Inspection on 02/11/05 for Park End Road

This inspection was carried out on 2nd 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

Park End Road 18/05/09

Park End Road 24/05/07

Park End Road 19/07/05

Park End Road 23/02/05

Park End Road 23/11/04

Park End Road 24/02/04

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 Park End Road 20-22 Park End Road Romford Essex RM1 4AU Lead Inspector Mr Roger Farrell Unannounced Inspection 2nd November 2005 02:45 DS0000027869.V264155.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 DS0000027869.V264155.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. DS0000027869.V264155.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Park End Road Address 20-22 Park End Road Romford Essex RM1 4AU 01708 736439 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) Outlook Care Gillian Margaret Leonard Care Home 7 Category(ies) of Learning disability (7) registration, with number of places DS0000027869.V264155.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th July 2005 Brief Description of the Service: Park End Road is a care home providing accommodation and support to seven people who have a learning disability. Opened in May 2000, it is operated by Outlook Care, a not-for-profit organisation who provide a range of services for vulnerable service users in N E London and Essex. The building is owned and maintained by Havering Council. All seven residents moved in when the home opened, six having lived in a council run old style home called Hamlin House, which was phased out of use. The manager is Gill Leonard, who had worked at Hamlin House for many years and took a lead role in arranging the transfers to the new facilities. She is also responsible for managing another of the organisations homes situated about three miles away in Widecombe Close. The premises are two joined together semi-detached houses that are a short walk away from the shops and transport links of Romford town centre. DS0000027869.V264155.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 Wednesday 2 November 2005 between 2.50 and 4.30pm. The last inspection had been in July 2005, and at that visit all the main core standards were checked. That report said that a good level of service was again evident across the board – and that the problems that had occurred the previous year had been overcome. The visit four month’s ago included checking the care plan files; being given an update on each person’s needs, including medical conditions and contact with their families; meeting with a group of staff and seeing what training they have done; making sure all new staff are properly vetted; looking at how medication is handled; and checking over the house, including safety arrangements. The inspector had lunch with the four residents who were at home, and they each showed him their bedrooms. The deputy from this home was currently spending a couple of months at the twinned home at Widecombe Close as part of her management development. The inspector is grateful to the stand-in deputy who remained on after her shift to help with some of the checks, and to the shift leader for the help he received. He is grateful for the warm welcome he receives, and appreciated the chance to speak with most resident, the opportunity for them to show him their bedrooms, and to hear about their holidays and other social events. The stand-in deputy was able to give an update on residents’ current support needs, and an overview of the staff team and working relations. What the service does well: The last report concluded that all the signs were that this home is back to running normally and the staff team are getting on well together. This means that they are doing their jobs in a way that Outlook Care expects, and can show they meet the standards asked for by inspectors. The seven residents are good friends and mostly get along well together. Tensions do crop up amongst two or three residents, but staff say they help ease problems by stepping when this occurs. At an earlier visit one person said – “This is quite a lively, friendly home, but it can be challenging. Certain residents wind others up. It is important to remember that a number [of residents] have medical conditions, and staff need to remain alert about this.” One of the positive findings again found at this recent visit is how medical details are set out and monitored in the support files, including where there are more recent changing needs. DS0000027869.V264155.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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. DS0000027869.V264155.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 DS0000027869.V264155.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): 2. All these standards were scored as satisfactory at the last visit. The use of pictures and symbols helps make key information understandable. This includes the information that would be used to help a new resident make a choice if a vacancy occurred. EVIDENCE: One resident wants to move to Widecombe Close as a vacancy was due to occur and he has good friendships with some of that household group. He had just been on a short-break with them to Blackpool, and said he was hoping to move before Christmas. A copy of Outlook Care’s ‘Referrals Procedure – Residential Care’ that was revised in August 2004 is available. This would be used to plan any future move-ins. The inspector has seen examples of the original assessments that were used to match places at Park End Road five years ago. These showed good cooperation between all those involved, including residents and their families. The up-to-date files have carried forward some important information, such as the good profiles and medical details. The ‘statement of purpose’ and ‘service-users’ guide’ have been put together in a way that make them understandable to the residents using pictures and photos. Each person has a pictorial contract of residency, and a signed copy of the licencee agreement on their personal file. DS0000027869.V264155.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, 7 and 9. The personal care files are being kept up-to-date, showing good detail of the help that is needed by each resident, including where their support needs are changing. A number of residents have medical conditions that have to be monitored, and staff are maintaining good tracking records of contacts with doctors and other health care workers, including health reviews. EVIDENCE: Outlook Care use the ‘Person Centred Planning’ (‘pcp) approach. This provides the framework for the layout and content of service-users’ plans. This includes a comprehensive set of needs assessments under a wide range of user-friendly headings, which lead on to the action plans and risk assessments. The main sections of the ‘pcp’ files are designed to fully involve the resident in their support planning and how they spend their time. Understanding and inclusiveness is helped by the extensive use of pictures and photos. At the last visit the inspector looked at a range of ‘pcp’ files; ‘health care files’; day-today activities diaries; and the ‘need to know’ files. These were all found to be satisfactory, having been brought up-to-date following a period where they had lapsed. The ‘support care plan sheets’ cover what help each person needs with personal care and daily life. These were very useful in guiding new staff as they joined the reforming team. DS0000027869.V264155.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): 0. All areas under this heading were entered as met at the main inspection. This group of residents continue to have busy lifestyles, each having an individual programme covering their abilities and preferences. This also includes social and leisure activities. Residents again said how much they enjoyed their main holiday. EVIDENCE: Files have weekly programmes showing that residents continue to attend a range of centres and colleges, typically for at least three days each week. All residents need to be accompanied when going out. The home does not have it’s own vehicle, but residents make extensive use of the council’s transport scheme and ‘dial-a-ride’. There are ten extra hours a week used for supporting activities in the community. Popular activities include – pub lunches; evening meals out; swimming; bowling; cinema; themed evenings such as a recent ‘Bollywood Night’, evening clubs’ and the monthly Spillsbury disco. All seven residents went on holiday in September to a holiday camp in Hastings, accompanied by five staff. The ‘pcp’ files have monthly resume sheets of activities, and set out each person’s family links and friendships. This includes helping one resident maintain contact with his only family member who lives in America. DS0000027869.V264155.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): 18 and 19. Based on descriptions of care, and the details in the service users’ files the conclusion is that these areas are being achieved. The three residents who gave opinions on how they are helped said that they were satisfied with the level of help they get. Medication arrangements were checked at the last visit, the supplying pharmacist saying - “The records of medication are the best I’ve seen in a home….the atmosphere is light and happy – a lovely home.” EVIDENCE: The stand-in deputy described the changing needs of a couple of residents, one of whom needs increased monitoring of his behaviour and health. This person’s file showed the increased monitoring that has been needed, and the involvement of health care workers, including the psychiatrist, behaviour specialist nurse, and continence advisor. There is good use of monitoring charts, recording contacts with the GP, and follow through with medical services. Duty staff were able to give details about this person’s increased support needs, referring to the relevant sections in the ‘day-to-day’ file. Although this visit involved looking at a smaller sample, it remains the case that service users’ files suitably detail the current level of assistance needed with personal care and monitoring of medical needs, along with details of the involvement of others such as a psychiatrist, physiotherapist, and a speech therapist. DS0000027869.V264155.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): 22 and 23. A good range of information is available to residents on complaints and protection. When matters are raised, the correct procedures are followed. Residents have the added safeguard of regular contact with an advocate who they know well. EVIDENCE: Outlook Care have a clear and effective complaints procedure pack, and a copy is available at this home. Information on making complaints is included in the pictorial ‘service users’ guide’, and displayed on the notice board. This includes details of how to contact the advocacy service and the Commission, with a ‘one touch’ telephone connection to both these external services. Complaints are a standing item on the agenda of the residents’ meeting held each month, there being a file that has the minutes of these meetings. The policies covering adult protection include ‘Infringement of Service Users’ Rights Procedures’; ‘Whistleblowing’; and ‘Abuse Management’. In addition there were copies of ‘No Secrets’, and the local Adult Protection Guidelines. The leaflet ‘No More Abuse’ produced by ‘Voice UK’ and ‘Change’ is also available. Staff do a one-day course on adult protection, and sign to confirm they have read the local guidelines. Each staff member has been given a copy of the General Social Care Council’s ‘code of practice’, and give informed answers when asked about safeguards. When issues were raised last year about how the home was being managed the procedures were followed. DS0000027869.V264155.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, 25, 26, 29 and 30. This is a well-maintained, homely and clean house, which residents say they like. Whilst the residents were on holiday in September the hallway in No.22 was painted and a new carpet fitted on that stairway. One person keeps her bedroom quite bare, but the six other residents have made their own rooms very comfortable, which show their tastes and interests. The manager and staff say that adding a conservatory would be very helpful, and there is now a need to rethink having the washing machine in the kitchen. EVIDENCE: The home was created by joining two neighbouring houses, there being one main communal room used as a lounge and dining area. The creation of a sleeping-in room meant that a small ‘quiet room’ was lost, however this was little used. The communal space falls fractionally below the recommended space standard, but overall the home provides reasonably good quality accommodation, and residents tell the inspector how much they like their home. The inspector again found the premises clean, safe, comfortable, well ventilated, and with good attention to home making. At this visit four residents showed the inspector their bedrooms, and he saw two others. These are generally pleasantly decorated and well equipped, DS0000027869.V264155.R01.S.doc Version 5.0 Page 14 reflecting individual’s interests. One resident’s room is quite sparse, but this is out of choice, and she does not like sleeping in a bed. Staff are continuing to try various ways to adapt her room to meet her preferences, a new chair had just been introduced. The main room is decorated in a bright contemporary style. However, when asked staff say that the main improvement they would like to see is a conservatory extension. They say that all residents use this room a lot, and just having the one main room means there can be restrictions, one person summing this up – “Sometimes some [residents] want to watch tv, some want to play music, and others want it quiet to get on with their writing or art.” The manager is still following up this possibility up with the local council, who own the building. Staff also say that having a separate utility room is growing more necessary as there is now increased assistance with continence and the washing machine is in the kitchen. There is plenty of garden space to the rear for such developments. Three residents need to use a wheelchair at times away from the building, but all are mobile in-doors. Bathrooms have a small range of adaptations. There is an assistance call system but this is not used at present. DS0000027869.V264155.R01.S.doc Version 5.0 Page 15 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): 32. The last report said – “All the signs are that a stable staff team has been reestablished following a difficult period last year. All permanent staff are new to this home, and they say there is a shared enthusiasm to make sure residents are well supported, and appreciate the leadership provided by the manager and new deputy.” Views expressed at this recent visit positively confirm that such stability has been maintained. EVIDENCE: The main staffing standards were not covered at this visit, but the stand-in deputy gave an overview. At the visit in July verbal and written comments made by relatives, the manager and deputy, support workers, and the visiting advocate all confirmed that good stability and unity had been restored. The manager and staff expressed mutual appreciation, with lots of positive references to the deputy who started in April. The staff team is made up of – manager (17.5 hours); deputy (currently 30 hours); 3 f/t, and 3 p/t support worker posts, plus 30 additional shift hours (total = 215 hours, excluding the manager and deputy’s time), and a further 10 hours for community support activities. This means that there are eighteen additional care hours since last year. Normal cover is two people on each of the early and late shifts, and one person on sleep-in duty. The extra eighteen hours is being used to have a third person on for the busy part of the morning three days a week. DS0000027869.V264155.R01.S.doc Version 5.0 Page 16 At his last visit the inspector looked at a number of staff files to check on vetting. These contained completed application forms; two written references; a photo; copies of passports; medical forms; and statements of terms and conditions. The organisation are a registered body with the CRB and have received enhanced level checks on all staff at this home. DS0000027869.V264155.R01.S.doc Version 5.0 Page 17 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 and 39. Residents have a good range of ways to voice their opinions and choices. This includes the way support plans are done, a range of service user forums, having regular meetings with an advocate, and being asked their views as part of Outlook Care’s own checks on the service. EVIDENCE: The shift leader helped the inspector look at the evidence of how residents have a say in the service. This included the file holding the notes of the monthly residents’ meeting; the very good ‘newspaper’ style sheets drawn up during the regular meeting with the advocate; information on being an ‘MP’ on the ‘People First’ parliament, and details of the two, sometimes three residents who go to these meetings; as well as the forum held by Outlook Care. DS0000027869.V264155.R01.S.doc Version 5.0 Page 18 Outlook Care operate a quality monitoring scheme system called the ’Continuous Improvement Programme’ (CIP). All staff have attended briefings on this the scheme, including signing to say they are aware of the company’s current policies and guideline - copies of which are available in the home’s office. Outlook Care are very good at carrying out their own ‘monthly visits’. A file containing these audits is available at the home, and these reports are sent to the Commission. At the last inspection documents were checked covering in-house and consultant fire checks and drills; fire equipment maintenance; gas, electricity and water certificates; general health and safety checks; and risk assessments. These were all satisfactory. DS0000027869.V264155.R01.S.doc Version 5.0 Page 19 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 x 3 x x x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 x x 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 x 3 x x x x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x x x DS0000027869.V264155.R01.S.doc Version 5.0 Page 20 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. 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 DS0000027869.V264155.R01.S.doc Version 5.0 Page 21 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. 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