Inspection on 03/08/05 for Person Centred Care Homes

This inspection was carried out on 3rd August 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 23/01/07

Person Centred Care Homes 15/12/05

Person Centred Care Homes 16/09/04

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 CENTRED CARE HOME 24 Little Park Gardens Enfield Middlesex EN2 6PG Lead Inspector Georgia Chimbani Unannounced 3 August 2005 @ 9.15 am 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 CENTRED CARE HOME G59 S58138 PCC Home (Little Park Gardens) V232462 03.08.05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Person Centred Care Home Address 24 Little Park Gardens, Enfield, Middlesex, EN2 6PG 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 8363 5398 Mr Savvas Michael Mrs Maria Newton PC - Care Home 4 beds Category(ies) of LD - Learning Disability registration, with number PD - Physical Disability of places PERSON CENTRED CARE HOME G59 S58138 PCC Home (Little Park Gardens) V232462 03.08.05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home will have a full time deputy manager who will be available when the manager is not present in the home. 2. The management of the home will be reviewed in six months time from the date of registration. The owner and the manager must be aware that, if by that time, the inspector finds that the care home is less than satisfactory, an application for an independent manager will have to be made. 3. The four service users being provided for from Chase Farm Hospital must be moved in to the new home in stages to ensure that each has the opportunity to to adapt to the new environment and to the new staff. The inspector will not set a time limit but expect the manager to make an appropriate decision based on the assessment of the service user. 4. The home must not have more than two wheelchair dependent service users, one of whom can be cared for in the ground floor room and one of the rooms on the first floor. Date of last inspection 16 September 2004 PERSON CENTRED CARE HOME G59 S58138 PCC Home (Little Park Gardens) V232462 03.08.05 Stage 4.doc Version 1.30 Page 5 Brief Description of the Service: Little Park Gardens is a care home for four younger adults with a learning disability and a physical disability. The home is owned by Mr Savvas Michael who also owns another care home in Enfield. Mrs Maria Newton manages both homes. The home has been registered with the CSCI since March 2004. The home is situated in a quiet street a few minutes walk from Enfield town centre and local transport links. The semi-detached home comprises four service user bedrooms that are decorated according to the tastes of individual service users. Three bedrooms are located on the first floor, the other is situated on the ground floor. The home also comprises a lounge, a kitchen with a dining area and a small paved garden. The laundry facilities are situated in a room at the top of the building. The stated aim of the home is to support adults with learning disabilities to lead inclusive lifestyles. PERSON CENTRED CARE HOME G59 S58138 PCC Home (Little Park Gardens) V232462 03.08.05 Stage 4.doc Version 1.30 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was three hours in duration. At the start of the inspection was the deputy manager Ms Gail Ellis. The manager, Mrs Maria Newton arrived after the inspection had commenced and remained until the inspection was completed to enable the deputy manager and other staff to go on a previously scheduled outing. Interviews were attempted with three service users however discussion was impossible due to their limited communication skills. Despite this the inspector is of the opinion that service users are happy, comfortable, safe and well cared for. The purpose of this inspection was to assess compliance with matters identified at previous inspections. 20 requirements were issued following the last inspection. Of these 17 are met and 3 relating to staff records and supervision are restated. A further 2 are issued bringing the total number of requirements following this inspection to 5. Requirements issued covered issues relating to staff training. What the service does well: What has improved since the last inspection? Adaptations have been made in the home to improve the facilities and living environment. For instance window restrictors and radiator covers have been installed and the laundry has been relocated to a room on the top floor of the home. Lockable storage cabinets are also available in each room. PERSON CENTRED CARE HOME G59 S58138 PCC Home (Little Park Gardens) V232462 03.08.05 Stage 4.doc Version 1.30 Page 7 The statement of purpose and service user guide has been reviewed in line with CSCI regulations. The complaints policy has also been reviewed to reflect the name CSCI. Evidence of consultation with service user regarding their care and general welfare is now available. A quality assurance exercise has been carried out to seek the views of relatives and other stakeholders. The majority of staff have received adult protection training. The staff rota now accurately reflects staff on duty and who is on duty at any given time. Staff are subject to an enhanced criminal records bureau check before they commence employment. 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 CENTRED CARE HOME G59 S58138 PCC Home (Little Park Gardens) V232462 03.08.05 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection PERSON CENTRED CARE HOME G59 S58138 PCC Home (Little Park Gardens) V232462 03.08.05 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 and 5 Service users or their relatives where appropriate, are now able to make informed decisions regarding the services and care offered by the home and their contractual obligations, based on the information contained in the statement of purpose and the statement of terms and conditions. Information contained in preadmission assessments ensures that service user’s needs and aspirations are assessed and can be fully met by the home. EVIDENCE: At the previous inspection, a requirement was made that the statement of purpose and service user guide be reviewed. Both documents were examined and the inspector confirmed that they contained the information detailed under regulation 5 and schedule 1 of the Care Homes Regulations 2001. At the time of the last inspection three service users were living in the home although the pre-admission process for the fourth service user had been started. The inspector was shown comprehensive pre-admission documentation relating to the fourth service user that clearly stated their needs and how these could be met. Two files were examined. Both contained contracts however only one had been signed. The manager explained that the other contract had not been signed as the service user was unable to do so themselves and their only relative was PERSON CENTRED CARE HOME G59 S58138 PCC Home (Little Park Gardens) V232462 03.08.05 Stage 4.doc Version 1.30 Page 10 unable to sign due to ill health. In light of this circumstance the inspector considers this requirement to have been met. PERSON CENTRED CARE HOME G59 S58138 PCC Home (Little Park Gardens) V232462 03.08.05 Stage 4.doc Version 1.30 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 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 the registered persons were required to ensure that care plans show consultation with service users or their representatives where appropriate. Two files were inspected. Both contained detailed care plans and risk assessments. There was also evidence of annual social services reviews that indicated that service users and their families were involved. The manager informed that the home carries out 6 monthly reviews of care planning documentation that are then sent to professionals directly involved in the care of the service user including their family. Any comments are then incorporated into the final care plan and risk assessment documents. Documentation seen indicated that the home made all attempts to ensure that service users are encouraged to make decisions regarding their care. PERSON CENTRED CARE HOME G59 S58138 PCC Home (Little Park Gardens) V232462 03.08.05 Stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 17 The home has a varied menu that takes into account individual preferences. This ensures that service user’s dietary needs are met. EVIDENCE: At the previous inspection a requirement was made that all food that had been opened must be labelled and dated. An inspection of the contents of the fridge confirmed that this was being done. The inspector observed that despite the fact that the weekly shopping was due to be done, there were sufficient quantities of fresh and frozen foods. The current menu was seen and it was confirmed that the ingredients for the evening meal were available. Due to service user’s lack of verbal communication skills it was difficult to determine their opinion on the food they were offered, however it is the inspector’s opinion that service users appeared healthy and well cared for. PERSON CENTRED CARE HOME G59 S58138 PCC Home (Little Park Gardens) V232462 03.08.05 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, 20 and 21 Staff have clear guidelines on administering medication that ensures that service users are protected from harm and abuse. The home and other health professionals regularly monitor service user’s health and their decisions relating to their health and welfare are respected and recorded. EVIDENCE: There was documentary evidence of visits to or by health care professionals such as GPs, dentist, optician and community nurse. There was also a letter on a file requesting that a service user attend a routine gynaecological examination. There are no service users who are self-medicating at the home. One service user has their medication covertly administered and signed consent detail information regarding how this was to be done was available. Only staff that have received medication training gives out medication. The manager explained that the deputy manager usually gave out medication. When the deputy manager was not on duty a member of staff was responsible for medication but they were required to give this out in the presence of another member of staff. An examination of the rota revealed that staff responsible for medication were clearly indicated. Following a requirement at the last PERSON CENTRED CARE HOME G59 S58138 PCC Home (Little Park Gardens) V232462 03.08.05 Stage 4.doc Version 1.30 Page 14 inspection, sample signatures of staff that are authorised to administer medication are now available. Of the two service user files examined, only one had information in the service user’s wishes in the event of their death. The manager reiterated that due to the ill health and difficulty in engaging the service user’s parent, they had been unable to get this information. The social worker is due to visit the service user’s parent and they have been asked if they could obtain this information on behalf of the home. It is however acknowledged that this is a sensitive topic and discussing it would depend on the parent’s state of health. The inspector acknowledges the attempts made by the home to seek this information and the constraints that they are encountering and in consideration of this considers this standard is met. PERSON CENTRED CARE HOME G59 S58138 PCC Home (Little Park Gardens) V232462 03.08.05 Stage 4.doc Version 1.30 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 The home recognises the importance of complaints in improving the quality of care and had demonstrated this by presenting complaints information in a way that makes it accessible to all service users. The training needs of recently recruited staff must not be overlooked as this could pose serious risks to service users. EVIDENCE: The home has a complaints policy that is in a format appropriate to the needs of service users and includes aids such as pictures and makaton signs. The home has received no complaints since registration with the CSCI in March 2004. The name NCSC in the complaints policy has now been changed to CSCI. At the previous inspection a requirement was issued for all staff to receive adult protection training. Records examined at this inspection confirmed that the majority of staff had received training towards the end of 2004. Staff recruited from the beginning of the year to date are still to receive this training. This is required. PERSON CENTRED CARE HOME G59 S58138 PCC Home (Little Park Gardens) V232462 03.08.05 Stage 4.doc Version 1.30 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) 26, 29 and 30 The home has made great progress in improving facilities to ensue a safe and hygienic living environment for service users. EVIDENCE: The inspector was able to view all 4 service user bedrooms. Further to a requirement made at the previous inspection, all contained a lockable storage space. A recommendation by an Occupational Therapist that a manual handling plan be compiled for a named service user had been carried out. At the previous inspection the laundry was situated in a separate building in the back yard with access through the kitchen. Concerns were raised about the risk of infection as soiled laundry was carried through the kitchen. In response to this the home has relocated the laundry room from the back yard to the former sleep in room at the top of the building. An inspection of the new laundry room revealed that a wash-basin had been installed as well as a washing machine with a sluice cycle. A discussion with the deputy manager revealed that at present no service users were doubly incontinent however should this occur staff were aware of the need to carry soiled laundry in bags. PERSON CENTRED CARE HOME G59 S58138 PCC Home (Little Park Gardens) V232462 03.08.05 Stage 4.doc Version 1.30 Page 17 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, 34, 35 and 36 There has been an improvement in recruitment practises at the home however service user are still being left vulnerable as a result of inconsistency in the checks carried out on new staff. The lack of training in core areas for some staff casts doubt on whether service users are consistently and effectively met. Current levels of staff supervision are irregular and therefore inadequate and must be improved, as this is likely to affect the standard of care offered to service users. EVIDENCE: A copy of the current rota displayed in the home was examined. This indicated the staff on duty in any 24 hour period. The hours of the deputy manager were listed and 9am to 5pm, Monday to Friday. In her absence over the weekends, a senior carer would be in charge. Through discussion with the manager it was confirmed that the hours of the deputy manager had been changed from parttime to full time to enable the manager to have more flexibility about the days and times she would be at either of the two care homes that she managed. The inspector confirmed that this arrangement was working very well. PERSON CENTRED CARE HOME G59 S58138 PCC Home (Little Park Gardens) V232462 03.08.05 Stage 4.doc Version 1.30 Page 18 Three files of the newest members of staff who has commenced work during the month of April 2005 were examined. All files contained an enhanced criminal records bureau check carried out by the home, a job description and a contract. All files also contained a recent photograph of the member of staff, a health declaration form, details of qualifications and training and evidence of participation in an induction programme. All files contained references however one file did not contain reasons as to why the member of staff left their previous positions where they had worked with vulnerable adults. 1 out of 3 files did not contain evidence of eligibility to work. This requirement is restated. Training records for the same 3 members of staff were also examined. Records indicated that training was very patchy and inadequate. For instance one member of staff had received training in abuse and health care assistant training from a former employer but there was no year on the certificate therefore it was impossible to determine how long ago this training had been carried out. There was no evidence that this same member of staff had received training in first aid, infection control, food hygiene or fire safety. Another member of staff had receive training in dementia, first aid and moving and handling from a former employer but there was no evidence of food hygiene, infection control and fire safety. A discussion with the registered manager confirmed that they were aware of staff training needs and training was being arranged. The registered persons must ensure that thee is evidence confirming that all staff working in the home have received training in first aid, fire safety, infection control, moving and handling and food hygiene. Supervision records seen indicated that staff are still not receiving regular supervision. Two members of staff who had started work in April 2005 had received supervision in May and none since then. A restated requirement is made relating to staff supervision. PERSON CENTRED CARE HOME G59 S58138 PCC Home (Little Park Gardens) V232462 03.08.05 Stage 4.doc Version 1.30 Page 19 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) 39 and 42 By carrying out a quality assurance exercise, the home has shown its commitment to listening and valuing the views of service users and other interested parties. The safety of service users has been promoted through adaptations to the home. EVIDENCE: At the previous inspection a requirement was made that a quality assurance be carried out to seek the views of service users, their relatives and other professionals. The manager showed the inspector evidence of letters written to relatives and various professionals requesting their views on various aspects of the home. The response received was very positive. During a tour of the home the inspector observed that radiator covers and window restrictors had been installed. PERSON CENTRED CARE HOME G59 S58138 PCC Home (Little Park Gardens) V232462 03.08.05 Stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x x 3 Standard No 22 23 ENVIRONMENT Score 3 2 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 3 x x 3 3 Standard No 11 12 13 14 15 16 17 x x x x x x 3 Standard No 31 32 33 34 35 36 Score x x 3 1 2 1 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 PERSON CENTRED CARE HOME Score x 3 3 3 Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x G59 S58138 PCC Home (Little Park Gardens) V232462 03.08.05 Stage 4.doc Version 1.30 Page 21 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 23 Regulation 13(6) Requirement The registered persons must ensure that all staff who commenced employment at the home from January 2005 onwards must receive adult protection training. The registered persons must ensure that where staff previously worked in a position that involved contact with vulnerable adults or children, written verification is available as to their reason for leaving. [timescale of 31/1/04 not met] The registered persons must ensure that there is documentary evidence confirming that staff working at the home are legally entitled to work. [timescale of 30/10/05 not met] The registered persons must ensure that there is evidence confirming that all staff working in the home have received training in first aid, fire safety, infection control, moving and handling and food hygiene. The registered persons must ensure that all staff working in the home receive regular Timescale for action 30/11/05 2. 34 19 Schedule 2, para 4 30/9/05 3. 34 19 30/9/05 4. 35 18(1)(c) (i) 30/11/05 5. 36 18(2) 30/9/05 PERSON CENTRED CARE HOME G59 S58138 PCC Home (Little Park Gardens) V232462 03.08.05 Stage 4.doc Version 1.30 Page 22 supervision at least six times a year. [timescale of 31/1/05 not met] 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 CENTRED CARE HOME G59 S58138 PCC Home (Little Park Gardens) V232462 03.08.05 Stage 4.doc Version 1.30 Page 23 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 CENTRED CARE HOME G59 S58138 PCC Home (Little Park Gardens) V232462 03.08.05 Stage 4.doc Version 1.30 Page 24 - 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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