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Inspection on 30/10/06 for Parkcare Homes (No 2) Ltd (Alexandra Road)

Also see our care home review for Parkcare Homes (No 2) Ltd (Alexandra Road) for more information

This inspection was carried out on 30th October 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 15 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There are current risk assessments in place, which protect the wellbeing of service users. There are staff guidelines on how to deal with identified areas of challenging behaviour, which assists staff to support service users. Service users undertake a range of activities in the community, which improves their quality of life. Service users benefit from varied and balanced meals of their choice. Service users have regular service user meetings, which allows them to express their views. Staff have regular supervision, which ensures a consistent approach is followed by staff when supporting service users.

What has improved since the last inspection?

Food stored in the fridge is correctly labelled and shows the date of opening which safeguards the health and wellbeing of service users. The sofa in the lounge has been replaced to ensure that all of the service users living in the home can be accommodated with regard to seating arrangements in comfort. The identified bedrooms have now been redecorated to enable the new service users to have appropriate personal space. The ceiling in the identified service users bedroom and the light has been investigated to ensure it is safe. The flooring in the shower room has been replaced by non-slip flooring to safeguard service users safety.The ground floor toilet has had the pipe replaced to meet health and safety requirements. Hot air dryers have been placed in bathroom and toilets to minimise the risk of infection to service users and staff. The home now has a permanent deputy manager in post, which ensures consistency for service users and staff.

What the care home could do better:

The service user guide needs to be up-dated to ensure it is more accessible to service users. Service user contracts need to be updated as they have moved to a new home and their contracts refer to their previous arrangements. Service users care plans must be kept up to date and evidence must be available to show how staff are supporting service users to meet their individual goals. Service users activities must be consistently and clearly recorded in one place to ensure a clear record of activities is maintained. A mini-bus would benefit service users to access the community more effectively. Service users appointments need to be clearly recorded with outcomes on one identified form to ensure their medical needs are being clearly monitored. Service users weight charts need to be kept up-to-date to ensure effective records are maintained. The up-to date adult protection procedure must be available in the home at all times to ensure that the procedures are accessible to staff. The shower door must be fixed to ensure it is safe for service users to use. The shower must be altered to ensure that the occupational therapists requirements in the report are undertaken to ensure the shower is fully accessible and safe for all service users. The dish -washer must be replaced to ensure that all equipment being used in the home is effective.

CARE HOME ADULTS 18-65 Parkcare Homes (No 2) Ltd (Alexandra Road) 17 Alexandra Road Enfield Middlesex EN3 7DD Lead Inspector Wendy Heal KeyUnannounced Inspection 30th October 2006 11:00 Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V317811.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 Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V317811.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. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V317811.R01.S.doc Version 5.2 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 8804 6518 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) Craegmoor Homes Ltd Mr Arthur Snelson Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V317811.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd February 2006 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 smallenclosed 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. The purpose and function document and last inspection report are available to be viewed at the entrance of the home and in the staff office. The fees range from £700.00 - £1200.00 per week. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V317811.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and took place as part of the inspection programme. Compliance was checked against key standards and took approximately 7 hours. The inspector undertook a tour of the building and spoke with service users. The inspector spoke with members of the staff team. The inspector gained further information by an inspection of the documentation kept in the home, including care plans and health and safety documentation. The deputy manager assisted the inspector throughout the day but was not able to provide all of the documents required. The inspector would like to thank the service users present during the inspection, the deputy manager and staff for their openness and participation. What the service does well: What has improved since the last inspection? Food stored in the fridge is correctly labelled and shows the date of opening which safeguards the health and wellbeing of service users. The sofa in the lounge has been replaced to ensure that all of the service users living in the home can be accommodated with regard to seating arrangements in comfort. The identified bedrooms have now been redecorated to enable the new service users to have appropriate personal space. The ceiling in the identified service users bedroom and the light has been investigated to ensure it is safe. The flooring in the shower room has been replaced by non-slip flooring to safeguard service users safety. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V317811.R01.S.doc Version 5.2 Page 6 The ground floor toilet has had the pipe replaced to meet health and safety requirements. Hot air dryers have been placed in bathroom and toilets to minimise the risk of infection to service users and staff. The home now has a permanent deputy manager in post, which ensures consistency for service users and staff. 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. The summary of this inspection report can be made available in other formats on request. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V317811.R01.S.doc Version 5.2 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 Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V317811.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,5, Quality in this outcome area is poor. The judgement has been made using available evidence including a visit to the service. Service users do not all have the information they need to make an informed choice about where they want to live, as the document is not fully accessible to all service users. Detailed assessments are undertaken prior to service users being placed in the home, which assists staff to fully meet service users needs. Each service user does not have an up-to date contract of terms and conditions, which means they do not know what to expect and vice versa which does not ensure service users rights are respected. EVIDENCE: Since the previous inspection there have been six new admissions to the home these service users have moved from another home within the organisation, which has closed. Alexandra Road has a service user guide which needs to be updated to ensure it is more service user friendly and needs to indicate if it can be translated and Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V317811.R01.S.doc Version 5.2 Page 9 be made available in Braille and audio to ensure that it is fully accessible to service users. A requirement has been made in relation to this. Service users do not all have an up-to date contract of terms and conditions as these contracts refer to their previous place of residence. The service users contract and terms and conditions must be fully updated which includes them being signed and dated by the individual service user or their representative and the manager of the home to ensure the service users rights are respected. A requirement has been made in relation to this. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V317811.R01.S.doc Version 5.2 Page 10 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): 6,7,9,10 Quality in this outcome area is adequate. This judgement has been made using evidence available including a visit to this service. Not all service users care plans are being kept up-to-date. There are identified goals but these are not all being acted upon evidence is not being made available to show how staff are supporting individual service users to ensure their needs are met. Service users make decisions about their lives with assistance, which empowers them. Service users are supported to take risks, which assists them to develop their independence. Service user information is handled appropriately which means service user confidentiality is respected. EVIDENCE: Service users care plans were seen which were clear to read but were not all being kept up-to-date. One service user who has identified within their care plan that when they listen to audio books their comments are noted by staff in a separate individual book as to their reactions to the books read. However when the inspector requested to see evidence of this book the deputy manager informed the inspector that this stopped taking place some time ago. Another Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V317811.R01.S.doc Version 5.2 Page 11 service user has information noted within the care plan referring to the fact that this particular service user cooks on a particular day and must be consulted with regard to what she wishes to be done with the finished product. The care plan states that staff must obtain feedback after each session, which is to be recorded. The inspector could not be provided with this documentation on the day of the inspection. It is also noted that a colouring session takes place with the same identified service user but no evidence could be provided to the inspector of this having been recorded on the day of the inspection. The care plans the inspector examined were detailed, and contained goals, as referred to above but there must be documented evidence to confirm these goals are being acted upon. A requirement has been made in relation to this. The service users care plans must also be kept up-to-date. A requirement has been made in relation to this. The care plans were informed by current risk assessments. The inspector noted evidence on service user files that there are guidelines for staff in relation to managing identified areas of service users challenging behaviour, which ensures that staff are being provided with appropriate information to allow them to support service users who have challenging behaviour. The inspector saw evidence of monthly service user meetings taking place, which means that service users are provided with a forum to express their views. The inspector saw evidence that the service users had been asked if they would like a Halloween party and what food would they like to eat they chose finger food, pumpkin soup, sandwiches and ice cream. The service users were asked what they would like to wear face - masks, cloaks, or face paints. Service user information is handled appropriately. The main files are kept in the office and information stored on the computer is accessed by a password, which protects service users confidentiality. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V317811.R01.S.doc Version 5.2 Page 12 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): 12,13,14,15,16,17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are getting a good quality of life because of the established links with the local community. However the record of activities is not recorded in a consistent or effective way to ensure easy access of this information. The opportunity for service users to access activities outside the home is being limited due to the fact that Alexandra Road has no minibus to ensure that service users needs are met in the most effective and cost efficient way in relation to their specific needs. Service user contact with their family is promoted which benefits their emotional wellbeing. Service users benefit from balanced meals. EVIDENCE: Service users activity records were inspected which are specific to individual service users. One particular service user has his likes and dislikes identified for example he likes listening to music and audio books. The documentation identifies what alternative action is to take if the service user is not happy and does not want to take part in music and movement, which ensures his individual wishes are respected. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V317811.R01.S.doc Version 5.2 Page 13 Service users undertake day care activities. One service user undertakes day care activities at college and is supported with sessions such as skills for life. Service users undertake a movement and dance session at the home, which is undertaken by an independent teacher. A musician also comes to the home and plays 60’s 70’s music he is flexible in relation to the activities provided depending on what service users like. Staff also support service users to undertake activities in the community for example the inspector saw evidence that service users went out with staff to have lunch which ensures service users social skills are developed. However these activities were difficult to identify, as the activities were not clearly recorded on one document the inspector was shown a number of documents but these were all only partly completed. A requirement has been made in relation to this. The opportunity for service users to maximise their enjoyment of external activities and personal choice are still not being maximised due to the fact that Alexandra Road still does not have access to its own means of appropriate transport. The inspector is disappointed that the organisation did not give due consideration to obtaining appropriate transport as this was a requirement made in the previous inspection which has not been met and is restated. The inspector is concerned that service users did not have a holiday in 2005 due to difficulties with practical arrangements. The manager had researched a holiday for 2006 however not all of the service users took part in this as the identified destination and accommodation did not suit their needs. The inspector would like the manager to investigate appropriate opportunities for all service users to go on a holiday. A good practice recommendation has been made in relation to this. Service users have regular contact with their relatives, which benefit their emotional wellbeing. Service users also have contact with friends in other local homes and the inspector saw evidence that service users had been invited to one of these homes for a Halloween party, which further develops their social interaction. On the day of the inspection the kitchen was clean and tidy, which benefits the health and safety of service users and staff. The menu of food available was wholesome and nutritious which ensures the service users dietary needs are being met which, further benefits their health and wellbeing. The service keeps a record of the food that service users have actually eaten which ensures their individual dietary requirements can be monitored. The fridge and fridge freezer were inspected and all food was identified as being within its use by date and properly labelled which ensures that service users are not eating food that could be harmful to their health. Service users benefit from a mixed staff team who bring a range of different ideas to the home in terms of food preparation. This benefits service users as Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V317811.R01.S.doc Version 5.2 Page 14 they have access to different types of food than they may otherwise experience. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V317811.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20, Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users receive support in a way they require and prefer which means their rights are being respected. Service users have access to the necessary health care appointments which means their health needs are being monitored. However one service user required a dental appointment to be followed up and this had not taken place, which means that this service users’ needs were not fully met. Not all service users weight charts are being kept up-to-date which is not beneficial to their health. The recording of medical information is not being completed in a consistent way and in detail, which does not assist good communication. The service users are protected by the homes policies and procedures for dealing with medicines. EVIDENCE: The service users health records were inspected. Service users do have access to specialist and primary health care when required. The inspector saw evidence of appointments, with the GP, chiropodist, district nurse neurologist, optician, psychiatrist and dentist. One service user required a dental appointment to be followed up and the inspector could see no evidence that this had taken place. A requirement has been made in relation to this. Appointments were not all clearly recorded with outcomes. The health planner Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V317811.R01.S.doc Version 5.2 Page 16 was not fully completed and information was not recorded fully in one place as some staff are writing information on the health planner and other staff were recording this information on the medical contact sheet. Medical appointments and outcomes must be fully recorded on one document. A requirement has been made in relation to this. The service users weight chart were not being kept up to date which means their weight gain or loss is not being monitored which is important with regard to service users health and wellbeing. A requirement has been made in relation to this. The home has appropriate policies and procedures regarding the administration of medication which safeguards service users and staff from error taking place, which would put service users health at risk. Service users were appropriately dressed at the time of the unannounced inspection, which assists them to have a positive self- image. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V317811.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23, Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Service users cannot be fully protected from abuse, neglect and self-harm as the necessary procedures are not available in an identified place for staff to access to ensure adequate procedures are followed. 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 seen in the service users folder kept in their room. Which, ensures that information regarding the complaints procedure is accessible to all. The inspector examined the record of complaints and noted that no complaints were recorded since the last inspection. The inspector spoke with the deputy manager in relation to the adult protection procedures and the provider organisations adult protection policy. This was seen at the last inspection. However the inspector has made a requirement in relation to this due to the fact that two separate members of staff one being the deputy manager could not locate these documents. The adult protection policy had not been updated since 2002 and a requirement was made for this to be updated at the last inspection this requirement has been restated. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V317811.R01.S.doc Version 5.2 Page 18 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, 25, 26,27,30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Service users benefit from recent improvements in the environment. However further maintenance is required is required to ensure that Alexandra Road is homely and safe. Service users bedrooms suit their needs and lifestyles and promote their independence. Service users bathrooms do not meet their needs and allow them maximum independence, as there is a shower, which is not accessible to all service users. The home is clean and hygienic which benefits service users and staff. EVIDENCE: Alexandra Road has increased service user numbers from four service users to ten service users. The number of sofas has been increased to ensure that the needs of this increased number of service users has been met to enable them to sit in comfort. The service users bedrooms have been decorated before the new service users occupied them. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V317811.R01.S.doc Version 5.2 Page 19 Service users moving into the home have had the combined units removed from the vacant bedrooms, which has enabled the new service users bedrooms to be personalised with their own items. The bedroom opposite the kitchen has had the ceiling investigated as there previously was cracking that was evident. The light has also been investigated to ensure it is safe which ensures the health and safety of service users and staff is protected. The carpet tiles in the shower room were loose have now been replaced with an appropriate non slip flooring which means they are no longer a potential health and safety hazard to service users. One of the two sinks in the shower room has been removed which has improved the amount of space available to service users. The downstairs toilet that had a pipe leading from it that was exposed on the exterior area of the tiled wall that appeared ready to break if grabbed by a service user has been made safe which ensures that the wellbeing of service users is safeguarded. Hot air dryers have been placed in some bathrooms, which minimises the risk of infection for service users and staff. The inspector was disappointed to see that appropriate professionals were not consulted in relation to the layout, adaptations and necessary equipment required before the service users moved into the home as requested by the inspector at the previous inspection. The Occupational therapists were consulted after the service users moved into the home once more at the inspector’s request. The shower has been updated but does not meet the specified occupational therapists requirements. The shower still does not meet the specific needs of one particular service user. A requirement has been made in relation to this. On the day of the inspection the shower door was hanging off and was not safe for service users to use. An immediate requirement was issued. On the day of the inspection the inspector was informed that the manager is in the process of obtaining a new fridge freezer, which will ensure there is no risk to service users health. Also on the day of the inspection the dishwasher was broken. A requirement has been made in relation to this. The home was clean and tidy throughout which protects the health and wellbeing of service users and staff. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V317811.R01.S.doc Version 5.2 Page 20 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): 32,34,35,36, Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are supported by qualified staff, which benefits service users. Service users are protected by the homes recruitment procedures from potential abuse. Staff are regularly supervised which ensures they have a consistent approach with service users. EVIDENCE: Since the previous inspection the manager has appointed a permanent deputy manager, which means that the current manager has been provided with support and assistance with the effective running of the home. Service users are protected by the homes recruitment policies and procedures all relevant documentation was in place, which included up-to-date CRB certificates and two references, which, ensures service users, are protected from potential abuse. Staff had undertaken training ranging from medication training, epilepsy and rectal diazepam, manual handling, non- violent crisis intervention, autism and fire marshal training which assists the further development of staff skills. A number of service users living at Alexandra Road have very individual communication needs, it is important that staff have the opportunity to Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V317811.R01.S.doc Version 5.2 Page 21 develop their communication skills on a regular basis. A requirement has been restated in relation to this. The inspector noted when inspecting staff training records that the identified staff need to update their training in relation to food hygiene and epilepsy training. The inspector was assured; by the deputy manager that there is rolling- programmes of training in place, which will ensure staff skills, are maintained. Staff supervision records were inspected. Staff supervision is taking place on a regular basis, which ensures that staff work with service users in a consistent way. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V317811.R01.S.doc Version 5.2 Page 22 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): 39, 41,42, Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users can be reasonably confident that their views underpin monitoring review and development within the home. The homes record keeping does not safeguard Service users best interests. Documentation needs to be provided to ensure that health and safety requirements are being met and health and safety is taken seriously by the home. EVIDENCE: A range of health and safety documentation was seen including a portable appliance- testing certificate valid until July 07, which ensures all electrical goods are checked by an electrician to ensure they met health and safety standards. An environmental health inspection took place on the 13/06/06. The current electrical certificate and any report outlining work that needs to be undertaken must be sent to the inspector’ as this documentation could not be provided to the inspector on the day of the inspection. A requirement has been Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V317811.R01.S.doc Version 5.2 Page 23 made in relation to this. The current gas certificate must be sent to the inspector’ as this could not be supplied to the inspector on the day of the inspection. A requirement has been made in relation to this. The registered person must ensure that all records in the home are properly organised and completed to enable ease of access to information as required. A requirement has been made in relation to this. The fire alarm system had been tested on the 24/10/06. A fire drill had taken place on the 3/10/06 and regular fire bell tests had taken place. The emergency lighting had been tested on the 24/10/06, which assists service users to be protected in the event of a fire-taking place. The Registered Manager must ensure that a certificate proving that identified work has been undertaken to the home’s water supply system to minimise the risk of legionella. A requirement has been restated in relation to this. The home has adequate quality assurance procedure. Quality assurance questionnaires are sent out and the feedback is then compiled into a report and actioned. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V317811.R01.S.doc Version 5.2 Page 24 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 2 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X X X 3 X 2 2 X Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V317811.R01.S.doc Version 5.2 Page 25 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. Standard YA1 Regulation 5 Requirement The Registered Person must ensure that the service user guide is updated and is fully accessible to service users. The Registered Person must ensure that service users contracts of terms and conditions are updated to reflect the new accommodation in which they now live. The Registered Person must ensure that service users care plans are kept up-to-date and the record of how staff supports service users to achieve their goals as recorded in the care plan is available for inspection. The Registered Person must ensure that there is a clear record of service users activities recorded on one document. The registered person must give due consideration to obtaining a minibus to ensure that service users needs are met. This requirement is restated from the previous inspection. Previous timescale of 01/06/06 was not met. DS0000010588.V317811.R01.S.doc Timescale for action 12/03/07 2. YA5 5 (1c) 12/01/07 3. YA6 15 28/12/06 4. YA41 17 20/01/07 5. YA32 23 (2) (C) 10/04/07 Parkcare Homes (No 2) Ltd (Alexandra Road) Version 5.2 Page 26 6. YA19 13 (1)(b) 7. YA23 13 (6) 17 (2) 8. 9. YA24 YA36 23(c) 18 (1) (c) 10. YA42 13 11. 12. YA42 YA42 13 13 (4) The Registered Person must ensure there is a record of each service users medical appointments attended and the outcome of these appointments. The Registered Person must also ensure that the identified service user is supported to follow up their dental appointment. The Registered Person must review and up date the Adult Protection Procedure. The Registered Person must ensure they have the procedures in relation to the service users placing authorities and that these documents are kept in an identified place within the home. This requirement is restated from the previous inspection. Previous timescale of 01/06/06 was not met. The Registered Person must ensure that the broken dishwasher is replaced. The Registered Person must ensure that staff undertakes Makaton training. This requirement is restated from the previous inspection. Previous timescale of 01/04/06 was not met. The Registered Person must ensure that the identified staff up date their food hygiene training. The Registered Person must ensure that the identified staff updates their epilepsy training. The Registered Person must ensure that a satisfactory electrical installations certificate is sent to the CSCI area local office. The Registered Person must also ensure that a certificate proving the identified work to the homes water supply system has been undertaken to DS0000010588.V317811.R01.S.doc 20/01/07 20/01/07 10/03/07 10/03/07 15/03/07 15/03/07 10/12/06 Parkcare Homes (No 2) Ltd (Alexandra Road) Version 5.2 Page 27 minimise the risk of legionella. 13. YA27 23( 2) The registered person must 20/01/07 ensure that occupational therapist is consulted and the requirements in her report are acted upon in relation to the layout and adaptations required in the shower room in the home, to ensure that service users needs are met. The register person must ensure 01/11/06 that the shower door is made safe to ensure it is safe for service users to use. Immediate requirement. The registered person must 10/02/07 ensure that all records in the home are properly organised and completed to enable ease of access to information as required. 14. YA27 13 (4) 15. YA41 17 (3) 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 YA14 Good Practice Recommendations The registered person should ensure that all of the service users at Alexandra Road experience a holiday in 2007. Parkcare Homes (No 2) Ltd (Alexandra Road) DS0000010588.V317811.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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. 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