Inspection on 08/07/05 for Perrymans

This inspection was carried out on 8th July 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

Perrymans 25/09/07

Perrymans 27/04/06

Perrymans 29/11/05

Perrymans 15/01/05

Perrymans 02/08/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

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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 08 July 2005 11.30 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 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 Stationary 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. Perrymans G55_S0000025917_Perrymans_V237062_060705_Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Perrymans Address 56a Abbey Road, Barkingside, Ilford, Essex IG2 7NA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8518 1058 020 8518 1058 Maidstone Community Care Housing Society Ltd Mr Robert Richard Mapother CRH Care Home 6 Category(ies) of LD Learning Disability (6) registration, with number of places Perrymans G55_S0000025917_Perrymans_V237062_060705_Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Clients with learning disabilities and associated physical disabilities. 2. To include one named person over 65 with PD. Date of last inspection 15 January 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 purposebuilt 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. Perrymans G55_S0000025917_Perrymans_V237062_060705_Stage 4.doc Version 1.40 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 the afternoon. It was the first of the two inspections that each home must have during the inspection year. The manager, four staff and all of the residents were spoken to. All of the communal rooms and one of the bedrooms were seen. Care and other records were checked. What the service does well: What has improved since the last inspection? What they could do better: Care plans and personal care guidelines give a lot of information about residents, their likes and needs but they must be reviewed regularly to ensure that they are up to date. Perrymans G55_S0000025917_Perrymans_V237062_060705_Stage 4.doc Version 1.40 Page 6 There are four requirements outstanding from previous inspections and new dates have been set for meeting these. The manager and staff team need to meet these requirements within the new timescales. As some of the requirements have been stated on more than one occasion, the Commission will consider enforcement action to secure compliance if the new timescales are not met. 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. Perrymans G55_S0000025917_Perrymans_V237062_060705_Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Perrymans G55_S0000025917_Perrymans_V237062_060705_Stage 4.doc Version 1.40 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 standard(s) 2, 3 and 4 Information is available to enable the staff team to meet residents’ needs. If a vacancy arose the required information would be gathered on a prospective resident and they and their relatives could spend time in the home to find out what it would be like to live there and to enable the resident to make a choice about living in the home, within their capacity to do so. EVIDENCE: There have not been any new admissions for a couple of years. The organisation has an admissions procedure that includes gathering of information and assessments. It also contains details of how a prospective resident would be introduced to the home. The staff are aware of this and would be able to assess and introduce a new resident to the home if needed. Each resident has a care plan that contains information about what they can do, their likes and dislikes and what help and support they need. The staff team know residents well and know what they can do, their likes and dislikes and what help and support they need to meet these needs. The residents are unable to comment on what it is like to live in the home, but they all appeared to be happy and relaxed Perrymans G55_S0000025917_Perrymans_V237062_060705_Stage 4.doc Version 1.40 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 standard(s) 6, 7 and 9 Residents’ plans contain detailed information so that staff can meet their needs. The residents’ plans and risk assessments are not reviewed often enough and therefore may not contain up to date information about their needs. EVIDENCE: Perrymans G55_S0000025917_Perrymans_V237062_060705_Stage 4.doc Version 1.40 Page 10 All of the residents have plans which give details of how they need/like to be supported. For example, one resident is aware when she has facial hair and wants it to be removed. Also details are available of how individual residents indicate when they want 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 detail of this information is improving as required by the previous inspection. The resident’s plans need to be reviewed and updated at least every six months in line with the National Minimum Standards for Care Homes for Younger Adults. Residents, their relatives and social workers must be invited to these reviews. Residents’ reviews were not up to date and the manager said that this was due to the fact that there had been a lot of new staff and they had needed time to settle in and to get to know the residents. The manager is in the process of introducing residents’ monthly evaluations. These will be completed by key workers and used to monitor the service provided to residents and also to provide information for the reviews. The requirements 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 also remains outstanding. 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. Some of the risk assessments were not up-to-date and had not been reviewed recently. Therefore they may not have contained the correct information to keep residents safe. The requirement from the previous inspection that risk assessments must be kept up-to-date and reviewed regularly therefore remains outstanding. The residents cannot look after their own finances and staff have to help them. Some residents can indicate what they want to buy when given choices in the shop and staff support them to do this. The section on concerns, complaints and protection gives more information about residents’ monies. Perrymans G55_S0000025917_Perrymans_V237062_060705_Stage 4.doc Version 1.40 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 standard(s) 11, 12, 13, 14, 15, 16 and 17 The residents are encouraged to be as independent as possible, 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 they like and that meet their needs and individual preferences. EVIDENCE: Residents are encouraged and supported to develop their skills. For example one resident takes her clothes to the laundry and when the inspector arrived one resident was helping to make tea in the kitchen. All of these need support from staff. Most of the residents go to day services for part of the week. Four of the residents have already been on holiday to Devon and it is planned that the remaining two residents will go on holiday in September. Staff said that the residents had really enjoyed themselves. Perrymans G55_S0000025917_Perrymans_V237062_060705_Stage 4.doc Version 1.40 Page 12 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. The inspector had visited the home the previous week the residents were just about to go to Clacton for the day. 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. The manager and staff were very active in establishing contact between one resident and a brother that she had not seen for over 50 years. He was contacted by letter and telephone and as he lived in Devon a meeting was arranged with him while the resident was on holiday in that area. The manager and the staff team are to be commended for this. Menus are based on staffs knowledge of residents’ likes and dislikes. Menus seen were healthy and nutritious. At lunch time the residents were given the assistance that they needed. One of the staff said that on the previous evening residents had tuna and pasta for their evening meal. One resident appeared not to be enjoying this so she had made something else for them. One of the residents receives her food via a “PEG” feeding tube. The staff have all received training in doing this. Staff also described how they try to offer residents choice. For example, when they go to bed. One resident says no if she doesnt want to go to bed, another resident gets up and walks into her room. The care plan of another resident says to offer her the choice of which perfume she wears. Perrymans G55_S0000025917_Perrymans_V237062_060705_Stage 4.doc Version 1.40 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 standard(s) 18, 19 and 20 Residents receive personal care that meets their individual needs and preferences. The staff team support the residents to get the healthcare that they need. Medication is appropriately administered by staff that have been trained to do this. EVIDENCE: The residents 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. 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. None of the residents can self medicate and staff are only allowed to Perrymans G55_S0000025917_Perrymans_V237062_060705_Stage 4.doc Version 1.40 Page 14 administer medication when they have completed the organisations training. The medication was securely stored in a separate locked cupboard in the office and all the necessary medication administration records are kept. Perrymans G55_S0000025917_Perrymans_V237062_060705_Stage 4.doc Version 1.40 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 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. All of the residents need help with their finances and do not have the capacity to understand about the concept of spending or saving money. Records are kept of financial transactions. Regular checks are made at the staff handover to ensure that these are correct. Residents’ finances checked at the time of the inspection were correct and appropriate receipts were on file. There are safeguards in place where large expenditures of personal money is being spent on behalf of a resident, and where the resident is not able to fully understand or contribute to the decision-making process. Perrymans G55_S0000025917_Perrymans_V237062_060705_Stage 4.doc Version 1.40 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 standard(s) 24, 25, 27, 28, 29 and 30 The residents live in a clean and comfortable home that is suitable for their needs. EVIDENCE: Perrymans G55_S0000025917_Perrymans_V237062_060705_Stage 4.doc Version 1.40 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. The kitchen was refurbished last year and a new dishwasher purchased. There are enough baths, showers and toilets and these are adapted to meet the residents’ needs. At the time of the inspection the home was clean and free from offensive odours. Staff spoken to all said that they felt that the standard of cleanliness in the home was very good. Perrymans G55_S0000025917_Perrymans_V237062_060705_Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 and 36 Staffing levels are sufficient, and staff receive the necessary training and support in order to meet residents’ current needs and provide an appropriate service for them. Although staff receive a lot of informal support regular formal supervision is needed. EVIDENCE: Some of the staff are fairly new but all have experience of working with people with learning disabilities. There are still two staff vacancies but two regular relief staff and one full-time 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. Three staff are on duty from 7 am to 9.30 pm. At night there is one member of staff awake and one sleeping in. The manager works a mixture of days and shifts. Staffing levels are sufficient to meet the assessed needs of the residents. Perrymans G55_S0000025917_Perrymans_V237062_060705_Stage 4.doc Version 1.40 Page 19 Staff meetings have been taking place regularly, providing staff with the opportunity to discuss problems and to be involved in the development of the service. Staff have not necessarily be receiving regular formal supervision but a new senior support worker has recently been appointed and it is planned that she will provide formal supervision as well as the manager. Staff spoken to say that they receive good support from the manager, that he listens and is easy to talk to. However all staff must receive regular recorded supervision meetings at least six times the year in addition to regular contact on day-today practice. This requirement remains outstanding from the previous inspection. Perrymans G55_S0000025917_Perrymans_V237062_060705_Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, 41 and 42 The home is well managed and provides a safe environment for the residents. The manager and organisation monitors the quality of the service provided to ensure that residents’ needs are being met. EVIDENCE: The manager has a lot of experience of working with people with learning disabilities and of managing residential services. He has successfully completed NVQ levels 2 & 3. Staff are involved in the running of the home and the staff team discuss any developments and changes. The home is well managed. The quality of the service provided to the residents is monitored by the home manager and by the organisation. The service manager carries out monthly monitoring visits to assess how effectively the home is operating to meet its stated aims and objectives, and reports are written. These indicate the action Perrymans G55_S0000025917_Perrymans_V237062_060705_Stage 4.doc Version 1.40 Page 21 to be taken when deficiencies are identified. Copies of these reports were available in the home and copies are sent to the Commission as required by the previous inspection. A selection of records was seen at the time of the inspection. These included service user files, medication, accidents, complaints, health and safety and staff records. These were appropriately kept as required. The majority of the necessary health and safety checks are carried out and a safe environment is provided for the residents. However fire alarm call points are still not always checked every week and this must be done. This requirement remains outstanding from the previous inspection. Staff spoken to were aware of the action that will be needed in the case of a fire at night but a fire procedure must be developed to ensure to 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. Perrymans G55_S0000025917_Perrymans_V237062_060705_Stage 4.doc Version 1.40 Page 22 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 3 3 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 4 3 3 Standard No 31 32 33 34 35 36 Score x x 3 x 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Perrymans Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x 3 2 x Version 1.40 Page 23 G55_S0000025917_Perrymans_V237062_060705_Stage 4.doc No 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 YA6 Regulation 15 Requirement Care plans must be reviewed with the service user and significant others at least every six months and updated to reflect changing needs. Reviews must cover all areas of the individuals care and the outcome/progress of recommendations and suggestions from previous meetings.(Previous timescales of 31 December 2004 and 30 April 2005 not met). Risk assessments must be kept up-to-date and reviewed regularly.(Previous timescales of 31 December 2004 and 31 March 2005 not met). 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). Fire alarm call points must be tested on a weekly basis and the outcome recorded. (Previous timescale of 31 March 2005 not met). G55_S0000025917_Perrymans_V237062_060705_Stage 4.doc Version 1.40 Timescale for action 31 December 2005 31 December 2005 2. YA6 15 3. YA9 13 31 October 2005 4. YA36 18 31 December 2005 5. YA42 23 31 October 2005 Perrymans Page 24 6. YA42 23 A night time fire procedure must be developed. 31 October 2005 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 None Good Practice Recommendations Perrymans G55_S0000025917_Perrymans_V237062_060705_Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Ferguson House 113 Cranbrook Road Ilford Essex 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. Extracts may not be used or reproduced without the express permission of CSCI Perrymans G55_S0000025917_Perrymans_V237062_060705_Stage 4.doc Version 1.40 Page 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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