Inspection on 29/11/05 for Perrymans

This inspection was carried out on 29th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Perrymans 25/09/07

Perrymans 27/04/06

Perrymans 08/07/05

Perrymans 15/01/05

Perrymans 02/08/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Perrymans 56a Abbey Road Barkingside Ilford Essex IG2 7NA Lead Inspector Jackie Date Unannounced Inspection 11:15 29th November & 12 December 2005 th DS0000025917.V269710.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 DS0000025917.V269710.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. DS0000025917.V269710.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Perrymans Address 56a Abbey Road Barkingside Ilford Essex IG2 7NA 020 8518 1058 020 8518 1058 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) Maidstone Community Care Housing Society Limited (MCCH) Mr Robert Richard Mapother Care Home 6 Category(ies) of Learning disability (6) registration, with number of places DS0000025917.V269710.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Clients with learning disabilities and associated physical disabilities. To include one named person over 65 with PD Date of last inspection 8th July 2005 Brief Description of the Service: Perrymans is a home for six adults with severe learning disabilities and some physical disability. Residents have little or no verbal communication skills, and very limited ability to make decisions about their lives. They all need a lot of support from staff for every aspect of their daily life. The home was purpose-built on one level and is accessible to wheelchair users throughout. The house is in Newbury Park close to bus routes, the station and local shops. Bathrooms and toilets are adapted to be suitable for residents with limited mobility. Each resident has their own bedroom that is decorated and personalised according to their likes. There is a lounge/dining area and a garden with patio areas. Most residents go to some day activities outside the home on one or two days of each week. At the time of the visit four ladies and two men were living at the home. DS0000025917.V269710.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection lasted for about five hours and took place during the late morning and afternoon. It was the second of the two inspections that each home must have during the inspection year. The manager, staff and all of the residents were spoken to. All of the communal rooms in the house were seen and care and other records were checked. The main purpose of this visit was to monitor the progress of the requirements from the previous inspection. After the visit some of the relatives and other professionals were contacted by telephone and asked for their opinions of the service. A second shorter unannounced visit was made on 12th December to check some of the things raised and to discuss these with the manager. This visit was the second statutory visit in the inspection programme 2005/06. Over the course of the two visits, all core standards have been assessed. What the service does well: What has improved since the last inspection? Five of the six requirements from the previous inspection have been met and the date to meet the sixth has not yet been reached. Residents’ reviews have been held and relatives and other professionals have been invited. Care plans and risk assessments have been updated. Therefore up-to-date information is available about residents’ needs. Fire alarm call points are now being tested each week to ensure that they work and a night-time fire procedure has been written and this clearly shows what should happen in the event of a fire at night. Both of these make the home a safer place for residents, staff and visitors. DS0000025917.V269710.R01.S.doc Version 5.0 Page 6 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. DS0000025917.V269710.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 DS0000025917.V269710.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): These standards were not tested on this visit. However evidence from the last inspection was that information is obtained to enable the staff team to decide whether or not the home can meet prospective residents’ needs. Prospective residents and their relatives can spend time in the home to find out what it would be like to live there. EVIDENCE: The above standards were not specifically tested on this visit, as there were no outstanding requirements in relation to the five standards. At the time of the last inspection standards two, three and four were tested and assessed as met. DS0000025917.V269710.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6&9 Residents’ plans contain detailed information so that staff can meet their needs. The residents’ plans and risk assessments have been reviewed and therefore contain up to date information about their needs. EVIDENCE: DS0000025917.V269710.R01.S.doc Version 5.0 Page 10 All of the residents have plans which give details of how they need/like to be supported. For example, one resident sometimes wakes in the night and the care plan states “offer a drink, make him comfortable and he will go back to sleep”. Also details are available of how individual residents indicate when they want to go to bed. For example “will rub her eyes when she is ready to go to bed”. Each resident has a “skills acquisition plan”. These set out how residents are helped to develop skills and to do things for themselves. The degree to which residents can be involved in the development of the plan is very limited due to their profound learning and communication difficulties. Each resident has a diary and the staff record details of what the person has done and progress towards individual goals. The residents’ plans have been reviewed recently and although minutes were not yet available a relative confirmed that they had been part of the review. A representative of the day service also attended. However the individual resident’s key worker at the home did not necessarily attend the review meeting. The manager indicated that it was not always possible to arrange a time that met relatives’ needs and fitted in with staff availability. It is strongly recommended that key workers attend residents’ reviews and are involved in the whole process as they are the main link between the home, relatives and other services. In addition they also work more closely with their key resident and prepare the reports and evaluations for the meeting and they take responsibility to progress any recommendations. The manager has introduced residents’ monthly evaluations. These are completed by key workers and used to monitor the service provided to residents and also to provide information for the reviews. Copies of the reports were in the residents’ files and they cover all areas of their care. The requirement from the previous inspection that reviews must cover all areas of the individuals care and the outcome/progress of recommendations and suggestions from previous meetings has therefore been met. There are risk assessments in place. These identify risks for the residents and indicate ways in which the risks can be reduced to enable the residents’ needs to be met as safely as possible. For example, the support a resident needs to get on the bus or when in the kitchen making tea. The risk assessments have been reviewed and updated as required by the previous inspection. However some files contain a mixture of old and new assessments and this can be confusing. It is recommended that up to date risk assessments be separated from older information to ensure that staff have easy access to correct and up to date information. DS0000025917.V269710.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 and 17 The residents are encouraged to take part in activities and to be part of the local community. Residents are supported to keep in contact with their relatives and relatives are welcomed at the home. Residents are given meals that meet their needs and individual preferences. EVIDENCE: Most of the residents go to day services for part of the week and they have all been on holiday this year. All of the residents need support from the staff team when they go out. The residents go out for lunch and go to the local shops and markets and they also do activities in the home. Some of the residents go to church on Sunday. During the course of the visit the church rang to invite two of the residents for a Christmas lunch. Also during the visit one resident had gone to local hairdressers and another went out to the local shops when he indicated to staff that he wanted to go out. He was obviously very pleased to be going out. The manager said that they are trying to DS0000025917.V269710.R01.S.doc Version 5.0 Page 12 arrange for someone to visit the home to do aromatherapy massage and reflexology. It is hoped that this will begin in the new year. Some of the residents have a lot of contact with their families. The mother of one resident comes to lunch every Sunday and staff also take this resident to visit his mother each week. Another visits her family each Saturday. Menus were not checked during this visit but at the last inspection were found to be nutritious and varied. One resident’s care plan said that he did not like spicy food and enjoyed sweet puddings. It also said that he was allergic to oranges, a fact that staff on duty were obviously aware of as they made a point of checking the yoghurt that he was given. The Inspector joined the residents at lunchtime and observed that they were given the assistance that they needed. One of the residents receives her food via a “PEG” feeding tube and staff have been trained to do this. Two other residents now have to have their food liquidised. Instructions on how this needed to be done are in the kitchen along with a picture of a liquidised meal showing that each item should be liquidised separately so that residents can still enjoy the taste of different foods. DS0000025917.V269710.R01.S.doc Version 5.0 Page 13 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 and 21 Residents receive personal care that meets their individual needs and preferences. The staff team support the residents to get the healthcare that they need. EVIDENCE: The residents all require a lot of support with their personal care and details of the help that they need and how they prefer to be supported are in their “primary care” guidelines. On the day of the visit all of the residents looked clean and well dressed. However some concerns have been raised with regard to the personal hygiene of one of the residents and this must be addressed. All of the residents must receive appropriate personal care to ensure that they are clean and free from body odour. All of the residents go to the local doctor and specialist help is received when needed. Staff take residents to all of their medical appointments. Residents’ files have details of health care issues and show that residents have regular access to health care professionals. Records are kept of medical appointments and these show that residents have checks from the optician, dentist and when needed the chiropodist. The day service confirmed that the home works with them on various programs and also discusses health issues and concerns with DS0000025917.V269710.R01.S.doc Version 5.0 Page 14 them. They also said that one specific resident is always “wrapped up well” due to their poor circulation. Another resident has not been well recently and sustained an injury due to a fall. She has now been referred to a falls clinic and staff have asked for a referral for a bone scan and medication to prevent osteoporosis. DS0000025917.V269710.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 There is a complaints procedure that would be followed in the event of any complaints being made. Staff are aware of issues of abuse and work to protect residents from abuse. EVIDENCE: There is a complaints procedure. However due to the degree of their disability is unlikely that any of the residents would be able to make a complaint without support. The organisation has produced a detailed adult protection policy that tells staff the actions to take in the event of abuse/suspected abuse being discovered. Staff have attended a course on protecting residents from abuse and are aware of their responsibility to residents. In the past the appropriate action has been taken when there has been a suspicion or allegation of possible abuse. DS0000025917.V269710.R01.S.doc Version 5.0 Page 16 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, 26, 27, 29 and 30 The residents live in a home that is suitable for their needs. The bathroom is about to be totally renovated and this will not only look nicer but also offer an improved specialist bath for residents’ use. Although residents’ bedrooms are suitable for their needs several of these require redecoration to meet an acceptable standard. EVIDENCE: DS0000025917.V269710.R01.S.doc Version 5.0 Page 17 The house is near to the local shops and bus routes. The communal space consists of a large lounge/diner, kitchen, laundry room and a garden. The building is accessible for wheelchair users throughout. Each resident has a single bedroom. These are decorated and furnished to meet individual needs and likes. The office is also used as a sleeping in room with a separate shower for staff. On three occasions recently the heating has broken down and temporary heating has been required. Repairs have been carried out. However when the heating is broken there is no hot water either and as a result of this an immersion heater has recently been fitted. A leaking radiator caused damp in some of the bedrooms and the wallpaper to peel off in places. This leak has now been remedied but the rooms are in need of redecoration. The manager said that the bedrooms are due to be decorated in the next financial year. That is from the first of April 2006. In addition to this the carpet in one of the bedrooms has several stains on it due to spillage when the “PEG” feeding machine is being used. This carpet must be cleaned and if necessary replaced. The bedrooms with damaged wallpaper must be redecorated so that residents live in a comfortable and homely environment. There are enough baths, showers and toilets and these are adapted to meet the residents’ needs. It has been agreed that the bathroom will be completely renovated. A new specialist bath will be fitted and the bathroom will be retiled and new flooring laid. All of this work is due to be completed before the end of February 2006. Due to the needs of the residents the home has a lot of items that need to be stored but there is very little storage space. This has been discussed previously and it was suggested that a shed be purchased for storage. However this has not happened. Sufficient storage space must be available so that items are appropriately and safely stored and that residents’ bedrooms and communal areas do not become cluttered. At the time of the inspection the home was clean, with the exception of the stained carpet, and free from offensive odours. Staff spoken to all said that they felt that the standard of cleanliness in the home was very good. DS0000025917.V269710.R01.S.doc Version 5.0 Page 18 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, 34 and 36 Staff are competent and receive the necessary training to meet residents’ current needs and provide an appropriate service for them. Staff are properly recruited and the necessary checks carried out. This helps to protect residents and keep them safe. Although staff receive a lot of informal support regular formal supervision and regular staff meetings are needed. EVIDENCE: The staff team all have experience of working with people with learning disabilities. There are still staff vacancies but regular relief staff and a casual worker cover these. Therefore the residents are receiving a service from a consistent group of staff. Staff on duty said that they had received training since they started work in the home. This has included induction, adult protection, manual handling, and medication and in some cases NVQ. They were clear about their duties and responsibilities towards the residents. Four staff have attained NVQ level 3 and two are studying for a learning disabilities degree at Havering College. Therefore the residents are supported by a competent and appropriately qualified staff team. DS0000025917.V269710.R01.S.doc Version 5.0 Page 19 The organisation operates an appropriate recruitment procedure. Jobs are advertised, application forms completed and interviews held. The necessary checks are undertaken prior to staff commencing employment. Staff meetings have not been taking place regularly. It is important that staff meetings do take place and that all of the staff team are involved in these. Regular staff meetings must take place, a minimum of six per year. In addition to this all staff must receive regular recorded supervision at least six times a year with a senior/manager in addition to regular contact on day-today practice. This will ensure that staff have an opportunity individually and together to discuss issues, concerns and the development of the service. The requirement with regard to supervision remains outstanding from previous inspections but the timescale set for this has not yet been reached. DS0000025917.V269710.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 The home provides a safe environment for the residents. EVIDENCE: The necessary health and safety checks are carried out and a safe environment is provided for the residents. The fire alarm call points are being checked every week as required by the previous inspection. A fire procedure has been developed to ensure that all staff are aware of the correct action to be taken in the event of a fire at night when all the residents are in bed. This was also a requirement of the previous inspection. DS0000025917.V269710.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X 2 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 X 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 X X Standard No 37 38 39 40 41 42 43 Score X X X X X 3 X DS0000025917.V269710.R01.S.doc Version 5.0 Page 22 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 YA18 Regulation 12 Requirement Timescale for action 31/01/06 2 2 YA24 YA26 18 23 All of the residents must receive appropriate personal care to ensure that they are clean and free from body odour. Sufficient storage space must 30/06/06 be available so that items are appropriately and safely stored. This stained bedroom carpet 30/06/06 must be cleaned and if necessary replaced. (Cleaned by 31st January 2006) The bedrooms with damaged wallpaper must be redecorated. Regular staff meetings must take place, a minimum of six per year. All staff must have regular, recorded supervision meetings at least six times per year in addition to regular contact on day-to-day practice. (Previous timescale of 30 April 2005 not met). 3 4 5 YA26 YA33 YA36 23 18 18 30/06/06 31/03/06 31/12/05 DS0000025917.V269710.R01.S.doc Version 5.0 Page 23 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 2 Refer to Standard YA6 YA9 Good Practice Recommendations It is strongly recommended that key workers attend residents’ reviews and are involved in the whole process. It is recommended that up to date risk assessments be separated from older information. DS0000025917.V269710.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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