Inspection on 24/04/07 for Riverside Drive

This inspection was carried out on 24th April 2007.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 13 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 09/06/06

Riverside Drive 01/02/06

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 4BW Lead Inspector Adrian Gordon Unannounced Inspection 24th April 2007 10:30 Riverside Drive DS0000033994.V335820.R01.S.doc Version 5.2 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.V335820.R01.S.doc Version 5.2 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.V335820.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Riverside Drive Address 112 Riverside Drive Mitcham Surrey CR4 4BW 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) www.merton.gov.uk/housingsupport London Borough of Merton Kenneth Nnamdi Iwenofu Care Home 8 Category(ies) of Learning disability (6), Physical disability (2) registration, with number of places Riverside Drive DS0000033994.V335820.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th January 2007 Brief Description of the Service: 112 Riverside Drive is a care home providing personal care and accommodation for eight 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 and is located 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 for a hoist. A lift provides access to 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. Information about the service is available in the Statement of Purpose and Service User Guide. Fees are not applicable to this service as it is an in-house service funded by the London Borough of Merton. However, residents are expected to pay towards holidays. Riverside Drive DS0000033994.V335820.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and completed over the course of one day. The inspection consisted of a tour of the premises, examination of records and observation of care practice. We met six residents, five members of staff and the manager. Feedback questionnaires were received from three relatives and one member of staff. A random unannounced inspection of the home was carried out on 9th January 2007. This was to look at requirements made at the last key inspection. It was found that fourteen requirements had been met and four were still outstanding. What the service does well: What has improved since the last inspection? What they could do better: There are two outstanding requirements from previous inspections regarding training staff in the protection of vulnerable adults, and making sure all staff have a training profile. These must be actioned to ensure that the staff team have the necessary skills to carry out their roles. Riverside Drive DS0000033994.V335820.R01.S.doc Version 5.2 Page 6 It is concerning that the level of overtime is currently very high. This must be monitored more carefully and consideration be given to using additional staff while absence levels are high. Excessive overtime does not promote the welfare of the staff team and can have a negative impact on residents. Concerns raised from the investigation of a recent complaint must be looked into, and the home must consider how it deals sensitively with any complaint received. More effort must be made into making sure residents are able to communicate effectively to get their views across. The use of alternative methods of communication must be considered. 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. The summary of this inspection report can be made available in other formats on request. Riverside Drive DS0000033994.V335820.R01.S.doc Version 5.2 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.V335820.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Service User Guide is not provided in alternative formats which prevents people who use the service from getting the information they need. EVIDENCE: An easy to read version of the Service User Guide and Statement of Purpose remains incomplete. This has been in progress for a year and must be finished so that people who want to live at the home and current residents have the information they need. Since the last key inspection in June 2006, one new person is living at the home. At the time of this resident visiting, the information held on them was out of date and lacking in detail. A full needs assessment is now in place for all residents. Riverside Drive DS0000033994.V335820.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. New care plans will support staff in meeting needs, however residents without care plans are disadvantaged. EVIDENCE: A new care plan document is being introduced although not all residents have had one completed yet. The new care plans are much more detailed and include a life picture, strengths and needs, likes and dislikes and goals. Some sections of the plan are completed well and are person centred, however, detail is inconsistent. Goals must be made more specific and meaningful to individual residents, and include timescale for review. The plans have the potential to be a useful working document. A keyworker system is in place so that each resident is linked to a member of staff who is responsible for promoting that residents needs in the home and externally. The keyworker is also responsible for making sure residents are Riverside Drive DS0000033994.V335820.R01.S.doc Version 5.2 Page 10 involved as much as possible in any decisions made about them. However residents would benefit if more alternative ways of communicating were used, for example pictures, symbols and audio. Up to date risk assessments are in place for most people that use the service. One resident had some information in their file about how staff can manage their behaviour safely. This was not included in the care plan. However, during the course of the inspection staff were observed to put this guidance into practice. Riverside Drive DS0000033994.V335820.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are able to take part in the local community, however a lack of planned activities means the people that live there are not always stimulated. EVIDENCE: Daily activities are noted in shift plans, however most of the time it is recorded as ‘home’. This does not give a clear picture of what each resident has done. During the inspection one resident was on a ‘community day’ but they had made a choice not to go out. The resident was observed to spend much of the day wandering the home with little planned involvement from staff. Staff must plan meaningful activities for each resident which are clearly recorded. Assessments include details of cultural needs, relationships and sexual awareness. These provide useful information for staff, for example one resident has an interest in German culture as part of their family history. Riverside Drive DS0000033994.V335820.R01.S.doc Version 5.2 Page 12 There were inappropriate pictures on the outside of one bedroom door. Staff were clearly respecting the right of a resident to have such pictures but need to make clear that there is a responsibility to display the pictures privately so as not to cause offence to other people. Planned menus show a good range of food is offered including fruit and juices. Fresh fruit is available from a bowl kept in the lounge. Alternatives to the menu are given if required and these are recorded. One relative commented that their relative ‘likes the food’. Riverside Drive DS0000033994.V335820.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good support is in place to meet residents health needs. EVIDENCE: Care plans include information on the likes and dislikes of people who use the service which gives staff a clearer idea of what choices to offer people. One resident confirmed that they are able to get the support they need. The home has good contacts with other professionals to support with meeting health needs. These include psychiatrists, psychologists, a community nurse and speech and language therapists. Appointments are recorded and relevant information passed on to the rest of the team in meetings and the communication book. Adaptations in the home support residents with physical disabilities. Medication profiles are in place for the people who use the service and these include a photograph. Medication administration record (MAR) sheets are clear although for one medication which stated ‘1 or 2 tablets to be taken as Riverside Drive DS0000033994.V335820.R01.S.doc Version 5.2 Page 14 required’ , it was not being recorded how many tablets were actually given. One medication which had recently been added to a MAR sheet had not been added to the profile. Riverside Drive DS0000033994.V335820.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Poor handling of complaints can lead to unsatisfactory outcomes and does not protect residents. EVIDENCE: There has been one serious complaint this year. This was not investigated appropriately and has left the complainant unsatisfied and has raised a number of other issues. Proper procedures were not followed. The complaint should have been referred to the local authority as a potential protection of vulnerable adults concern. A policy for the receipt of money has been implemented since the allegation but this should have been in place beforehand. The attitude of staff and management at the home, in demanding an apology from the complainant is of serious concern. The home follows the London Borough of Merton’s procedures for the protection of vulnerable adults (POVA). There has been some recent training for staff in this area, but some members of the team have still to go on it. Riverside Drive DS0000033994.V335820.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a clean, comfortable and homely environment. EVIDENCE: All areas of the home were clean and tidy and communal areas felt homely and comfortable. The kitchen is well equipped and accessible. A large rear garden is well maintained. Bathrooms and toilets were clean, however a shower curtain in one bathroom was stained and dirty and must be replaced. Bedrooms are made personal with pictures and ornaments. One resident had a number of soft toys on display. Televisions and DVD players were seen in some rooms. One resident pointed out a broken window opener in their room which they said had been a problem for a while. This must be fixed or removed as the broken part was a health and safety risk. Riverside Drive DS0000033994.V335820.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff are well informed about the needs of residents but the excessive level of overtime is not good practice and can have a negative impact on residents. EVIDENCE: Staff spoken to had a good understanding of the needs of people who use the service. The majority of staff who commented felt that staffing levels were not sufficient and that this sometimes meant it was difficult to do activities with residents outside the home. Due to long term staff absence, there is a high level of overtime being carried out by the team. Evidence was seen of staff working too many days without a day off or doing long shifts without a break. The level of overtime must be monitored closely to comply with the European Working Directive and to make sure staff are working safely. The use of bank or agency staff should be considered as a temporary support during this time. Riverside Drive DS0000033994.V335820.R01.S.doc Version 5.2 Page 18 Recruitment records are not kept at the home and the manager was not able to provide any written confirmation that the necessary checks, including an up to date Criminal Records Bureau disclosure, were in place. New staff receive appropriate induction and records of probation meetings were seen. Recent training includes managing challenging behaviour, epilepsy, and person centred planning. In order to make sure all staff are given opportunities to increase their knowledge and skill training needs profiles must be completed and kept up to date. Riverside Drive DS0000033994.V335820.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good health and safety systems promote the welfare of residents. EVIDENCE: The manager of the home is suitably qualified and was registered with the CSCI in January 2007. The manager said he is committed to making improvements to the home. However, management needs to have a greater awareness of dealing with sensitive issues, such as complaints and dealing employment issues, such as staff overtime. Monthly monitoring visits are being carried out regularly. Four residents are taking part in a project being run by the British Institute of Learning Disabilities. This will involve quality review of residential services and Riverside Drive DS0000033994.V335820.R01.S.doc Version 5.2 Page 20 will be used to compile an action plan for Riverside Drive. Resident meetings take place every month and minutes show that most people take part. Health and safety records are well maintained and all necessary checks have been carried out and are up to date. Riverside Drive DS0000033994.V335820.R01.S.doc Version 5.2 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 1 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 3 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 X 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 3 X X 3 X Riverside Drive DS0000033994.V335820.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 YA1 Regulation 4, 5, 12(2)(4) Requirement Timescale for action 15/07/07 2. YA6 3. YA7 4. YA12 5. YA16 6. YA20 In order to make sure people who use the service have the information they need, the Statement of Purpose and Service User Guide must be in an easy to read format. 15 To ensure that people who use the service have their needs met, a Care Plan must be in place which includes individual, person centred goals. 12(2)(3)(4) So that people who use the service can make decisions about their lives, staff must develop alternative forms of communication. 16(2)(m)(n) Planned activities must be offered to residents who stay at home so that they are properly stimulated. 12(4)(a) To protect the privacy and dignity of people who use the service, personal pictures must be displayed appropriately. 13(2) To protect people who use the service medication administration records must accurately reflect the dose given, and medication profiles must be updated when there is DS0000033994.V335820.R01.S.doc 15/07/07 15/07/07 15/07/07 15/07/07 01/07/07 Riverside Drive Version 5.2 Page 23 any change of medication. 7. YA22 22 To fully protect residents, any complaints must be investigated fully and sensitively, and be referred to another department if necessary. For the protection of residents, all staff must be trained in the Protection of Vulnerable Adults. Previous timescale of 31/08/06 not met. To improve the environment for the residents and make it safe, the shower curtain in the downstairs bathroom must be replaced and the broken window opener fixed or removed. To ensure that there is an effective staff team, the level of overtime must be closely monitored and comply with the European Working Directive. For the protection of residents, the registered person must have confirmation that all the necessary recruitment checks have been carried out on staff. The registered person must ensure that all staff have a training needs profile. Previous timescales of 15/05/06 and 31/07/06 not met. So that the manager has the skills necessary for running the home training must be given in dealing with complaints. 01/07/07 8. YA23 13(6) 15/07/07 9. YA24 23(2)(b) 15/07/07 10. YA33 18(1) 15/07/07 11. YA34 19(4) 15/07/07 12. YA35 18(1)(c) 15/07/07 13. YA37 10(3) 15/07/07 Riverside Drive DS0000033994.V335820.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Riverside Drive DS0000033994.V335820.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Riverside Drive DS0000033994.V335820.R01.S.doc Version 5.2 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. 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