. The temporary manager stated that she is keen to access for one resident a dementia assessment. He may have a disposition to this condition and she wishes to establish a baseline in case he should develop it. The inspector thought this very sensible. Since the last inspection a medication error did occur at the home. However it was report to CSCI and the appropriate steps have been taken to safeguard against errors in future. Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 19 The temporary manager stated that all new staff in the home have undertaken an in house medication training. They are also booked on more Mencap training. The inspector viewed the arrangements for the administration of medication. Medicines are stored in a locked cabinet. There is a medication folder which is separated into sections for individuals. There is a photograph of the person followed by their Medication Administration (MAR) sheet. This is provided by the pharmacist and lists all the prescribed medications they are taking. The inspector viewed the MAR sheets for the three residents she was casetracking. She also balanced the remaining stock of medication against their sheets. The sheets were in good order and there were no discrepancies. The medications received into the home are recorded on the MAR sheet but should also be recorded separately in a Medications IN and OUT book. When the pharmacist accepts returned medication he should check it and sign the book. The manager stated that she would put this book/system into place straightaway (see requirements). The medication folder included information about epilepsy and staff had signed to confirm that they had read this information. This is good practice. One resident had an over the counter medication prescribed, a year ago and was not using the remedy currently. The inspector asked the temporary manager to check with the general practitioner whether the medication was still needed and if not delete it from the MAR sheet and return the surplus to the pharmacist. The temporary manager agreed to do this. The manager stated that no staff administer medication without appropriate training. Relief staff do not administer medication. The inspector noted that two records of seizures were being kept for a service user. One had had the most recent seizure recorded and one had not. The manager agreed that duplication can lead to confusion and destroyed the second unnecessary record. Residents files now contain basic information regarding their preferences for funeral arrangements, apart from one resident who chooses not to discuss the topic. This was appropriately recorded. The inspector suggested to the manager that the information could be developed and that a nicer title might be Afterlife Arrangements. She suggested that residents might like to note their favourite music, maybe hymns for a crematorium or church service. Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 20 The inspector felt that the dignity and respect afforded to residents in life would be demonstrated towards their death. Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Residents experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Complaints are taken seriously and there is a proper complaints procedure. The temporary manager has been reminded that follow up actions must be recorded. Residents are safeguarded from abuse, neglect and self-harm. EVIDENCE: The inspector viewed the information on how to complain, which is provided for residents. She also viewed the complaints folder. There was an old complaint outstanding without a resolution. The temporary manager undertook to consult with the service manager to ascertain the result and will record it against the complaint (see requirements). The inspector suggested that a sheet be placed at the front of the complaints folder to list complaints In, Processing and Resolved. In this way complaints are unlikely to be left unresolved and the temporary manager can, at a glance track any complaint received. The temporary manager said she would add this sheet (see recommendations). The inspector viewed three residents finance records and noted that they were completed and signed. All residents have a client charge which details their rent payments, and all residents have a risk assessment for finance. Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 22 The inspector was satisfied that the money of residents is properly handled. The inspector viewed the policy and procedure for the protection of vulnerable adults and was satisfied with it. The home keeps a booklet which outlines the local authority procedure for dealing with adult protection referrals. An incident did occur since the last inspection, when residents were not collected from an activity and were at some risk. The inspector felt that the illustrated schedule and daily activity planning file which the temporary manager will be introducing, should go some way to ensuring that staff always provide the support residents need to access their activities. Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27, 28 and 30. Residents experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The residents live in a comfortable homely environment which is safe, clean and hygienic. EVIDENCE: The inspector viewed the premises including with his permission the bedroom of one resident. The home has had some refurbishment with newly painted wall, and new flooring. It looks lighter and brighter. The lounge in number 71 has been furnished and a television installed there. The lounge in 69 has a new plasma screen TV, but there are some trailing cables which the temporary manager agreed to have clipped tidily against the walls. The shared spaces in the home were comfortable and homely. Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 24 The residents bedroom seen was personalised. The temporary manager stated that the bedroom of a recently admitted resident is not personalised but that he will be choosing things for it with the assistance of staff. The bathroom in number 69 needs some refurbishment with old fixtures being removed, the tiles regrouted and radiator repainted. (see requirements). The temporary manager said she would like to replace the downstairs shower in number 71 as it is rather institutional in style. The inspector agreed. The kitchen of number 71 is not being used except by one resident who likes to make tea there. The temporary manager is considering various uses for the kitchen. The home has a new high specification washing machine. On the day of the inspection the home was clean and hygienic. Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 25 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 and 36. Residents experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are supported by competent staff who work effectively as a team. The recruitment policy is sound and staff are trained and supervised. However training must be brought up to date. EVIDENCE: There have been some changes in staff at the home, with two new staff joining Changes are planned for overnight staffing arrangements. The staff team are culturally diverse reflecting the ethnic mix of the local area. The temporary manager has an NVQ 3 and is working towards the Registered Managers Award and NVQ 4. She has two years experience at management level. The deputy manager has NVQ 3. Two staff members have NVQ 2 and two are working towards it. Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 26 The temporary manager stated that she has enough staff to ensure that the needs of residents are met. There are always two staff on at peak times and over the weekends to facilitate residents getting out and about. The manager though present during the weekdays, is supernumerary. The temporary manager said that staff are allowed time to complete their paperwork and those studying for NVQ get a day off a week to dedicate to it. The inspector viewed three staff files and reviewed the recruitment system, which is followed. She found it to be safe and robust. The manager and inspector agreed on the training topics which are basic and should be renewed every year, as follows: Adult Protection Fire Health and Safety Manual Handling Food Hygiene Medication The manager and inspector agreed that, infection control and manual handling training courses are not needed by staff working in the home. The manager stated that she will arrange for staff to undertake epilepsy training in view of the needs of residents. The temporary manager stated that all the necessary training has been booked for staff and should be completed by December 2007 (see requirements). The inspector had a conversation with a relief worker. He told her he works for Mencap regularly, undertaking shifts in various home. He had worked at the home once before, some time ago. The temporary manager stated that she will always use relief staff who are familiar with the home if she can, but if there is no alternative she will use unfamiliar relief staff rather than agency staff. The inspector noted that the temporary manager has organised individual training records so that she can identify training needs easily. The inspector viewed the supervision records for three staff members, including two who are still on probation. She noted evidence of regular and frequent supervision as well as evidence of appraisal and performance review. Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 27 Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 28 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39, 41,42, and 43. Residents experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well organised and run home. Sound policies and procedures safeguard them and their views are considered. The management is competent and accountable. EVIDENCE: The home is well run by the current management. The systems which were described to the manager are joined up and form a safety net which supports good resident focussed work. The recording which the inspector viewed was generally of good quality and easily accessible. Residents at the home are consulted and encouraged to express their views. The tenants meeting is the main forum for this and works in a meaningful way Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 29 with issues seen through to resolution. The inspector viewed evidence of tenants meetings. These have been improved with the input of an advocate. She had prepared user friendly minutes of meetings for the residents. The temporary manager stated that Regulation 26 visits are carried out consistently by the same person and goals are set. The inspector noted that a goal set for a resident to have a certain medical test had been achieved. The temporary manager has clear ideas about standards of recording. She told the inspector she is going to be encouraging the staff to make the daily logs more meaningful, leaving out the routine events which are repetitive and instead concentrating on the particular aspects of a day from a resident point of view. The inspector viewed the health and safety folder for the home. She noted that hot and cold water temperatures are taken every week; fridge and freezer temperatures are recorded; the first aid box was adequately stocked; gas safety was checked in January 2007 and the call alarm system was serviced in February 2007. The fire risk assessment for the home was reviewed in April 2006, fire alarms are tested weekly and the record of evacuation drills was acceptably frequent. In May 2007 the outside contractor tested the fire systems. Accident and incident forms are completed as necessary and the inspector noted that they are signed off by the staff member involved, and the manager. The inspector viewed the arrangements for the Control of Substances Harmful to Health (COSHH). The organisation has produced generic sheets which give the data regarding all the products in use. The substances are kept in a locked cupboard and there were no substances stored without product information being available for them. The temporary manager is complying with the COSHH legislation. There is no current certificate of employers liability displayed at the home. The inspector realises that the policy should have been renewed by the organisation but it needs to make the new certificate available to the temporary manager for display (see requirements). The temporary manager has an overall plan from the organisation which she intends to customise to the home. The lines of staff accountability within the home are clear. In terms of forward planning the inspector believes there are two important issues for the smooth running of the home, and the wellbeing of the residents. Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 30 (a) the temporary manager remains at the home until she has all the new standards of work fully integrated into the life of the home, and all systems which underpin them running smoothly. (b) the temporary manager must hand over the service to a manager who is capable of running it to the standards which are being set now. Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 31 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 2 28 3 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 3 3 x 3 x 3 3 2 Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 32 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 YA19 Regulation 13 Requirement Before the night staffing arrangements are changed the following precautions must be taken. 1. The specialist nurse for epilepsy who works with the epileptic resident must approve the arrangement. 2. Appropriate risk assessments must be undertaken and all support mechanisms, for example call bells must be considered and if necessary installed. 3. The social workers of any residents who have been placed on the basis of waking night being provided, must be consulted before the change is made Medications received into the home are recorded on the MAR sheet but should also be recorded separately in a Medications IN and OUT book. When the pharmacist accepts returned medication he should DS0000010300.V343722.R01.S.doc Timescale for action 01/08/07 2. YA20 13 01/08/07 Old Ford Road (69-71) Version 5.2 Page 33 check it and sign the book. 3. 4. YA22 YA27 13 23 (2)(j) An outstanding complaint must be resolved and this is recorded. The bathroom in number 69 needs some refurbishment with old fixtures being removed, the tiles regrouted and radiator repainted. All staff must renew training in the following topics every year. Adult Protection Fire Health and Safety Manual Handling Food Hygiene Medication 6. YA43 25 (2) (e) A certificate of employers liability must be displayed in the home. 01/08/07 01/08/07 01/12/07 5. YA35 18 (1)(c)(1) 01/12/07 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 YA15 Good Practice Recommendations The inspector recommends that family tracing for one resident be taken forward as a project, and if necessary additional funding sought for staff hours to support it. She has given the home the details and recommended that if the resident desires it, the keyworker seeks to restore this link (see recommendations). The inspector suggested that a sheet be placed at the front of the complaints folder to list complaints In, In Process and Resolved. In this way complaints are unlikely to be left unresolved and the temporary manager can, at a glance track any complaint received. 2. YA13 3. YA22 Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 34 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Old Ford Road (69-71) DS0000010300.V343722.R01.S.doc Version 5.2 Page 35 - 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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