Inspection on 21/07/05 for Person Centred Care Homes

This inspection was carried out on 21st 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Person Centred Care Homes 15/12/05

Person Centred Care Homes 12/11/04

Person Centred Care Homes 29/06/04

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 Person Centre Care Homes 1 Bodiam Close Enfield Middlesex EN1 3HZ Lead Inspector Georgia Chimbani Unannounced 21 July 2005 @ 14.15 pm 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. Person Centre Care Homes G59 S30409 Person Centre Bodiam Close V232469 19.07.05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Person Centre Care Home Address 1 Bodiam Close, Enfield, Middlesex, EN1 3HZ 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 8366 7557 Mr Savas Michael Mrs Maria Newton PC Care Home 4 beds Category(ies) of LD - Learning Disability registration, with number of places Person Centre Care Homes G59 S30409 Person Centre Bodiam Close V232469 19.07.05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Manager Qualification: That the Registered Manager attains NVQ level 4 in Management and Care by 2005. This is in accordance with Regulation 9 of The Care Home Regulations 2001 and the National Minimum Standards for Care Homes for Younger Adults - Standard37.2 (ii). 2. Physical Disabilities Restriction: That the home may not be used by people with physical disabilities. This is in accordance with Regulation 16 of The Care Home Regulations 2001 and the National Minimum Standards for Care Homes for Younger Adults - Standard 25.4. Date of last inspection 12 November 2004 Brief Description of the Service: Person Centred Care Home is a care home registered to provide residential services for up to four adults with a learning disability. The home is located in a quite residential area close to the shopping and transport facilities of the Enfield Town Centre. The provider, Mr Savvas Michael, has another home near Enfield Town Centre. The home has two floors. The bedrooms, staff sleeping room, bathroom and toilet are situated on the first floor. The ground floor comprises of the kitchen, dining area, lounge, activities’ room, office and laundry room. There is a spacious garden both at the front and the rear of the house. The home specialises in providing support for service users who are on the autistic spectrum and who may have complex behavioural needs. The philosophy of the home is to support service users to “achieve individual lifestyles, enhance people’s daily experiences and improve social inclusion”. Person Centre Care Homes G59 S30409 Person Centre Bodiam Close V232469 19.07.05 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was one hour and 45 minutes in duration. Present was the registered manager, Mrs Maria Newton. As part of the inspection process, the inspector was able to engage in discussions with 2 members of staff and visiting relatives. Feedback from relatives on the quality of care offered by the home was very positive. Interviews were attempted with all 4 service users however this was unsuccessful due to their limited verbal communication skills Despite this the inspector is of the opinion that service users are happy, comfortable, safe and well cared for. 3 requirements issued at the last inspection were all met. Following this inspection one requirement is made relating to staff criminal record checks and medical declarations. What the service does well: Observations of service users and feedback from relatives confirm that the home provides a good standard of care and makes every attempt to meet service user’s needs. Service user’s opinions and decisions regarding their care are sought together with that of their relatives where appropriate. This gives them confidence that any concerns they may have will be listened to. The home has enabled service users to maintain close links with a variety of community groups/organisations and visitors are welcomed at the home. The home provides a safe, secure and comfortable living environment where staff are provided with appropriate training. Care planning documents are very comprehensive and include short-term and long-term care goals. There is also a high level of involvement of professionals involved in the care of service users in care planning and review meetings and general day-to-day support. The living and working environment is very comfortable with a good rapport between service users, management and staff. The manager at the home has been in post since the home was registered and it is the inspector’s opinion that the home has benefited from her leadership and direction. Person Centre Care Homes G59 S30409 Person Centre Bodiam Close V232469 19.07.05 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? 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. Person Centre Care Homes G59 S30409 Person Centre Bodiam Close V232469 19.07.05 Stage 4.doc Version 1.30 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 Person Centre Care Homes G59 S30409 Person Centre Bodiam Close V232469 19.07.05 Stage 4.doc Version 1.30 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 Although there have been no new admissions to the home recently, the inspector is confident that the needs of prospective service users will be assessed prior to admission. EVIDENCE: No new service users have been admitted to the home since the last inspection. The inspector is confident that the needs of service users will be assessed prior to admission as pre-admission assessments were carried out before the current service users moved in. Person Centre Care Homes G59 S30409 Person Centre Bodiam Close V232469 19.07.05 Stage 4.doc Version 1.30 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 The standard of care planning documents in the home is commendable and indicates that a comprehensive assessment of needs has been carried out. Despite the limited verbal skills of service users, the home was able to demonstrate its commitment to involving service users and where appropriate their families in relation to their care. EVIDENCE: At the previous inspection a requirement was made that each care plan contain a photograph of the service user. The two files were examined at this inspection contained photographs of the service user. Both files were dated July 2005 indicating that they had been recently reviewed. Care plans were very detailed including information on communication, behaviour, physical abilities, personal care and health. A review meeting was in progress for a service user at the time of the inspection. Present at this meeting were a number of professionals and the family of the service user. A discussion with the service user’s family after the review meeting revealed that they were extremely satisfied with the care provided by the home. The mother of the service user confessed she had initially been unhappy about her son moving into the home although she Person Centre Care Homes G59 S30409 Person Centre Bodiam Close V232469 19.07.05 Stage 4.doc Version 1.30 Page 10 stated her reservations were not specifically related to the home. She made it very clear that any reservations she had were gone as the staff at the home were wonderful, her son was happy and that it is all that she wanted. The presence of the service user’s family at the review meeting and their comments to the inspector confirmed that they were involved in their son’s care. Risk assessments were seen on each of the two files examined. These contained sufficient detail to inform staff of risks and strategies to minimise risks. Where the use of restraint might be necessary in dealing with service users, the circumstances and type of restraint to be used where explained in detail. The limited level of verbal communication of service users in the home makes seeking their views difficult. Despite this the inspector observed that staff and service users communicated through a variety of non-verbal language. For example a service user returning to the home at the end of the day knew it was time for their quality time in their bedroom that is usually supervised by a member of staff. As a way of communicating this to staff, the service user took the arm of a member of staff and pulled them upstairs. Another service user went into the lounge, sat down and became tearful. A member of staff tried to reassure the service user and establish the cause of their distress. The service user made it very clear through non-verbal language that they wanted to be left alone. The member of staff understood and respected this and left the service user alone. A few minutes later the service user was their usual self, their previous distress seemed forgotten. Person Centre Care Homes G59 S30409 Person Centre Bodiam Close V232469 19.07.05 Stage 4.doc Version 1.30 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) 12, 13,15 and 17 The home facilitates a variety of activities tailored to individual needs and preferences that ensure that service users are kept stimulated. Service user’s dietary needs are met by the home. EVIDENCE: Records examined indicated that service users participated in a variety of activities both at the home and in the community. It was noted that a particular service user attends a daycentre three times a week and the remaining days are occupied through activities such as swimming, food shopping, going bowling, cinema attendance and domestic tasks such as cleaning their room. A trampoline has been set up in the back garden and one service user enjoys playing on it more than the others. Staff informed the inspector that two service users went for a weekend break near Dover. Service users are not currently involved in formal education however this has been acknowledged as a long term goal for two of the service users whose files were examined. Discussions with staff on duty revealed that service users have regular contact with their relatives. This was confirmed by entries in the visitor’s book. Care plans contain information on service user’s dietary needs and preferences. For example a service user was described as diabetic and Person Centre Care Homes G59 S30409 Person Centre Bodiam Close V232469 19.07.05 Stage 4.doc Version 1.30 Page 12 only eating haalal meat. Another service user was prescribed a healthy eating plan to control their weight gain. The inspector saw culturally appropriate foods in the kitchen that staff advised were for a named service user. Person Centre Care Homes G59 S30409 Person Centre Bodiam Close V232469 19.07.05 Stage 4.doc Version 1.30 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) 19 and 21 The home has made attempts to seek the wishes of service users in the event of their death to ensure that their wishes are known and respected. The health of service users is monitored and maintained through regular health checks. EVIDENCE: There was substantial evidence on file to indicate that staff were aware of service user’s need to have regular health checks. The inspector was shown documentary evidence confirming that service users were visited by a variety of health care professionals such as a community nurse and dentist. At the previous inspection the manager was required to ensure that service user’s wishes in the event of their death are recorded. During a discussion with the manager, the inspector was informed that this had been completed for two service users. The relatives of the other two service users had been consulted however the home was still waiting for a response from them. The manager discussed how difficult it was to keep following up this information from relatives. It was agreed that where unsuccessful attempts had been made to obtain this information, this should be recorded on file. Person Centre Care Homes G59 S30409 Person Centre Bodiam Close V232469 19.07.05 Stage 4.doc Version 1.30 Page 14 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 The home recognises the importance of complaints in improving the quality of care and makes every attempt to resolve issues of concern. Service users have the assurance of being looked after by staff that have the training to safeguard them from abuse. EVIDENCE: The complaints record was examined and indications were that the home had received no complaints since the last inspection. The inspector over heard a discussion between the manager and the family of a service user that indicated that the home made all attempts to receive and resolve complaints. The manager advised that if they visited at weekends when she was not working they could ask the staff on duty to ring her or she could come to the home so that they could discuss any issues. At the previous inspection the inspector was informed that staff were due to receive adult protection training. Separate discussions with two members of staff confirmed that they had received this training. Person Centre Care Homes G59 S30409 Person Centre Bodiam Close V232469 19.07.05 Stage 4.doc Version 1.30 Page 15 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) Standards 24 and 30 were not assessed on this occasion and will assessed at the next inspection as they are key standards to be inspected at least once during a 12 month period. EVIDENCE: Not applicable. Person Centre Care Homes G59 S30409 Person Centre Bodiam Close V232469 19.07.05 Stage 4.doc Version 1.30 Page 16 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) 34 and 35 Recruitment checks at the home are of a high standard however there must be consistency in applying for criminal records bureau checks to safeguard service users. The investment in staff training means that competent staff care for service users. EVIDENCE: The inspector examined the files of two members of staff who commenced work at the home following the last inspection. Both files contained a recent photograph, a contract, a job description, two references, evidence of eligibility of work and information on qualifications and working experience. Both files contained an enhanced criminal records bureau however one of these had been transferred from a previous employer. The inspector queried this with the manager as the member of staff had commenced work towards the end of 2004. According to revised protection of vulnerable adults guidance, staff who commenced new employment after 26 July 2004 were required to have a new criminal records bureau [CRB] check each time they started a new job. CRBs could no longer be transferred from one employer to another. One file contained a medical declaration however this was not available on the second file. The registered persons are required to ensure that a new CRB application is made for the named member of staff. A statement as to the physical and mental health of a named member of staff is required. Person Centre Care Homes G59 S30409 Person Centre Bodiam Close V232469 19.07.05 Stage 4.doc Version 1.30 Page 17 Training records of the same members of staff were examined. Records seen indicated that both are working towards a national vocational training qualification. There was also evidence that staff had received training in moving and handling, first aid and food hygiene. Person Centre Care Homes G59 S30409 Person Centre Bodiam Close V232469 19.07.05 Stage 4.doc Version 1.30 Page 18 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) Standards 39 and 42 were not assessed on this occasion and will assessed at the next inspection as they are key standards to be inspected at least once during a 12 month period. EVIDENCE: Not applicable. Person Centre Care Homes G59 S30409 Person Centre Bodiam Close V232469 19.07.05 Stage 4.doc Version 1.30 Page 19 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 x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x x 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score x x x 2 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Person Centre Care Homes Score x 3 x 3 Standard No 37 38 39 40 41 42 43 Score x x x x x x x G59 S30409 Person Centre Bodiam Close V232469 19.07.05 Stage 4.doc Version 1.30 Page 20 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 34 Regulation 19 Requirement The registered persons are required to ensure that a new CRB application is made for the named member of staff. A statement as to the physical and mental health of a named member of staff is required. Timescale for action 30/8/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Person Centre Care Homes G59 S30409 Person Centre Bodiam Close V232469 19.07.05 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Solar House 1st Floor, 282 Chase Road Southgate, London, N14 6HA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Person Centre Care Homes G59 S30409 Person Centre Bodiam Close V232469 19.07.05 Stage 4.doc Version 1.30 Page 22 - 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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