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Inspection on 30/04/08 for Parkcare Homes (No 2) Ltd (Roseneath Avenue)

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

This inspection was carried out on 30th April 2008.

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 16 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

The staff at Roseneath have a good understanding of people`s needs. People do access community activities, which enriches their lives. The manager has now completed the necessary interviews and is a registered manager, which will improve the quality of care, provided to the people living in the home.

What has improved since the last inspection?

One persons care plan now indicates how their day is structured and how he/she is being encouraged to take part in key worker meetings. This assists them to feel secure and valued. One person has information regarding their date of birth accurately recorded in their care plan. This ensures accurate information is available to the staff supporting and working with the person. This improves their quality of life. Two people who are involved in a relationship now have a document, which is a monitoring form. This is to be used to monitor when they meet and how their privacy and dignity is respected. This ensures their rights are respected to some degree. (See what the service could do better) Two people`s bedroom carpets have been replaced. This provided them with a pleasant bedroom to relax in. There are now clear records in relation to fire procedures within the home. This safeguards people`s health and wellbeing.

What the care home could do better:

The service user guide needs to be updated. This will ensure that people are provided with the most up-to-date information about the home. The care plans have improved greatly but would improve further if all specific areas of the care plan contained completed detailed information. This would ensure people`s needs were fully met. The couple that are involved in a relationship need to have a fully completed document that monitors the times when they meet and indicate how their dignity and privacy is respected. To ensure their rights are acknowledged. People`s health care appointments need to be effectively recorded and indicate the outcome of appointments attended. All health care appointments including dental appointments need to take place. This will ensure people`s health and wellbeing is promoted. People`s health action plans need to be kept up to date and indicate when they have been reviewed. People`s weight charts need to be kept up to date. This will ensure that people`s weight monitoring programme is being effectively managed. The identified person`s epilepsy chart needs to provide enough space for people to document information so that it can be clearly read. There must be an identified space were staff can sign the document and it must be dated. This will ensure effective recording is in place. This will ensure the person`s health can be effectively monitored. The procedure for administering and recording medication needs to be correct to ensure people`s health is safeguarded. The list to indicate who administers medication needs to be up to date to ensure professional practice is followed. One identified person needs a form developed that will provide the necessary information that professionals have requested. This will ensure the person`s health is monitored to ensure their specific needs can be met.A copy of the adult protection policy in relation to the relevant placing authorities and protection procedures needs to be obtained or available for inspection if they are in the home. This will ensure the people working in the home are fully informed and able to protect the people living in the home from potential abuse. One identified person`s bedroom carpet needs to be replaced, their bedroom needs to be decorated, a new bed obtained and the protected coating on their bedroom window replaced. This will ensure their privacy and dignity is respected. Microwaves need to be obtained to ensure that adequate equipment is provided in the home to ensure people`s needs are met. A towel dispenser needs to be available in the kitchen fixed to the wall to ensure hygienic standards are maintained. Magnetic closures need to be fitted to specific fire doors and one fire door needs to be replaced to ensure people live in a safe environment. A deputy manager needs to be appointed to assist the manager to effectively manage the home. This will improve the quality of care provided.

CARE HOME ADULTS 18-65 Parkcare Homes (No 2) Ltd (Roseneath Avenue) 15 Roseneath Avenue Winchmore Hill London N21 3NE Lead Inspector Wendy Heal Unannounced Inspection 30th April 2008 11:00 Parkcare Homes (No 2) Ltd (Roseneath Avenue) DS0000010592.V362058.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 (Roseneath Avenue) DS0000010592.V362058.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 (Roseneath Avenue) DS0000010592.V362058.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Parkcare Homes (No 2) Ltd (Roseneath Avenue) Address 15 Roseneath Avenue Winchmore Hill London N21 3NE 020 8292 2715 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) roseneath.ave@craegmoor.co.uk Parkcare Homes (No2) Ltd Theresa Simon Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Parkcare Homes (No 2) Ltd (Roseneath Avenue) DS0000010592.V362058.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th April 2007 Brief Description of the Service: The service provides twelve places for people with a learning disability. The age range of the people that live in the home is mid twenties to mid fifties. There are four female and five male adults living in the home. There is an ethnic mix of people in the home. All of the people living in the home have complex behavioural needs. Roseneath Avenue is located in a quiet residential street in Winchmore Hill. The home is a house converted into three flats each with its own bathroom, kitchen, and lounge/dining area. All of the people living in the home have their own bedrooms. The home has an office and small meeting room on the ground floor. There is an enclosed garden accessed by all the flats. There is also a communal laundry external to the home within the garden area. Only female staff supports the female occupants living on the ground floor flat. All staff rotate the support they provide to people living in the home. The stated aims of the service is to treat people 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 fees in the home range from one thousand four hundred pounds to one thousand five hundred pounds. Interested parties can access the homes Purpose and Function Document and inspection report as it is on display on the homes notice board. Parkcare Homes (No 2) Ltd (Roseneath Avenue) DS0000010592.V362058.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Quality rating for this service is (1 star) this means the people who use the service receive adequate outcomes. This was an unannounced inspection and took place as part of the inspection process. Compliance was checked against key standards and took approximately 8 hours. I undertook a tour of the building spoke with the people who live in the home and members of the staff team. I gained further information from the Annual Quality Assessment form, by an inspection of the documents kept in the home including care plans and health and safety documentation. The registered manager of the home was on training and the deputy manager position is vacant. The acting senior support worker offered their assistance throughout the period of the inspection. I would like to thank the people who use the service and the staff team for their openness and participation. What the service does well: What has improved since the last inspection? One persons care plan now indicates how their day is structured and how he/she is being encouraged to take part in key worker meetings. This assists them to feel secure and valued. One person has information regarding their date of birth accurately recorded in their care plan. This ensures accurate information is available to the staff supporting and working with the person. This improves their quality of life. Two people who are involved in a relationship now have a document, which is a monitoring form. This is to be used to monitor when they meet and how their Parkcare Homes (No 2) Ltd (Roseneath Avenue) DS0000010592.V362058.R01.S.doc Version 5.2 Page 6 privacy and dignity is respected. This ensures their rights are respected to some degree. (See what the service could do better) Two people’s bedroom carpets have been replaced. This provided them with a pleasant bedroom to relax in. There are now clear records in relation to fire procedures within the home. This safeguards people’s health and wellbeing. What they could do better: The service user guide needs to be updated. This will ensure that people are provided with the most up-to-date information about the home. The care plans have improved greatly but would improve further if all specific areas of the care plan contained completed detailed information. This would ensure people’s needs were fully met. The couple that are involved in a relationship need to have a fully completed document that monitors the times when they meet and indicate how their dignity and privacy is respected. To ensure their rights are acknowledged. People’s health care appointments need to be effectively recorded and indicate the outcome of appointments attended. All health care appointments including dental appointments need to take place. This will ensure people’s health and wellbeing is promoted. People’s health action plans need to be kept up to date and indicate when they have been reviewed. People’s weight charts need to be kept up to date. This will ensure that people’s weight monitoring programme is being effectively managed. The identified person’s epilepsy chart needs to provide enough space for people to document information so that it can be clearly read. There must be an identified space were staff can sign the document and it must be dated. This will ensure effective recording is in place. This will ensure the person’s health can be effectively monitored. The procedure for administering and recording medication needs to be correct to ensure people’s health is safeguarded. The list to indicate who administers medication needs to be up to date to ensure professional practice is followed. One identified person needs a form developed that will provide the necessary information that professionals have requested. This will ensure the person’s health is monitored to ensure their specific needs can be met. Parkcare Homes (No 2) Ltd (Roseneath Avenue) DS0000010592.V362058.R01.S.doc Version 5.2 Page 7 A copy of the adult protection policy in relation to the relevant placing authorities and protection procedures needs to be obtained or available for inspection if they are in the home. This will ensure the people working in the home are fully informed and able to protect the people living in the home from potential abuse. One identified person’s bedroom carpet needs to be replaced, their bedroom needs to be decorated, a new bed obtained and the protected coating on their bedroom window replaced. This will ensure their privacy and dignity is respected. Microwaves need to be obtained to ensure that adequate equipment is provided in the home to ensure people’s needs are met. A towel dispenser needs to be available in the kitchen fixed to the wall to ensure hygienic standards are maintained. Magnetic closures need to be fitted to specific fire doors and one fire door needs to be replaced to ensure people live in a safe environment. A deputy manager needs to be appointed to assist the manager to effectively manage the home. This will improve the quality of care provided. 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 (Roseneath Avenue) DS0000010592.V362058.R01.S.doc Version 5.2 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 (Roseneath Avenue) DS0000010592.V362058.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2, People who use the service receive an adequate outcome in this area. This judgement has been made using available evidence including a visit to this service. People do not have all of the information they need to make an informed choice about whether the service is suitable for them and their needs. The service has not completed any new assessments regarding people’s aspirations and needs as no new admissions have been made to the home since the previous inspection. EVIDENCE: Since the previous inspection there have been no new admissions to the home. I looked at the statement of purpose, which has been updated, which ensures that accurate information is available in relation to this document about the service for those people who need it. However the service user guide needs to be updated, as it does not contain the up to date information with regard to the current staff team that are working in he home. This does not provide people who are living in the home or may wish to move into the home with accurate information to assist them to know who the people are who will be supporting them with regard to their care. At the time of the inspection the service user guide and the last inspection report were not available for inspection on the homes notice board. I was provided with a service user guide taken from a person’s individual file. Not all of the people’s files contained a service user guide this does not ensure the documents are fully accessible to people who may wish to view them. Parkcare Homes (No 2) Ltd (Roseneath Avenue) DS0000010592.V362058.R01.S.doc Version 5.2 Page 10 No new individual assessments had been completed due to the fact that no new people have moved into the home. Parkcare Homes (No 2) Ltd (Roseneath Avenue) DS0000010592.V362058.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9, People who use the service receive an adequate outcome in this area. This judgement has been made using available evidence including a visit to this service. The care plans need to contain all of the information in specific areas to ensure they are fully effective. People do make decisions about their lives, which, ensures their rights are respected. People are supported to take risks as part of an independent lifestyle. EVIDENCE: The registered manager has introduced person centred care plans. This ensures that care plans are more specific in relation to people’s needs. Care plans were inspected and are much more detailed than the previous documents. Some care plans still need to be fully completed with regard to particular areas of the care plan. The manager is in the process of ensuring this takes place with the assistance of the staff team. This will ensure that people’s specific needs can be fully met. One person who had incorrect details regarding their date of birth entered on their care plan now has this information correctly recorded. This ensures that Parkcare Homes (No 2) Ltd (Roseneath Avenue) DS0000010592.V362058.R01.S.doc Version 5.2 Page 12 accurate information is recorded on the care plan and no longer misinforms those people reading the document. One persons care plan indicates that they have a relationship with another person who lives at the home. One person in the relationship is currently unwell and the monitoring form used to indicate how these two people’s physical and emotional needs are monitored and documented is not adequate. Sufficient information is not being recorded. Staff do not always sign the document. (Staff should clearly write their name under the staff signature to ensure all parties can identify who has signed the document) This is an essential task given the persons ill health. This area of concern was discussed with the area manager and the registered manager of the home after the inspection. I have been assured that urgent action will take place to ensure that effective recording mechanisms are in place. This will safeguard the health and wellbeing of the people living in the home. Not all of the people living in the home have a freely available allocated key worker since the position of senior support worker and deputy manager has become vacant. The registered manager is attempting to act as key worker to ensure all necessary support is provided to the people living in the home. I discussed this topic with the registered manager. It was agreed that the appointment of staff to vacant post must take place as a matter of urgency. This will assist the manager to ensure the key worker system operates in a consistent way. (Please see staffing section.) The manager is working hard to ensure that peoples risk assessments are regularly reviewed and updated. This will ensure that identified risks are minimised in relation to people’s individual needs. Parkcare Homes (No 2) Ltd (Roseneath Avenue) DS0000010592.V362058.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17, People who use the service receive an adequate outcome in this area. This judgement has been made using available evidence including a visit to this service. People are supported to develop their individual skills within the home, which assists their independence. People are part of the community, which enriches their lives. However effective recording is not in place to indicate the extent to which activities are undertaken in line with the activity programme. People are supported to maintain appropriate relationships, which assists their emotional wellbeing. People are offered an adequate diet. However more choice needs to be indicated on the menu to ensure people’s cultural needs are met. EVIDENCE: At Rosneath Avenue the activity records were inspected. People undertake activities ranging from two days per week to five days per week. The home operates a system, which has two separate recording sheets one for community- based activities and one based on activities taking place within the home. Staff are not effectively recording activities that take place in adequate detail for the documents to reflect people’s daily achievements. Parkcare Homes (No 2) Ltd (Roseneath Avenue) DS0000010592.V362058.R01.S.doc Version 5.2 Page 14 I looked at the weekly activity programme. On the activity programme music therapy was due to take place. However this had not been recorded on the activity sheet and was not noted in the daily log. Where the activity programme specified lunch out and the daily log was checked the identified person had not gone out for lunch. One specific person had a date which been entered indicating that the person had gone to college but the date entered was the incorrect date. The person does not attend college on this particular date. Staff on shift also confirmed this. The home no longer has its own vehicle to assist people in relation to accessing the community. This is disappointing given some of the people living in the home do not use the bus or train due to the risks identified with regard to their particular needs. On the day of the inspection all of the kitchens in the individual flats were clean and tidy. The menu of food available was the same on all three menus for all of the people living in the individual flats. I have spoken with the manager who has agreed to review the menu of food available. This will to ensure that people’s individual cultural needs and choices are provided for by including more varied choice with regard to meals. Parkcare Homes (No 2) Ltd (Roseneath Avenue) DS0000010592.V362058.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, People who use the service receive an adequate outcome in this area. This judgement has been made using available evidence including a visit to this service. People receive personal care in a way they prefer and require, which ensures their individual rights and choices are respected. People’s physical and emotional health care needs are not being met due to ineffective recording. The process for recording and administering medication is not effective and does not promote good health. EVIDENCE: The record of people’s health care appointments for each person was inspected. They indicated that people are not being supported to receive all of their individual healthcare checks. This does not ensure people’s health is being fully monitored. Information is not always effectively recorded on the health record or noted on the daily recording sheet. One identified person did not have a follow up dental appointment recorded or any outcomes to suggest the action the dentist said needed to be taken had been completed. A consistent process with regard to the recording of information is not being used. People’s health action plans need to be fully up-to-date including the date when they are reviewed. This will ensure that accurate health care information is available to the people who need to access it. Parkcare Homes (No 2) Ltd (Roseneath Avenue) DS0000010592.V362058.R01.S.doc Version 5.2 Page 16 People’s weight charts were not all up–to date. This means their weightmonitoring programme is not being effectively followed. This does not ensure people’s health needs are fully met. Since the inspection the manager has confirmed that weight charts are now being completed effectively. People’s preferences in relation to how they wish their personal care to be provided are highlighted in their individual care plans. This means their individual choices are being respected. The epilepsy charts need to be improved and include a specific area to allow staff to sign the document. The chart also needs to allow a larger area for information to be recorded, as currently information is difficult to read. One the day of the inspection the medication administration records were inspected and staff had administered the medication but had not signed the medication administration record. This does not ensure that professional practice is followed. I contacted the area manager and informed her that effective recording was not in place with regard to the administration of medication. The manager of the home has informed me that the staff member was prevented from administrating medication. The staff member has now completed a competency test with regard to the administration of medication. This safeguards the people living in the home from further errors being made with regard to the recording of medication. The record of staff signatures highlighting who can administer medication must be up-dated. The current document includes a number of staff that no longer work for the organisation. This means that the document does not accurately reflect the current staff that can administer medication and this is not good practice. One identified person who currently has a medical condition, which means that the level of personal support that is required for this person may increase in future. I requested at the previous inspection that a professionals meeting take place to make sure that all the necessary support systems were in place. This would ensure this person’s needs could be met. However the person’s general practioner has informed the manager that this person does not require a professionals meeting to take place at this stage. It has been requested by medical professionals that this particular person is monitored with regard to their bowel movements. The information is then passed onto the appropriate health care professional. I could not locate any document recording this information. I have made the manager of the home and area manager aware of this situation. I have been informed by the manager that a document for recording this information is now in place. Given the fact that the area manager and manager have acted quickly with regard to the action needed. I have rated the section as adequate but Parkcare Homes (No 2) Ltd (Roseneath Avenue) DS0000010592.V362058.R01.S.doc Version 5.2 Page 17 improvements must been made to ensure the rating of the service does not decline. Parkcare Homes (No 2) Ltd (Roseneath Avenue) DS0000010592.V362058.R01.S.doc Version 5.2 Page 18 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 People who use the service receive an adequate outcome in this area. This judgement has been made using available evidence including a visit to this service. People are not fully protected from abuse neglect and self-harm as all of the required guidance with regard to the placing authorities adult protection policy and procedures are not available to the staff team. EVIDENCE: I examined the complaints book and no new complaints had been made since the previous inspection. The organisations whistle blowing policy was seen and found to be in order. This ensures that people have the necessary information to report any concerns in relation to professional practice within the home. This will benefit the people living and working in the home. There was no evidence of advocacy contracts or related information being available for the people living in the home, which does not benefit them if they require assistance when making a complaint. The senior person on duty located the adult protection guidelines for the organisation. This ensures staff have some of the information they need to protect people from potential abuse. The adult protection procedures in relation to the relevant placing authorities could not be made available at the time of the inspection. The documents need to be kept in an identified place. This will ensure that staff have all of the information they need to ensure people are protected from potential abuse. Parkcare Homes (No 2) Ltd (Roseneath Avenue) DS0000010592.V362058.R01.S.doc Version 5.2 Page 19 Parkcare Homes (No 2) Ltd (Roseneath Avenue) DS0000010592.V362058.R01.S.doc Version 5.2 Page 20 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, People who use the service receive an adequate outcome in this area. This judgement has been made using available evidence including a visit to this service. People are living in a homely environment but it is not safe which does not benefit people’s health and wellbeing. EVIDENCE: Roseneath Avenue is located in a residential street in Winchmore Hill near to local shops and public transport. The home is converted into three flats. I undertook a tour of the home with the assistance of the senior staff member on duty. I inspected people’s bedrooms and the premises having sought people’s permission. At the previous inspection it was identified that two of the people living in the home needed their bedroom carpet replaced. The bedroom carpets in both of these bedrooms have now been replaced. This ensures that these people are sleeping in a comfortable bedroom. Parkcare Homes (No 2) Ltd (Roseneath Avenue) DS0000010592.V362058.R01.S.doc Version 5.2 Page 21 At the previous inspection I identified that the middle floor bathroom smelt of damp. I have spoken with the manager of the service who has assured me that the maintenance man has investigated this and no damp was identified. One identified person needs a new bed to be obtained. This will ensure he/she has a comfortable bed to sleep in at night. The bedroom carpet needs to be replaced as it is worn and dirty and the bedroom needs to be decorated. This will ensure that the person lives in a clean homely environment. This identified person also needs the protective coating on their bedroom window replaced as it is worn and does not prevent people from looking into the bedroom. This does not ensure that the person’s privacy and dignity is respected. The manager informed me at the time of writing the report that the window covering has been replaced and the bed has been ordered. The kitchen door on the middle floor has had a whole made in the bottom of the fire door. This means that the door - stop does not prevent the door from opening completely and the door can rest flat against the wall when the door is open. The whole made in the door means the door is no longer an effective fire door as smoke can pass through it. This means that people’s health and safety is not promoted. The fire door to the lounge on the middle floor and the fire door in the ground floor hall that, leads to the garden was propped open with paper. The danger and risks this causes was discussed with staff at the time of the inspection and the paper removed. This practice impacts on everybody living and working in the home. I feel that magnetic door closures need to be fitted to the fire doors to ensure that people’s health and safety is protected. This concern has been discussed with the manager of the service. The manager is going to bring this concern to the attention of the area manager. The manager has confirmed that a request has been made in writing for the magnetic door closures to be fitted. I have rated environment as adequate due to the fact action has been taken quickly. Both kitchens on the top and middle floor need to have a microwave brought for them. This will ensure that the kitchen is adequately equipped to meet the needs of the people living in the home. The kitchen on the middle floor needs a paper towel dispenser fitted to the wall. At the time of the inspection no towels were available in the kitchen. This does not promote the health and wellbeing of the people living and working in the home. Parkcare Homes (No 2) Ltd (Roseneath Avenue) DS0000010592.V362058.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36, People who use the service receive an adequate outcome in this area. This judgement has been made using available evidence including a visit to this service. A registered manager is now in post. However the home cannot be consistently managed, as the deputy manager position is vacant. The staff records were not accessible do to the absence of the manager due to training. EVIDENCE: The manager has now completed the registration process and is now the registered manager for the service. This assists to ensure the home is run effectively to some extent. However the manager does not have a deputy manager in post and this position has been vacant for a considerable time. This means that the manager is not assisted with regard to the effective running of the service. This does not ensure that the people living in the home are provided with consistent care. The staff rota was inspected and there were adequate numbers of staff on shift to meet the needs of the people living in the home on the day of the inspection. The manager was on a days training on the day of the inspection and therefore I was unable to look at the staff records in relation to staff recruitment, staff Parkcare Homes (No 2) Ltd (Roseneath Avenue) DS0000010592.V362058.R01.S.doc Version 5.2 Page 23 training or staff supervision. This was due to the fact that the manager who was on training had the keys to access the necessary documents. Parkcare Homes (No 2) Ltd (Roseneath Avenue) DS0000010592.V362058.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42, People who use the service receive an adequate outcome in this area. This judgement has been made using available evidence including a visit to this service. A registered manager is now in post. This means the home can be managed in a more effective way. The manager is beginning the process to ensure that people’s views underpin all self- monitoring review and development within the home. The health and safety of the people living in the home is not fully promoted and protected due to the outstanding environmental improvements. EVIDENCE: The manager of the service has now completed the registration process and is the registered manager of the home. This means that the manager has the skills to ensure the home is run effectively. The manager of the home is in the process of sending out documentation to the people who live in the home, their relatives and relevant professionals to Parkcare Homes (No 2) Ltd (Roseneath Avenue) DS0000010592.V362058.R01.S.doc Version 5.2 Page 25 ensure that people’s views underpin all self-monitoring review and assessment in the home. I could not look at the documentation regarding provider visits, as the staff member did not know were these were kept. I am being sent regulation 37 notifications of incident forms. I inspected a range of health and safety documentation. Fire drills had taken place. The weekly bell tests were complete, the fire alarm and emergency lighting had been checked regularly. This indicates that people are protected with regard to these specific areas. However on the day of the inspection two fire doors were wedged open with paper. (This is also referred to under the section environment.) This does not promote people’s health and safety. The electrical certificate, portable appliance certificate was seen and found to be in order. The liability insurance certificate was seen and found to be in order. The gas certificate was due to be updated. The manager is going to ensure this takes place as a matter of urgency. The health safety and welfare of people living in the home is not fully promoted and protected. This is due to a number of fire doors being wedged open. I have asked the manager to speak with the area manager and seek approval for magnetic door closures to be fitted and provide me with a date when this work can commence. Parkcare Homes (No 2) Ltd (Roseneath Avenue) DS0000010592.V362058.R01.S.doc Version 5.2 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 Standard No Score 1 2 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000010592.V362058.R01.S.doc 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 2 X 3 X 2 X X Version 5.2 Page 27 Parkcare Homes (No 2) Ltd (Roseneath Avenue) 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 4 Timescale for action The Registered Person must 15/06/08 ensure that the service user guide is up-dated. This will ensure that all information is accurate. People using the document will then be provided with the most up to date information regarding the service. This document must be available on public display on the notice board and available in all of the people’s files. This will ensure it is fully accessible to those people who wish to view it. The Registered Person must 26/06/08 ensure that all of the care plans specific sections have been fully completed. This will ensure that the document is as up-to date as possible and therefore effective with regard to providing consistent levels of care to people living in the home. The Registered Person must 15/06/08 ensure that the two people who are involved in a relationship and have a monitoring form to record the frequency of their meetings have a fully completed and detailed record. To indicate how DS0000010592.V362058.R01.S.doc Version 5.2 Page 28 Requirement 2. YA6 15(1) 3. YA6 15 (1) Parkcare Homes (No 2) Ltd (Roseneath Avenue) 4. YA19 12 5. YA19 12 6. YA19 12 7. YA19 12 8. YA19 12 their dignity and privacy is respected. How they are being supported with regard to their emotional needs. Staff must sign this document. This will ensure their health and wellbeing is promoted and protected. The Registered Person must ensure that all health care appointments are undertaken. This must include dental appointments. All appointments must be effectively recorded with outcomes. This will ensure that people’s health care needs are fully met. The Registered Person must ensure that all of the information in people’s individual health action plans are up-to-date and indicate the date when they have been reviewed. This will ensure their health is monitored effectively. The Registered person must ensure that people’s weight charts are kept up to date. This will ensure that people’s weight is being effectively monitored and their health and wellbeing is being promoted. This requirement has been restated. The previous timescale of 10/10/07 was not met. The Registered Person must ensure that the identified persons epilepsy chart has adequate space to record the information and an identified space for staff to sign the document. This will ensure that effective recording systems are in place and promote good practice. The Registered Person must ensure that there is an effect means to record the information DS0000010592.V362058.R01.S.doc 20/06/08 10/07/08 27/06/08 10/06/08 15/06/08 Parkcare Homes (No 2) Ltd (Roseneath Avenue) Version 5.2 Page 29 9. YA20 13 10. YA22 22 11. YA24 23 (b) 12. YA24 23 (2) (c) 13. YA24 23 (2) (c) requested by care professionals with regard to a person’s bowel movements. This will ensure the persons health care needs are fully met. The Registered Person must ensure that an investigation takes place in relation to the medication that was administered and not signed for on the medication administration record. The staff list to indicate who can administer medication must be updated to ensure professional practice is followed. The Registered Person must ensure that a copy of the Adult Protection Policy in relation to the relevant placing authorities adult protection policy and procedures are obtained or available for inspection. This will ensure that people working in the home are fully informed and able to protect people from potential abuse. The Registered Manager must ensure that the identified person has their carpet replaced, their room decorated, a new bed ordered and a protective covering placed on their window. This will ensure they have a comfortable bedroom to sleep-in and their dignity and privacy will be respected. The Registered Person must ensure that a microwave is obtained for the top and middle floor flats. This will ensure the home has all of the equipment to ensure people’s needs are met. The Registered Person must ensure that a towel dispenser is fitted to the wall in the kitchen located on the middle floor. This will ensure that all of the staff are provided with the equipment DS0000010592.V362058.R01.S.doc 10/06/08 28/06/08 20/08/08 02/07/08 01/06/08 Parkcare Homes (No 2) Ltd (Roseneath Avenue) Version 5.2 Page 30 14. YA24 23 (2) (b) 15. YA37 18 (1) 16. YA41 16 to wash and wipe their hands. This will ensure people’s health and safety is promoted and protected. The Registered Person must 26/06/08 provide documented evidence to the Commission for Social care Inspection confirming that the magnetic closures have been fitted to the identified doors and the identified kitchen door has been replaced. This will ensure that people’s health and wellbeing is fully safeguarded. The Registered Person must 10/07/08 ensure that a deputy manager is appointed. This will ensure that the home is effectively managed and the needs of the people living in the home are met. The Registered Person must 15/06/08 ensure That people’s activity records are more accurately recorded. Information must be recorded on the correct document. The document must reflect the activity that people are actually undertaking on their activity programme. The document must be signed and the correct date must be recorded when the activity took place. This will ensure that clear recording mechanisms are in place. Parkcare Homes (No 2) Ltd (Roseneath Avenue) DS0000010592.V362058.R01.S.doc Version 5.2 Page 31 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 YA17 Good Practice Recommendations The menus need to be reviewed to ensure they are more varied and ensure they provide more choice to guarantee people’s cultural needs are meet. Parkcare Homes (No 2) Ltd (Roseneath Avenue) DS0000010592.V362058.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Parkcare Homes (No 2) Ltd (Roseneath Avenue) DS0000010592.V362058.R01.S.doc Version 5.2 Page 33 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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