Inspection on 03/02/06 for Parkcare Homes (No 2) Ltd (Alexandra Road)

This inspection was carried out on 3rd February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Parkcare Homes (No 2) Ltd... 03/06/09

Parkcare Homes (No 2) Ltd... 12/06/08

Parkcare Homes (No 2) Ltd... 10/05/07

Parkcare Homes (No 2) Ltd... 30/10/06

Parkcare Homes (No 2) Ltd... 21/10/04

Parkcare Homes (No 2) Ltd... 21/06/04

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

CARE HOME ADULTS 18-65 Parkcare Homes (No 2) Ltd (Alexandra Road) 17 Alexandra Road Enfield Middlesex EN3 7DD Lead Inspector Wendy Heal Unannounced Inspection 10:00 3 February 2006 rd Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.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 Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.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. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Parkcare Homes (No 2) Ltd (Alexandra Road) Address 17 Alexandra Road Enfield Middlesex EN3 7DD 020 8443 5240 020 8443 5240 Telephone number Fax number Email address The Lily in June in 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) Craegmoor Homes Ltd Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st August 2005 Brief Description of the Service: Alexandra Road is managed by Craegmoor Healthcare services. It is a home, which is registered to provide a service to ten younger adults with a learning disability. Alexandra Road is located in Ponders End. The home is purpose built and first opened in 1994. It is an attractive detached house. The accommodation is over two floors. On the ground floor there is a large lounge and dining room and a kitchen. The lounge leads out to a small-enclosed garden with chairs. Also on the ground floor there is a small second lounge, which offers an alternative quiet seating area. In a separate building accessed through the garden there is a laundry. On the ground floor there are bedrooms and an assisted bathroom for disabled people and two toilets, one of which is wheelchair accessible. On the first floor there are the remaining bedrooms, a bathroom, a shower room and the office. The house does not have a lift. The stated aim of the service is to treat the service users as individuals and to promote independence and ensure that privacy and dignity is maintained. The service promotes a holistic approach to care where physical, social and psychological needs are given equal importance and appropriate care plans and interventions are put into place. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that took approximately 5 hours. The manager assisted the inspector throughout the day. The inspector undertook a tour of the building, spoke to service users and observed the interaction between the service users and staff. Further information was obtained by the inspection of the documentation kept in the home, including care plans and health and safety documentation. The inspector would like to thank the service users present during the inspection, staff and manager for the openness and participation. What the service does well: What has improved since the last inspection? Care planning meetings had taken place for all four service users. This was a requirement made at the previous inspection that has now been met. A requirement was made that the registered person ensures that the prescribing GP reviews the prescribed medication being administered. This requirement has been met. Service users did not have a holiday last year. A good practice recommendation has been made in relation to this. The manager was able to locate a copy of the provider organisations Adult Protection Policy. This was a requirement made at the last inspection, which has now been met. The Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.R01.S.doc Version 5.0 Page 6 downstairs toilets have been tiled in relation to the area around the toilet basin and wooden surface in the downstairs bathroom. This was a requirement made at the previous inspection, which has now been met. A student nurse on placement had a satisfactory Criminal Records Bureau check. This was a requirement made at the previous inspection, which has now been met. The actions required in the fire safety risk assessment have been met. The kitchen refurbishment has taken place. This was an immediate requirement made at the last inspection. What they could do better: Staff must have the opportunity to develop their communication skills on a regular basis. Staff had not had training in relation to Makaton. A requirement has been made in relation to this. The opportunity for service users to maximise their enjoyment of external activities is not being fully achieved, as Alexandra Road does not have it’s own minibus. A requirement has been made in relation to this. Food in the fridge was not appropriately stored. A requirement has been made in relation to this. The provider’s Adult Protection Policy needs to be reviewed. A requirement has been made in relation to this. The vacant bedrooms are not adequate. At the last inspection a requirement was made that these rooms are decorated before any week the service users occupy them. This requirement has been restated. The organisation should remove the combined wardrobe sink and vanity unit to allow the service users moving into the home to personalise their own bedrooms. A requirement has been made in relation to this. A good practice recommendation was made at the last inspection that the provider organisation reviews the bedroom units to ensure they fit in more sympathetically with the style of the rest of the bedrooms. It is strongly recommended that this recommendation be met. One of the bedroom ceilings needs to be investigated as it is cracked. A requirement has been made in relation to this. The identified service users bedroom needs to be decorated and the hot water tap repaired. Requirements have been made in relation to these. The sofas in the lounge must be replaced to ensure there is adequate seating for the increased number of service users in the home. The carpet tiles in the shower room had not been replaced. This was a requirement made at the last inspection, which has not been met. The shower room flooring must be replaced with a non-slip alternative. A requirement has been made in relation to this. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.R01.S.doc Version 5.0 Page 7 The downstairs toilet has an exposed pipe. A requirement has been made in relation to this. The Bathrooms and toilets need hot air dryers. A requirement has been made in relation to this. The provider needs to consult appropriate professionals on the layout, adaptations and necessary equipment required in relation to the bathrooms and toilets, to ensure the needs of both the current service users and new service users are met. Staff vacancies need to be filled. A requirement has been made in relation to this. Staff must undertake National Vocational Qualifications in care. A requirement has been made in relation to this. Staff must receive regular supervision. A requirement has been made in relation to this. The document showing that all outstanding electrical work has been completed must be sent to Commission for Social Care inspection. A requirement has been made in relation to this. The Fire Officer must be consulted regarding fire safety arrangements. A requirement has been made in relation to this. 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. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,5, Service users are given the information they need to make an informed choice about whether the services is suitable for them and their needs are agreed prior to them receiving the service. EVIDENCE: Since the previous inspection there have been no new admissions to the home. The inspector looked at the statement of purpose, which has been updated but has not been signed by the relevant parties. The manager has agreed to send a signed copy of this document to the inspector. The service has a service user guide, which was seen and it takes into consideration the needs of service users. The document is very service user friendly and it is in a pictorial form. Evidence was seen that the service user guide had been issued to each service user for their information and, where appropriate, for the information of their family and relevant stakeholders. Three service user files were inspected and all contained a range of assessment information that was relevant to the time they were admitted to the home. The homes service user agreement clearly specifies the terms and conditions of the home including details of the notice period. Service users care plans are being reviewed on a regular basis. The manager showed a good understanding of the individual service users needs and could talk in detail in relation to his role. All four service users living in the home have very Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.R01.S.doc Version 5.0 Page 10 individual communication needs, it is important that staff have an opportunity to develop their communication skills on a regular basis. At the time of the inspection staff had not had training in relation to Makaton for some considerable time. A requirement has been made in relation to this. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.R01.S.doc Version 5.0 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7, 8,9,10 Service users benefit from up-to-date individual care plans. Service users are supported to make decisions about their daily lives. Service users are supported to take appropriate risks as part of their overall lifestyle. EVIDENCE: Three service user files were inspected and contained detailed care plans. The care plans were based on the service users current and changing needs. There is evidence that they were regularly reviewed. The plans contained goals. The care plans were also seen to have been informed by current risk assessments. All three files contain detailed guidelines for staff on how to deal with identified areas of challenging behaviour. Evidence was seen that care-planning meetings had taken place for all four service users. The decisions from these meetings must be incorporated into each service users plan. This was a requirement made at the previous inspection that has now been met. The Registered Provider must ensure that the process for consultation with staff and the arrangements in relation to the new service users moving into Alexandra Road are sent to the Commission for Social Care Inspection. A requirement has been made in relation to this. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.R01.S.doc Version 5.0 Page 12 Service user information is handled appropriately. The main files are kept in the office. The information stored on computer is accessed by a password. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.R01.S.doc Version 5.0 Page 13 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): 12,13,14,15,17 Service users are getting a good quality of life because of the established links with the local community and because they take part in a range of stimulating and appropriate activities. The opportunity for service users to undertake activities outside of the home is being limited due to the fact that Alexandra Road has no minibus of its own to meet the needs of service users. EVIDENCE: Service users activity records were inspected. The care plans reflect how the service users are supported to develop their independent living skills, and are specific to service users and are kept up-to-date. Service users undertake day-care activities ranging from two and a half days per week to five days per week. The courses cover areas like communication and day-to-day living skills. All service users have enrolled with the local organisation that provides a range of social activities in the community for vulnerable people. Staff also support service users to attend other activities and resources in the local community. Service users have been involved in activities like horse riding Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.R01.S.doc Version 5.0 Page 14 and swimming. There is also a dance and movement group once a week within the home facilitated by an external person. The opportunity for service users to maximise their enjoyment of external activities and personal choice is not being maximised due to the fact that Alexandra Road does not have its own minibus. A requirement has been made in relation to this. At the last inspection a discussion took place with the manager in relation to supporting service users to have a holiday. Due to difficulties with the practical arrangements a holiday for service users did not take place in 2005. The manager had informed the inspector about the research he had undertaken in relation to service users having a holiday abroad. These had obviously been actively explored. The manager has confirmed that a holiday will be organised for 2006. This is in relation to the service users currently living at Alexandra Road. A good practice recommendation has been made in relation to this. The service users have regular contact with their relatives. The service users also have contact with friends in other local homes that are managed by the provider organisation. The inspector is of the opinion that the manager has made great efforts to develop the service users opportunities to undertake a range of appropriate activities. Service users enjoy varied and balanced meals of their choice. Staff are aware of the service users preferences in relation to their meals and these are clearly identified in the individual care plans. On the day of the inspection the inspector noted that fresh fruit and vegetables were available. The kitchen was clean and tidy. Food in the fridge was not appropriately stored but was within its sell by dates. A requirement has been made in relation to this. The inspector also saw evidence of the necessary colour-coded chopping boards, which prevent cross infection when the food preparation takes place. Service users benefit from a mixed staff team who bring a range of different ideas to the home in terms of food preparation. This means that service users have access to different types of food than they may otherwise experience. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.R01.S.doc Version 5.0 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20, 21 Service users are supported to access the necessary health care appointments and personal support is provided. Service users needs in the event of serious illness or death are known to allow these to be dealt with appropriately and with respect should the need arise. EVIDENCE: In relation to the four service users that live in the home one service user needs regular direct support with their personal care needs. Three service users need direct support on occasions with clear verbal prompts. Evidence was seen on the three service user files inspected that service users needs were satisfactorily documented on all their service user plans. There was clear evidence on the service users files inspected that their health care needs were being met. The service users have access to specialist and primary health care when required. There was evidence of appointments with health care professionals including consultant psychiatrists, and the dietician. Evidence was seen that service users are supported to monitor their weight. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.R01.S.doc Version 5.0 Page 16 The home has appropriate policies and procedures regarding the administration of medication. Specific guidance for staff regarding prescribed medication to be administered when required (PRN) was inspected and was found to be satisfactory at the previous inspection. A requirement was made that the registered person ensures that the prescribing GP reviews the (PRN} medication for the identified service users. The manager informed the inspector that this had been undertaken. Service users were appropriately dressed at the time of the unannounced inspection. The service users files were inspected and included a record of the service users wishes in the event of their death. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.R01.S.doc Version 5.0 Page 17 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, 23 Service users can be confident that their views are listened to and acted upon since the recording of the complaints and action taken is adequate. Service users are protected from abuse, neglect and self-harm. EVIDENCE: The home has a satisfactory complaints procedure that was seen displayed in the entrance hall to the home. A satisfactory accessible pictorial version of the complaints procedure was also seen in a copy of the service user guide and there was evidence that a copy of that guide had been issued to each service user. The manager stated that no complaints had been recorded at the home since the last inspection. The inspector spoke with the manager about adult protection issues and the action that a home should take if an allegation or disclosure of abuse is made. The home now has a copy of the adult protection procedure for the local authority in which the home is located. The manager was also able to locate a copy of the provider organisations adult protection policy and practical guidance for staff on the action that should be taken if an allegation or disclosure is made to them. This was a requirement made at the last inspection, which has now been met. The provider’s adult protection policy needs to be reviewed and updated, as this has not taken place since 2002. A requirement has been made in relation to this. There was evidence that staff Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.R01.S.doc Version 5.0 Page 18 had undertaken adult protection training. The home has a satisfactory whistle blowing policy that was seen displayed in the entrance hall to the home. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.R01.S.doc Version 5.0 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26, 27,29, 30 Service users benefit from the recent improvements in the environment. However, further maintenance is required to ensure the environment is homely comfortable and safe. EVIDENCE: The home offers an appropriate domestic type environment. Service users currently benefit from plenty of lounge space so they can choose where they want to sit. Alexandra Road is due to increase service user occupancy numbers from four service users to ten service users. The inspector is of the opinion that the current sofas will not meet the needs of this number of service users. A requirement has been made in relation to this. All of the service users bedrooms were inspected. The vacant bedrooms are not adequate. A requirement was made for these bedrooms to be redecorated before any of the new service users occupy them. This requirement has not been met. The manager informed the inspector that these bedrooms were going to be decorated and the start date for this work to begin was the 13th of Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.R01.S.doc Version 5.0 Page 20 February 2006, given the fact that this date has been provided an immediate requirement was not made. The requirement has been restated. Each bedroom contains a combined unit that includes a wardrobe, sink and vanity units. These must be removed to allow those service users who are moving into the vacant bedrooms to personalise these bedrooms with their own furniture, which they already own. The inspector is of the view that it would be unfair for service users to be expected to incur the cost of this furniture and not reap the benefits of an individual, personalised space. A requirement has been made in relation to this. In the previous inspection report the inspector noted that some stakeholders considered these combined units as overpowering and rather institutional looking. A good practice recommendation was made that the provider organisation reviews the units and considers replacing them with modern units that fit in more sympathetically with the style of the rest of the bedrooms. This recommendation has not been acted upon. Given the fact that six new service users are moving into the living space of the four service users that are already established in the home it is essential that they also have the opportunity to furnish their bedrooms in an individual way, and maintain the environment to an equal standard for each service user. This good practice recommendation has been restated. The bedroom opposite the kitchen must have the ceiling investigated as there is cracking that is evident. The ceiling light must also be investigated to ensure that it is safe. These actions must take place before a service user occupies the bedroom. A requirement has been made in relation to this. The identified bedroom of the service user must have her hot water tap repaired and her room decorated. A requirement has been made in relation to this. The kitchen has now been refurbished as it posed a potential health and safety hazard to those living in the home. The kitchen walls have been retiled, the kitchen units have been replaced, and the cooker has been replaced. This was an immediate requirement at the last inspection that has now been met. It was noted that the carpet tiles in the shower room were loose and had not been replaced. This was a requirement that had been made at the last inspection, which had not been met. As a result of the required action not being taken more floor tiles are loose this is a potential health and safety hazard. The shower room flooring must be replaced with appropriate nonslip flooring. A requirement has been made in relation to this. There is currently two sinks in the shower room and the hot water tap to one of these sinks does not work. This sink should be removed. A requirement has been made in relation to this. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.R01.S.doc Version 5.0 Page 21 The downstairs toilets have been tiled around the toilet basins and the wooden surface in the downstairs bathroom that was water damaged has also been tiled. This was a requirement that was made at the previous inspection that has now been met. At this inspection the inspector noted that the ground floor toilet has a pipe leading from it that is exposed on the exterior area of the tiled wall and appears bent and ready to break if grabbed by a service user. This ground floor toilet must be inspected and action taken to rectify this fault. A requirement has been made in relation to this. On the day of the inspection one toilet did not have a hand towel available. The manager explained that this was because one service user repeatedly blocks the toilets with paper towels. This was an immediate requirement made at the previous inspection. A risk assessment in relation to the service user that gave guidance to staff on how to minimise the service user blocking the toilet with paper towels had been completed. The inspector is of the opinion that consideration should be given to installing hot air dryers in all toilet hand washing areas as a means of rectifying this ongoing difficulty and minimise the risk of infection. A requirement has been made in relation to this. The inspector would like to see appropriate professionals e.g. occupational therapists consulted in relation to the layout, adaptations and the necessary equipment required. This will ensure that all of the service users needs including the new service users that are going to move into the home will be met in relation to the bathrooms and toilets. A requirement has been made in relation to this. The home has a satisfactory laundry facility. The home was clean and tidy throughout. The quiet room is going to be an essential space once all of the service users accommodate the home. The manager informed the inspector that the quiet room is going to be decorated. The inspector has decided given this information that a requirement will not be made at this inspection. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.R01.S.doc Version 5.0 Page 22 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, 33, 34, 35, 36 Park Care Homes are not fully meeting the needs of their service users, as staff are not being adequately trained in relation to their National vocational qualifications. EVIDENCE: The staff rota was seen and satisfactorily recorded the staff that were on duty during the inspection. The manager confirmed that the minimum staffing for the home was two staff on the early shift, two staff on a late shift and one waking and one sleeping staff at night. The manager stated that there is often three care staff on duty on the daytime shifts and this was consistent with the numbers of staff recorded on the rota. The manager informed the inspector that a deputy manager is not yet in post at Alexandra Road. The position of deputy manager has been offered to an applicant but the necessary documentation to enable her to take up a position has not yet been obtained. The deputy manager position must be filled urgently to provide support to the current manager and assist with the effective running of the home. A requirement has been made in relation to this. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.R01.S.doc Version 5.0 Page 23 A student nurse on placement at the home must have a satisfactory criminal records bureau check and protection of vulnerable adults clearance. Staff must be supervised at all times until the criminal records bureau check is received. This was a requirement that was made at the previous inspection. This requirement has now been met. The manager of the home informed the inspector that staff had undertaken training on how to appropriately support service users who have complex and challenging behaviours. This requirement has been met. Staff have not undertaken National Vocational Qualifications, as they are not able to complete their course due to the fact they have not had access to assessors. A requirement has been made in relation to this. Supervision records were inspected. All staff are not receiving regular supervision. This was reported to be partly due to the absence of a permanent deputy. A requirement has been made in relation to this. Regular staff meetings are taking place. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.R01.S.doc Version 5.0 Page 24 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): 42 Further action is needed regarding a number of potential hazards identified to ensure that health and safety is taken seriously by the organisation. EVIDENCE: A range of satisfactory health and safety documentation was seen including a gas certificate, portable appliance testing and servicing of a bath and hoist. The manager showed the inspector evidence that an inspection of the electrics had taken place but the report outlining work that may be required is currently at the head office. A requirement has been made in relation to this. This was a requirement that was made at the previous inspection that has been partly met. At the last inspection it was a requirement that the identified work to the homes water supply system is undertaken to minimise the risk of legionella. The manager informed the inspector that this work had been completed. The Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.R01.S.doc Version 5.0 Page 25 provider organisation must provide documentary evidence to show this work has been completed to the CSCI Area Local Office. This requirement has been restated. The house fire log was inspected that included a satisfactory fire plan, evidence of servicing of fire equipment, checking of fire alarms, and regular two weekly fire drills. The provider organisation has engaged the services of a company to complete a fire risk assessment for the home. A requirement was made that the home completes all of the work identified in the fire risk assessment and consult with the fire officer when this is done. This will ensure that the work is of a satisfactory standard and all safety requirements are met. The provider has completed the areas of action identified in the fire risk assessment but the fire officer has not been consulted. A requirement has been made regarding this. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.R01.S.doc Version 5.0 Page 26 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 2 X X 3 Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 2 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 2 2 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 2 3 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score X X X X X 2 X Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.R01.S.doc Version 5.0 Page 27 Yes 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. 2. Standard YA36 YA32 Regulation 18 (1) (C) 23 (2) (C) Requirement The registered person must ensure that staff undertake Makaton training. The registered person must give due consideration to obtaining a minibus to ensure that service users needs are met. Food that is open and stored in the fridge must be correctly labelled showing the date of opening. The registered person must review and up date the Adult Protection Procedure. The registered person must make arrangements to replace the current sofa to ensure that the needs of all of the service users living in the home can be met. The registered person must ensure that the identified bedrooms are redecorated before new service users are accommodated within them. This is restated from the previous inspection date given 31/10/05 The combined unit in the vacant bedrooms must be replaced to ensure that the service users DS0000010588.V270273.R01.S.doc Timescale for action 01/04/06 01/06/06 3. YA42 16 (2) (j) 03/02/06 4. 5. YA23 YA24 13 (6) 23 (g) 01/06/06 01/05/06 6. YA26 23 (2) (a) 13/02/06 7. YA26 23 15/05/06 Parkcare Homes (No 2) Ltd (Alexandra Road) Version 5.0 Page 28 8. YA42 23 (2) (b) 9. 10. YA42 YA27 23 (2) (b) 23 (2) (b) 11. 12. YA27 YA27 23 (2) (J) 23 13. YA27 13 (a) 14. YA27 23 15 YA42 13 (2) who occupy these bedrooms can personalise their bedrooms with the furniture they already own. The ceiling in the service users bedroom and light must be investigated and pending the outcome appropriate action taken to ensure it is safe The service users bedroom must be redecorated and the hot water tap on the sink repaired. The registered person must ensure that the flooring in the shower room is replaced. This requirement is restated previous date given 31/10/05 The second sink in the shower room must be removed. The ground floor toilet must have the pipe that is at risk of breaking investigated and appropriate action taken. The registered person must give consideration to installing hot air dryers in the toilets and bathrooms or identify an alternative means by which to minimise the risk of infection from use of the toilets. The registered person must ensure that occupational therapists and other relevant professionals are consulted in relation to the layout and adaptations required in the bathrooms and toilets in the home and act on any advice given to ensure that service users needs are met. The register person must ensure that a satisfactory electrical installations certificate is sent to the CSCI area local office. The registered person must ensure that a certificate proving the identified worked to the homes water supply system has been undertaken to minimise the risk DS0000010588.V270273.R01.S.doc 01/03/06 01/03/06 01/03/06 01/05/06 20/02/06 01/04/06 01/05/06 01/03/06 Parkcare Homes (No 2) Ltd (Alexandra Road) Version 5.0 Page 29 of legionella. 16 YA2 12 (1) (3) The registered person must 20/02/06 ensure that the Commission for Social Care Inspection is informed in writing of the arrangements for the consultation with staff and the arrangements regarding the transition process in relation to the new service users moving into the home. 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 YA26 Good Practice Recommendations The registered person should strongly consider replacing the bedroom wardrobe/ sink/ vanity units with more modern units that fit in more sympathetically with the style of the rest of the bedrooms. The registered person should ensure that the service users at Alexandra Road the experience a holiday in 2006. 2 YA14 Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V270273.R01.S.doc Version 5.0 Page 30 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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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