Inspection on 01/02/06 for Riverside Drive

This inspection was carried out on 1st February 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 14 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Riverside Drive 11/05/09

Riverside Drive 19/06/08

Riverside Drive 24/04/07

Riverside Drive 09/06/06

Riverside Drive 08/08/05

Riverside Drive 14/10/04

Riverside Drive 18/05/04

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 Riverside Drive 112 Riverside Drive Mitcham Surrey CR4 Lead Inspector Liz O`Reilly Unannounced Inspection 1st & 10 th February 2006 10:00 Riverside Drive DS0000033994.V285464.R01.S.doc Version 5.1 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 Riverside Drive DS0000033994.V285464.R01.S.doc Version 5.1 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. Riverside Drive DS0000033994.V285464.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Riverside Drive Address 112 Riverside Drive Mitcham Surrey CR4 020 8640 8279 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) London Borough of Merton Mr Roberto Sarah Care Home 8 Category(ies) of Learning disability (6), Physical disability (2) registration, with number of places Riverside Drive DS0000033994.V285464.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th August 2005 Brief Description of the Service: 112 Riverside Drive is a care home providing personal care and accommodation for eight younger adults with learning disabilities, up to two of whom may have physical disabilities. The home is staffed and managed by the London Borough of Merton social services department. The premises are owned by a housing association. The home was purpose built on a site set back from a residential road in Mitcham. All residents are provided with their own single bedroom. One bedroom is furnished with en suite facilities and tracking. A passenger lift is available to access the first floor. An enclosed garden is provided to the rear of the premises. Parking is available to the front of the home. The home is close to bus and tram links. Riverside Drive DS0000033994.V285464.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by one regulation inspector on 1st February 2006 over five hours and was completed on the 10th February 2006. The inspector had the opportunity to speak with three of the seven residents living at the home one member of staff and the acting manager. A sample of records were examined. What the service does well: What has improved since the last inspection? What they could do better: Work needs to focus on ensuring that care plans are up to date, reviewed on a regular basis and accessible. Care plans need to indicate how the needs and goals of individuals will be met. As noted in previous reports, the home is registered for up to two people with physical disabilities but the transport available does not meet the needs of people who need to use a wheelchair. This restricts activities and community access. Staff must keep a record of food provided. The nutritional needs of individuals cannot be assessed if there is no information on individual diets. Riverside Drive DS0000033994.V285464.R01.S.doc Version 5.1 Page 6 Staff need to monitor the recording of medication to ensure that records are up to date and accurate. Those involved in the recruitment of staff must ensure that appropriate pre employment checks are carried out and full information is available on the previous employment and education history of each staff member. Quality monitoring and assurance systems need to be implemented. Sufficient staff must be provided with first aid training to make sure a qualified first aider is available on each shift. 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. Riverside Drive DS0000033994.V285464.R01.S.doc Version 5.1 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 Riverside Drive DS0000033994.V285464.R01.S.doc Version 5.1 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): 1&2 Documents are available for prospective residents which set out the service they can expect from the home. Work needs to continue to make these documents more accessible. Pre admission assessments are carried out for all new residents. EVIDENCE: The home has produced a service user guide and a statement of purpose which provides present and prospective residents information on the service they will receive. This allows prospective residents and or their representatives good information on which to base their decision about moving into the home. Work needs to continue to make the service user guide more accessible to residents. Assessments are carried out by staff from the local authority on all prospective residents and staff from the home also carry out their own assessment. This ensures that the home are aware of and can meet the needs and aspirations of any new resident. Riverside Drive DS0000033994.V285464.R01.S.doc Version 5.1 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, 7 & 9 Individual care plans are produced for each resident. Care plans were not seen to be reviewed on a regular basis and documentation was not signed and dated. Residents confirmed they made their own decisions and choices on day to day issues. Individual risk assessments are in place. EVIDENCE: Each resident is provided with an individual care plan. Care plans were seen to cover a wide range of support needs and good information was seen to be available on the individual likes and dislikes of residents. The majority of care plans seen were not up to date and reviews were not being carried out in line with national minimum standards. Only one care plan seen was signed and dated. In one instance the last review was dated March 2005 and in a second instance no record of any review was available since 2004. It was noted in that an eating and drinking plan for one resident had not been up dated following an injury which prevented them from feeding themselves. Riverside Drive DS0000033994.V285464.R01.S.doc Version 5.1 Page 10 The Registered Persons must ensure that a review of the care plan is carried out at least six monthly or more frequently is changes occur. Clear goals were seen to be documented. Staff need to document any progress made in meeting or achieving goals for individuals. The registered persons should ensure that care plans are held by residents unless there are clear and recorded reasons not to do so. Individual risks assessments were seen to be in place and were updated and reviewed. However in some instances these documents were not signed or dated. Residents confirmed that they made their own decisions about day to day life and staff were observed to offer assistance and advice in an appropriate manner. Riverside Drive DS0000033994.V285464.R01.S.doc Version 5.1 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): 13, 14, 16 & 17 As noted in previous inspection reports the majority of residents are supported to participate in community activities. The lack of appropriate transport does not allow for one resident to fully access activities. Residents are supported to continue with their own individual interests. Staff need to keep an accurate record of food in the home. EVIDENCE: Residents are well informed on activities available in the community. Staff have good information on the individual interests and hobbies of residents and will support residents to try out new activities. Records include good information on the likes and dislikes of residents. Staff need to ensure that records also contain information on how wishes of residents in relation to social activities will be met. Staff time is available to support residents in activities outside the home. The majority of residents have a “community day” during which they spend time going out with a member of staff. Riverside Drive DS0000033994.V285464.R01.S.doc Version 5.1 Page 12 All residents are registered to vote and staff will support residents who wish to take part in voting. It was noted that the last recorded residents meeting took place in August 2005. Staff should consider more frequent residents meetings. At the time of this inspection residents were in the process of planning their annual holidays for the coming year. As noted in previous inspections the financial arrangements for holidays do not meet national minimum standards which state that the option of a seven day annual holiday should be included as part of the basic contract price. Residents confirmed that they were offered a key to their bedroom. Residents confirmed that they choose when to be alone or in company. Residents have unrestricted access to the communal areas of the home. Staff were observed to interact in a positive manner with residents. Residents said they enjoyed the food provided and those residents who were unable to provide verbal feedback on the food were seen to enjoy their meals. A large amount of fresh fruit was seen to be available to residents. Discussion took place with the manager on the day of inspection about the manner in which one resident was being assisted with eating. Staff must keep accurate up to date records on the food provided. This was a requirement in previous inspection reports and it is some concern that this has been outstanding since December 2004. The lack of accurate and in some instances any record of the food provided means that no evidence is available to show that residents are receiving a balanced and varied diet. Failure to comply with this requirement may result in the CSCI taking enforcement action against the home. Riverside Drive DS0000033994.V285464.R01.S.doc Version 5.1 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 & 20 The health care needs of residents are met. Staff must take more care in maintaining up to date and accurate records of medication. EVIDENCE: All residents are registered with local GP practices. Arrangements are in place for residents to receive physiotherapy, occupational therapy and district nursing services should they be required. Staff from the community learning disabilities team are available to offer support and advice. Staff maintain a record of residents weight and monitor the condition of individuals. If staff have any concerns about the physical or emotional health of any resident they seek advice. Medication is appropriately stored in the home. A medication profile is produced for each resident which sets out the medication prescribed and information for staff on what each medicine is for. Staff keep a record of any medical appointments. Further work needs to focus on the medication administration sheets to ensure that all medication is signed for at the time of administration, all instructions Riverside Drive DS0000033994.V285464.R01.S.doc Version 5.1 Page 14 on the administration of each medication must be followed and documented carefully and any medication to be given “as required” must be accompanied by clear instructions on the circumstances and frequency of administration. Senior staff need to make regular checks on the medication administration sheets to ensure that they are completed correctly. The Registered Persons must ensure that all staff who administer medication are provided with accredited training on the management of medication. Riverside Drive DS0000033994.V285464.R01.S.doc Version 5.1 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 & 23 The home has in place a clear complaints procedure. Work is in progress to make sure that all staff have received training on the protection of vulnerable adults. EVIDENCE: Residents spoken to during this visit felt that if they had any complaints the manager would “sort it out”. The home has produced a version of the complaints procedure in a pictorial form which makes this more accessible to residents. Systems are in place for the recording of any complaints received. These records indicated that staff take any complaint seriously and respond appropriately. Records included any actions taken and outcomes. The home follows the London Borough of Merton policy and procedures on the protection of vulnerable adults. At the time of this inspection the manager stated that training for staff on the protection of vulnerable adults was on going. Facilities are available for residents to deposit cash with the home for safekeeping. The recording of finances held on behalf of residents has been reviewed to simplify the recording system. Riverside Drive DS0000033994.V285464.R01.S.doc Version 5.1 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 & 30 The home is well maintained and comfortably furnished. All areas of the home seen at this inspection were clean and tidy. EVIDENCE: Residents are provided with a comfortable and homely environment. Furnishings and fittings are of a good quality. The building is well maintained. Residents are provided with their own individual bedroom and a lounge/dining room. The kitchen for the home is well equipped and open to residents. CCTV cameras are used at the entrance to the home. The home has a separate appropriately equipped laundry room. Some of the residents spoken to said they helped to keep their own room clean. Good standards of hygiene were seen in the home. Riverside Drive DS0000033994.V285464.R01.S.doc Version 5.1 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 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, 33, 34 & 35 Residents gave positive comments on the staff group. Sufficient staff were seen to available to meet the needs of the resident group. Further work needs to be carried out on the information held on staff. Assessment of individual staff training needs and the training needs of the staff team as a whole needs to be completed. EVIDENCE: Residents said they were happy with the way they were supported and helped by staff. None of the residents spoken to had any concerns or complaints about the care they received. A minimum of three staff are available during the day with one person awake and one person sleeping on the premises at night. These staffing levels were seen to be sufficient to meet the needs of the residents accommodated in the home at this time. Should the needs of individuals increase then these staffing levels will need to be reviewed. A selection of staff files were examined. The Registered Persons must ensure that an up to date photograph is held of each member of staff. In one instance the Criminal Records Bureau check was dated four months prior to the person commencing work. The organisation must carry out their own Criminal Records Bureau checks on staff. Riverside Drive DS0000033994.V285464.R01.S.doc Version 5.1 Page 18 Information available on application forms was not comprehensive in each instance. Large gaps with no explanation were evident on the list of employment and education provided by two members of staff. The Registered Persons must ensure that all staff provide full employment and education details and must ensure that any gaps are appropriately explained and documented. As noted in previous inspection reports the Registered Persons must carry out an individual training needs assessment for each member of staff and an assessment of the training needs of the staff group as a whole. This will make sure that residents are supported by an appropriately trained staff group. All staff have completed food hygiene and moving and handling training. Sufficient staff must be provided with appropriate training to make sure that a qualified first aider is available on each shift. Riverside Drive DS0000033994.V285464.R01.S.doc Version 5.1 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 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): 37, 39 & 42 The home manager is well qualified. An application for the registration of the manager needs to be made. Further work needs to be carried out on the quality assurance and monitoring for the home. Staff carry out regular checks on the building to ensure the health and safety of residents. Staff need to follow through on any faults they find. EVIDENCE: The home manager has completed significant training in management. The manager has also completed NVQ level four and the Registered Managers Award. The CSCI have not received an application for the registration of this person as manager for this home. The Registered Persons must make an application for the registration of the manager. The organisation has not fully developed a quality monitoring and quality assurance programme. Work needs to be done to carry out an annual review of the service taking into account the views of residents and other Riverside Drive DS0000033994.V285464.R01.S.doc Version 5.1 Page 20 stakeholders. The results of consultation with residents must be made available to present and prospective residents. A copy of the report produced following each annual review of the service must be provided to the CSCI. Staff ensure that regular checks are carried out on the building and equipment to protect the health and safety of residents, staff and visitors to the home. Weekly checks are carried out on the fire alarm system and regular fire drills are carried out. A fire risk assessment is in place. Regular maintenance checks are carried out on moving and handling equipment and the passenger lift. It was noted that records showed one fire door had not been closing properly since April 2005. Staff must make sure that any faults are reported and dealt with promptly. The Registered Persons must provide written confirmation that all fire doors are closing correctly. Riverside Drive DS0000033994.V285464.R01.S.doc Version 5.1 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 Standard No Score 1 2 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 2 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 2 x LIFESTYLES Standard No Score 11 x 12 x 13 2 14 3 15 x 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 x 2 x 2 x 2 x x 2 x Riverside Drive DS0000033994.V285464.R01.S.doc Version 5.1 Page 22 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 The registered persons must ensure that care planning documentation is signed and dated. Care plans must be reviewed at least six monthly or more frequently if required. Care plans must set out the full needs and wishes of residents with clear measurable goals and timescales. (timescale of 20.03.05 not met) 2 YA6 15 Information on how the wishes of residents in relation to social activities will be met needs to be documented. 2. YA9 13(4) The registered persons must ensure that risk assessments are signed and dated. (timescale of 01.10.05 not met) 15/05/06 15/05/06 Requirement Timescale for action 15/05/06 Riverside Drive DS0000033994.V285464.R01.S.doc Version 5.1 Page 23 3. YA13 12 The registered persons must take action to ensure that all residents have access to suitable transport facilities to meet their needs. ( timescale of 01.10.05 not met) 15/05/06 4. YA17 17(2) Sch 4 (13) The registered persons must ensure that an up to date, accurate record of food is retained in the home. (timescale of 20.12.04 not met) 01/05/06 5. YA20 13(2) The registered persons must ensure that all medication is signed for at the time of administration. All instructions for the administration of medication must be followed and documented. Any medication to be administered “as required” must be accompanied by clear instructions on the circumstances and frequency of administration. Regular checks must be carried out on the medication administration sheets to ensure these are completed correctly. 01/05/06 6. YA20 13(2) The registered persons must provide written confirmation that all staff who administer medication have been provided with accredited training. 15/05/06 Riverside Drive DS0000033994.V285464.R01.S.doc Version 5.1 Page 24 7. YA34 19 The registered persons must ensure that they carry out their own Criminal Records Bureau checks on staff prior to commencing work in the home. 01/05/06 8 YA34 19 The registered persons must ensure that prospective staff provide full details of education and employment and that any gaps are fully explained and documented. An up to date photograph of each member of staff must be available. 01/05/06 9. YA35 18(1)( c) The registered persons A training needs assessment for the staff team as a whole must be carried out. 15/05/06 10. YA37 8&9 The registered persons must make an application for the registration of the home manager. 15/05/06 11 YA39 24 The registered persons must ensure that a regular review of the care provided is carried out taking into account the views of residents and other stakeholders. A copy of the report produced following the review of the service must be provided to the CSCI. 15/05/06 Riverside Drive DS0000033994.V285464.R01.S.doc Version 5.1 Page 25 12. YA42 13(4) 23(2)(c ) 01/05/06 The registered persons must ensure that prompt action is taken with a record maintained for any faulty equipment. 15/05/06 Sufficient staff must be provided with first aid training to ensure that a qualified first aider is available on each shift. (timescale of 01.10.05 not met) 13 YA42 18(1)(c ) 13(4) 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 YA1 YA6 Good Practice Recommendations The registered persons should ensure that the service user guide is made available to residents in an accessible format. The registered persons should ensure that care plans are held by residents unless there are clear and recorded reasons not to do so. Consideration should be given to holding more frequent residents meetings. 3. YA16 Riverside Drive DS0000033994.V285464.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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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