Inspection on 01/12/05 for Parkcare Homes (No 2) Ltd (Devonshire Road)

This inspection was carried out on 1st December 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 found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Parkcare Homes (No 2) Ltd... 18/09/07

Parkcare Homes (No 2) Ltd... 05/04/06

Parkcare Homes (No 2) Ltd... 04/05/05

Parkcare Homes (No 2) Ltd... 11/01/05

Parkcare Homes (No 2) Ltd... 21/05/04

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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 (Devonshire Road) 43 Devonshire Road London N13 4QU Lead Inspector Wendy Heal Unannounced Inspection 09:00 1 December 2005 st Parkcare Homes (No 2) Ltd (Devonshire Road) DS0000010589.V261376.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 (Devonshire Road) DS0000010589.V261376.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 (Devonshire Road) DS0000010589.V261376.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Parkcare Homes (No 2) Ltd (Devonshire Road) Address 43 Devonshire Road London N13 4QU 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) 01992 309318 Craegmoor Homes Ltd Mr Brian Hughes Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Parkcare Homes (No 2) Ltd (Devonshire Road) DS0000010589.V261376.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th May 2005 Brief Description of the Service: Devonshire Road is a home for six young adults with a learning disability. The home was first registered in October 1991. Parkcare Homes Limited, which is a subsidiary of Craegmoor Healthcare Limited, manages the home. Whilst the home is registered for six young adults, one of the bedrooms could be shared but currently is occupied by one resident. At the time of the inspection there were five residents living at the home. The home is a terraced house located a short walk from the shops at Palmers Green. There is one bedroom on the ground floor and four bedrooms on the first floor. There is a bathroom and separate shower room on the first floor. There is a small garden at the rear of the house. The staff team consists of a manager, deputy manager and a team of care staff. The residents access local community facilities and the home has a people carrier vehicle to support these activities. Parkcare Homes (No 2) Ltd (Devonshire Road) DS0000010589.V261376.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over six hours and was an unannounced inspection. A tour of the premises took place and staff and care records were inspected. The inspector met and spoke with all residents and all staff on duty. The staff spoke freely with the inspector and provided the inspector with all of the information required. The inspector wishes to thank the manager, deputy manager, staff and residents for their co-operation during the inspection. What the service does well: What has improved since the last inspection? What they could do better: The home would benefit from having a planned schedule of improvements in relation to the home environment on an ongoing basis. Some environmental tasks need to be completed in relation to painting and decorating and replacing flooring. The kitchen door needs to be replaced. The quality assurance review needs to be completed. The outstanding tasks in relation to UK Fire risk Parkcare Homes (No 2) Ltd (Devonshire Road) DS0000010589.V261376.R01.S.doc Version 5.0 Page 6 assessment needs to be completed. The certificate to confirm the boiler meets current standards needs to be obtained and sent to the CSCI area local office. 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 (Devonshire Road) DS0000010589.V261376.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 Parkcare Homes (No 2) Ltd (Devonshire Road) DS0000010589.V261376.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 5 Residents are given the information they need to make an informed choice about whether the service is suitable for them and their needs. The admissions process is working well and prospective residents are introduced in an appropriate manner to the home. Residents can be confident that their needs can be met. This standard was met. EVIDENCE: Four residents files were inspected. They contained copies of completed contracts between the home and the residents. There was a format that was clear and specified the terms and conditions of the home, including a notice period. The contracts were signed by the residents. The home has an up to date purpose and function document. Residents files contained assessment information and are being reviewed on a regular basis. The care plans of residents whose needs have changed have been amended to reflect changing need. This was a requirement made at the previous inspection. The manager and staff interviewed showed they had a good understanding of individual residents needs and could talk in detail in relation to their role. The residents spoke very positively in relation to staff and the support they Parkcare Homes (No 2) Ltd (Devonshire Road) DS0000010589.V261376.R01.S.doc Version 5.0 Page 9 received from them. The staff were observed to be supporting residents in an appropriate manner, with a very person centred approach. Parkcare Homes (No 2) Ltd (Devonshire Road) DS0000010589.V261376.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 The service is good at enabling residents to make decisions for themselves about what they want to do and when they want to do it. The staff take calculated risks so that residents are helped to be as independent as possible. Residents benefit from having care plans which set out clearly and in detail how they wishes will be met by the service. This standard has been met. EVIDENCE: Residents case notes were inspected. Each resident has a named link worker. Staff interviewed knew the residents well and were aware of their needs and wishes. Residents had satisfactory care plans. The care plans were based on their current and changing needs. There is evidence that they were regularly reviewed. The plans contained goals. There was evidence that the plans were being followed. One resident who takes inappropriate items from the bathroom are subsequently removed from her bedroom as agreed in her care plan. In addition, due to her personal and behavioural needs, she had been allocated the use of her own bathroom and toilet. A range of risk assessments informed the plans. In response to one resident’s risk assessment, he had been provided with his own en suite shower and toilet to limit the danger that accessing the stairs to use the main bathroom would cause. Where residents Parkcare Homes (No 2) Ltd (Devonshire Road) DS0000010589.V261376.R01.S.doc Version 5.0 Page 11 have complex behaviours there were guidelines in place about how the residents should be supported with these individual needs. Residents meetings to discuss issues relating to the service do take place. A good practice recommendation has been made in relation to residents meetings. Residents demonstrated that they can make decisions and choices about their daily lives. On the day of the inspection one resident who works at the hairdressers returned to the home and stated how she wanted to spend the money she had earned and when to do this. One resident attends college and showed the manager and inspector pottery items that she had made and subsequently made the decision to give these items as gifts to relatives. The inspector particularly liked the fact that residents were encouraged to take part in all aspects of “their home”. One resident was encouraged to answer the telephone whilst the inspector was in conversation with the manager, which the resident did appropriately. Parkcare Homes (No 2) Ltd (Devonshire Road) DS0000010589.V261376.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17 Residents are supported to develop individual skills within the home and are provided with support to broaden the activities they participate in within the community. EVIDENCE: Two residents attend college to cover areas like literacy, pottery, cookery and art. One resident works at a hairdressers two hours per week and the inspector observed her full enjoyment in relation to this. Another resident showed the inspector examples of her achievements at college (pottery items). One resident is due to undertake activities at a resource two days per week, which will cater for his particular needs and interests e.g. music. The inspector was pleased to observe the efforts that had been made in relation to improving activities for the residents. One the day of the inspection, the inspector witnessed a conversation with another professional in relation to arrangements which are being made for one particular resident in relation to new day care arrangements which would particularly take into account his sensory needs. Parkcare Homes (No 2) Ltd (Devonshire Road) DS0000010589.V261376.R01.S.doc Version 5.0 Page 13 One resident who is Jewish is in the process of attending a social activity on a Wednesday evening with other Jewish residents. One resident who does not attend college and will not go out at present chooses to spend her time developing her domestic skills and accessing local community facilities. The inspector spoke at length to residents and staff. The residents were able to describe how they are supported to help with domestic activities e.g. doing the laundry, preparing snacks. The staff explained how residents with high needs are encouraged to increase their skills. One resident is being encouraged to use more words to develop his communication. A record of activities was inspected. The residents are being supported to access a wide range of community based activities which now appears to be more appropriately linked to the individual needs and preferences. This was a requirement made at the previous inspection. Staff were observed knocking on residents doors before entering bedrooms. There was evidence of mutual respect between staff and residents. Residents were observed sharing jokes with staff. The residents were able to discuss their meals and how they shopped for local produce. On the day of the inspection it had been agreed the residents would eat out for lunch and this took place. A record of food consumed showed that meals are healthy and nutritious. Devonshire Road has its own vehicle to assist with community activities and transport to college. Parkcare Homes (No 2) Ltd (Devonshire Road) DS0000010589.V261376.R01.S.doc Version 5.0 Page 14 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 Residents are supported to access the necessary health care appointments and personal support is provided. Where residents refuse to attend health appointments, risk assessments have been completed. EVIDENCE: It was observed that during the inspection residents were supported with their personal care if required. The residents were supported in an appropriate manner. One resident had a discussion with a staff member in relation to her recent haircut and how she plans to have it done on her next visit. This resident now also attends a community facility to have her nails manicured. One resident who has experienced a reduction in his mobility has received a wheelchair to meet his specific needs. The record of healthcare appointments for each resident was inspected. These showed they are being supported to receive their individual healthcare checks. Where residents refuse optical checks, there is now an appropriate risk assessment in place. This was a requirement made at the previous inspection. Parkcare Homes (No 2) Ltd (Devonshire Road) DS0000010589.V261376.R01.S.doc Version 5.0 Page 15 One resident who has refused to undertake dental checks for the last two years, now attends a dentist. It was noted on the day of the inspection that where there are concerns re a residents healthcare needs, these are acted upon quickly. One the day of the inspection a professional arrived to discuss a residents needs. The medication and administration records were inspected which were found to be in order. Staff have received medication training. The residents case notes were inspected and included a record of the residents and relatives wishes in the even of their death. Parkcare Homes (No 2) Ltd (Devonshire Road) DS0000010589.V261376.R01.S.doc Version 5.0 Page 16 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 Residents can feel that their views are listened to and acted upon and can be confident that they will be protected from abuse and self-harm. EVIDENCE: The record of complaints was inspected and there have been no complaints since the previous inspection. Staff are now undertaking adult protection training. The residents’ case records were inspected and a record of how they are supported to manage their personal finances was clearly recorded. This was a requirement made at the previous inspection. Parkcare Homes (No 2) Ltd (Devonshire Road) DS0000010589.V261376.R01.S.doc Version 5.0 Page 17 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, 28, 29 Residents would benefit from improvements in the environment to ensure the home is homely, comfortable and safe. EVIDENCE: The home is a terraced house and is in keeping with surrounding premises. The home is clean. The home provides access to local amenities including shops, parks and public transport. Each resident has a single bedroom and these were appropriately furnished. One resident has his own shower and toilet, which has been provided as a result of his risk assessment. There is a bathroom and separate shower room on the first floor. The bathroom needs to be updated. A requirement has been made in relation to this. The shower room is currently being updated. There is a small lounge, dining room and kitchen on the ground floor, which is appropriately furnished. The kitchen needs to be repainted. A requirement has been made in relation to this. The home also has a small utility room on the ground floor, which needs to be redecorated and the flooring replaced. A requirement has been made in relation to this. Parkcare Homes (No 2) Ltd (Devonshire Road) DS0000010589.V261376.R01.S.doc Version 5.0 Page 18 The office is currently in the process of being painted and the carpet replaced. The home has a small, enclosed garden which has tables and chairs to allow residents to sit outside. The inspector noticed the following maintenance tasks outstanding. One resident has holes in her bedroom wall. This must be repaired. The cracks on the right hand side of the street door must be repaired. The back door of the kitchen leading to the garden must be replaced. Requirements have been made in relation to all of the above. Parkcare Homes (No 2) Ltd (Devonshire Road) DS0000010589.V261376.R01.S.doc Version 5.0 Page 19 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 The home has a stable and effective staff team and the necessary recruitment documentation is in place to protect residents. EVIDENCE: The staff rota was inspected. A good practice recommendation has been made in relation to this. The staff team is very stable and there are adequate numbers of staff in the home to meet the needs of residents. Staff files were inspected. All staff had a Criminal Records Bureau check and two written references. They also had a copy of their terms and conditions. All staff files contained a copy of the staff members passport and, where appropriate, a record to show they have authorisation to stay in the country. These were requirements made at the previous inspection. The records of staff meetings were inspected and these take place every two to three months. Each member of staff has an individual staff training record and an ongoing training programme is in place. The staff records show that staff had completed the required training. The manager has completed his NVQ4 and Registered Managers Award. The deputy is undertaking NVQ4. team members are undertaking NVQ2 and NVQ3. Training is taking place to support Parkcare Homes (No 2) Ltd (Devonshire Road) DS0000010589.V261376.R01.S.doc Version 5.0 Page 20 the staff to meet the needs of specific residents in relation to dementia, epilepsy and mental health. The staff supervision records were inspected and staff receive regular supervision and appraisal. Parkcare Homes (No 2) Ltd (Devonshire Road) DS0000010589.V261376.R01.S.doc Version 5.0 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 41, 42, 43 The home is well managed. Appropriate health and safety measures need to be in place and the quality assurance audit needs to be fully completed. EVIDENCE: The home has a permanent registered manager who has the appropriate skills and experience and provides professional leadership to the service. The quality assurance system has been implemented. Questionnaires have been sent to residents, relatives and care professionals on several occasions. Not all responses have been received. The responses will need to be collated to prepare an action plan. A requirement has been made in relation to this. Staff training records were inspected. Staff had received training on fire safety, food hygiene, first aid and moving and handling. The necessary certificates were available to confirm the gas system, electrical system, water system and fire appliances had been serviced. The record of smoke detectors and fire drills indicates that these were taking place as Parkcare Homes (No 2) Ltd (Devonshire Road) DS0000010589.V261376.R01.S.doc Version 5.0 Page 22 required. The business plan was seen. The insurance certificate was inspected along with the registration certificate, which was in order. The UK Fire risk assessment states that an additional detector is required in the office/sleep-in room and an additional CO2 extinguisher is required outside the office. The boiler must be rectified to show that it meets current standards. An immediate requirement was made in relation to this. Parkcare Homes (No 2) Ltd (Devonshire Road) DS0000010589.V261376.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 X 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 2 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 3 3 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 3 3 2 X 3 2 3 Parkcare Homes (No 2) Ltd (Devonshire Road) DS0000010589.V261376.R01.S.doc Version 5.0 Page 24 Are there any outstanding requirements from the last YES 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 YA24 YA24 Regulation 23 (2)(a) 23 (2)(b) Requirement The registered manager provider need to ensure bathroom is updated. The registered manager provider need to ensure kitchen is painted. and that the and that the Timescale for action 15/04/06 15/02/06 The utility room must be painted and the flooring replaced. The hole in the wall of the identified resident’s bedroom must be repaired. The registered manager and provider need to ensure that the cracks on the right hand side of the street door are repaired. The back door to the kitchen must be replaced. The information obtained from the quality assurance review must be compiled into a report. The registered manager and provider need to ensure that all recommendations outlined by UK Fire in their latest risk assessment need to be completed. The additional detector and CO2 extinguisher DS0000010589.V261376.R01.S.doc 3 YA24 23 (2)(b) 01/03/06 4 5 YA39 YA42 24 (1)(b) 24 (4)(v) 30/01/06 15/02/06 Parkcare Homes (No 2) Ltd (Devonshire Road) Version 5.0 Page 25 must be obtained. 6 YA42 23 (2)(c) Immediate Requirement. The registered manager and provider need to ensure that the certificate to confirm that the boiler meets the required standard is obtained and sent to the local CSCI area office. 08/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA38 Good Practice Recommendations The manager should ensure that the residents’ meeting is expanded to include other areas of interest and try to highlight the areas where the residents have increased their involvement within the home. The manager needs to show more clearly staff shift times on the rota with full names including the staff member on call. 2 YA37 Parkcare Homes (No 2) Ltd (Devonshire Road) DS0000010589.V261376.R01.S.doc Version 5.0 Page 26 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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