Inspection on 30/01/06 for Robinia Care (Sheringham Avenue)

This inspection was carried out on 30th January 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Robinia Care (Sheringham Avenue) 25/09/06

Robinia Care (Sheringham Avenue) 06/09/05

Robinia Care (Sheringham Avenue) 06/01/05

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 Robinia Care (Sheringham Avenue) 1 Sheringham Avenue Oakwood London N14 4UB Lead Inspector Brian Bowie Unannounced Inspection 30th January 2006 13.45p Robinia Care (Sheringham Avenue) DS0000061218.V279001.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 Robinia Care (Sheringham Avenue) DS0000061218.V279001.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. Robinia Care (Sheringham Avenue) DS0000061218.V279001.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Robinia Care (Sheringham Avenue) Address 1 Sheringham Avenue Oakwood London N14 4UB 020 8360 5075 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) martin.ccrick@robinia.co.uk The Robinia Care Group Ltd Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Robinia Care (Sheringham Avenue) DS0000061218.V279001.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th September 2005 Brief Description of the Service: This home is one of three in North London operated by Robinia Care Group Ltd, which has a number of care homes throughout the UK. The home opened in September 2004 and is situated in a quiet residential area with access to local shops and buses. This home is a service for five people who have an autistic spectrum disorder. The service user guide for the home describes it as a home environment to support people with Autistic Spectrum Disorder and Aspergers Syndrome, moderate learning disability and behaviours that challenge. There are five men living at the home. In practice, most do not have a learning disability but do have an autistic spectrum disorder. The home encourages people to gain independence skills with a view to living more independently in the long-term. Robinia Care (Sheringham Avenue) DS0000061218.V279001.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced so nobody at the home knew the inspector would be coming and lasted 5 hours. The inspector looked around the building, met with the manager, spoke to all 5 of the residents and interviewed a member of care staff. A variety of records, including care plans and health & safety documents, were looked at. The overall impression from the inspection was of a home that is providing a very good standard of care within a friendly, homely and supportive environment. What the service does well: What has improved since the last inspection? The home has got better at finding new activities and interests for residents based on responding to things that residents say they want to do. For example one resident is now attending an evening class at a local FE college and another one is being supported in his search for work by a specialist agency. Robinia Care (Sheringham Avenue) DS0000061218.V279001.R01.S.doc Version 5.1 Page 6 The home has continued to maintain a high standard of care at a time of change with a new manager in post and new staff in the process of being recruited. What they could do better: 7 areas for improvement, including 4 relating to medication, are identified at this inspection: • • • Medication profiles to be in place for all residents The medication profile for each resident to be detailed and up to date All medication obtained or received for residents to be documented and signed for on the administration charts. The room temperature where the medication is stored to be monitored and recorded daily and maintained at 25oC or below CSCI to be notified of the outcome of the adult protection incident under investigation and action taken. The manager to obtain the current L.B. of Enfield guidelines (revised May 2005) on dealing with adult protection and to ensure that all staff are aware of the procedures to be followed. The company recruitment procedure to include verification of references and a copy of this procedure sent to CSCI. • • • • The manager at the home emphasised that she is keen to work closely with CSCI to raise standards further at the home in order to continue to provide the best possible quality of life for the residents. 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. Robinia Care (Sheringham Avenue) DS0000061218.V279001.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 Robinia Care (Sheringham Avenue) DS0000061218.V279001.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): 2 The home is good at assessing and meeting the needs and wishes of residents. EVIDENCE: All the current group of residents moved into the home when it opened in 2004. The files indicate that residents’ needs had been carefully assessed before they moved in. Residents spoken to said the home was able to meet their needs. This was confirmed by the staff interviews and the review reports on residents. Robinia Care (Sheringham Avenue) DS0000061218.V279001.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): 6,9 Residents at this home have their individual needs recorded and reviewed regularly and they are fully involved in this process. Residents are supported to be independent and to take risks. EVIDENCE: Care plans were inspected along with risk assessments, activity plans and records of reviews. The care plan for each resident consists of a number of support plans; one for each of their identified needs. The resident signs the plan as evidence that they agree to it and any restrictions placed on them. The care plans seen were comprehensive and had been regularly reviewed and updated. Residents are encouraged to make decisions for themselves and are provided with the level of support they need. Following a risk assessment being completed, one resident was travelling independently to watch his football team play. Risk assessments clearly record the risks for each individual and the action that needs to be taken to minimise risk and protect the safety and welfare of the resident concerned. Where the level of risk causes concern the home contacts the relevant agency, such as the local mental health team. Robinia Care (Sheringham Avenue) DS0000061218.V279001.R01.S.doc Version 5.1 Page 10 Robinia Care (Sheringham Avenue) DS0000061218.V279001.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): 12,13,16 Residents are encouraged to live a full life, using community facilities and taking part in educational and leisure activities of their choice. The home is good at promoting the rights of each resident and getting them to accept their responsibilities. EVIDENCE: Each resident buys their own food and cooks their own meals, with staff support. They all go out independently. One person goes to football matches and another is doing work experience and applying for jobs. There were also records that residents have the opportunity to take part in personal development activities relating to their social and emotional needs. Residents follow their own interests and have a written weekly activity plan. These include independent living skills such as cooking, laundry, travel training and other activities such as drama therapy, pottery, meals out, cinema and daytrips. All residents are encouraged to further their education at local colleges and/or seek employment. They use community facilities such as local pubs, church and colleges. Feedback from residents was positive about life in Robinia Care (Sheringham Avenue) DS0000061218.V279001.R01.S.doc Version 5.1 Page 12 the home with one person saying: ‘I’ve done well here- I’ve got more independent, I’m less stressed and I’m hoping to move on to my own flat.’ Staff interviewed were aware of the rights of the residents, particularly to go out independently into new situations having first considered the risks involved. As a result residents said they felt more independent. Staff are also working with residents on behaving appropriately when in the community and the importance of recognising their responsibilities when out and about, as well as at home. The home has achieved a very good balance between promoting independence whilst carefully weighing up risks and enabling residents to take more responsibility for their lives. As a result residents are gaining in confidence and becoming better prepared to move onto more independent accommodation. Robinia Care (Sheringham Avenue) DS0000061218.V279001.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 home is good at meeting the needs of the residents. The home’s practice is basically sound in the area of medication but needs improvement in specific areas. EVIDENCE: Residents’ files detailed appointments attended and confirmed that the home is supporting residents to meet their healthcare needs. One resident has specific mental health difficulties so that at times he displays some challenging behaviours. Staff interviews and records showed that the home is responding appropriately to the situation and had liaised with the local mental health team so that a reassessment could be made. Residents said they felt well supported with one saying: ‘I’m getting on well here- the staff are nice to me and help me get things done.’ The medication cabinet and medication records were looked at and in general were satisfactory. However the following improvements must be made to ensure residents are protected by rigorous medication procedures at all times: • Medication profiles to be in place for all residents so that there is very clear information in more than one place as to each resident’s current medication regime. These profiles are in the process of being put DS0000061218.V279001.R01.S.doc Version 5.1 Page 14 Robinia Care (Sheringham Avenue) together for all residents and it is important that each resident has an accurate and up to date profile which can be checked against the administration record. • The medication profile for each service to be detailed and up to date. In one case the profile did not have the detailed information which was on the administration record relating to how and when PRN medication could be administered. All medication obtained or received for residents to be documented and signed for on the administration charts. In one case medication received had not been entered accurately on the person’s administration record. The room temperature where the medication is stored to be monitored and recorded daily and maintained at 25oC or below. The home had not been recording the temperature of the room where the medication is stored to ensure that it is kept at the required temperature. • • Robinia Care (Sheringham Avenue) DS0000061218.V279001.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 Residents’ concerns and complaints are listened to and acted on. The home needs to improve further its procedures and practices in the area of adult protection. EVIDENCE: Records seen showed that complaints by residents are taken seriously and are properly followed up and appropriate action taken. Residents themselves said they either had no complaints about their care or that if they had had to complain then staff had sorted the problem out. The home has in the past trained staff in how to protect residents from abuse and has an adult protection procedure so that staff have clear guidance on what to do if they suspect a resident has been abused or if a disclosure is made to them. However a recent incident in the home had highlighted that the procedures to be followed were not fully understood by staff. At the time of the inspection this adult protection incident was being investigated by the home, which must notify CSCI of the outcome of this investigation and action taken. The manager must also ensure that the home has the current L.B. of Enfield guidelines (revised May 2005) on dealing with adult protection and that all staff are aware of the procedures to be followed. Robinia Care (Sheringham Avenue) DS0000061218.V279001.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): 24,25,30 The home is comfortable, homely and clean making it a very pleasant place to live for the residents. EVIDENCE: One of the residents showed the inspector around his home. He took a pride in showing the inspector his bedroom pointing out how he had made it more personal and homely for himself. Other bedrooms seen had also been personalised by the residents so that they reflected their own individual tastes and preferences. The standard of furniture and decor throughout the home is good, as is the level of cleanliness. There are two kitchens for the five residents. Three share one and two share the other. Each person has a cupboard and fridge space for their own food. Both kitchens are very hygienic. Residents said they liked the house which from outside appears as an ordinary house in an ordinary street. Robinia Care (Sheringham Avenue) DS0000061218.V279001.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): 32,34 Staff in the home are sufficiently experienced, competent and qualified to meet the individual needs and wishes of the current group of residents. Improvements need to be made in recruitment practice in order to protect residents. EVIDENCE: There is a stable staff team at the home who benefit from a comprehensive training programme. Most staff have completed or are currently undertaking NVQ Level 3 training in the care of adults. Staffing levels vary according to the needs of residents. Staff receive regular supervision in order to guide and improve their care practice. Staff interviewed showed that they had a good understanding of the needs of the residents and a commitment to good practice. As a result residents get the benefit of being supported by staff who are aware of what they need and how to get these needs met. One resident said: ‘Staff help me as much as they can.’ Staff at the home have done a basic one day course organised by Robinia Care in First Aid. Some staff have done a more substantial four day course run by St. Johns. It is recommended that the manager ensures all staff at the home undertake this training so that residents are protected at all times by staff with Robinia Care (Sheringham Avenue) DS0000061218.V279001.R01.S.doc Version 5.1 Page 18 a good knowledge of first aid and the ability to take appropriate action to protect residents. Inspections at other homes had highlighted that Robinia Care does not always double check references to ensure they are genuine. In the absence of evidence to the contrary in relation to the recruitment of staff to Sheringham Avenue a requirement is made for Robinia Care to ensure a thorough check of the authenticity of staff references is made before any new person commences employment at Sheringham Avenue. Robinia Care (Sheringham Avenue) DS0000061218.V279001.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 Residents benefit from a well run home which regularly reviews and improves the quality of care. The health and safety of residents and staff is promoted and achieved. EVIDENCE: The manager has worked at the home since it opened and has developed her skills in supporting people with a diagnosis of Asperger’s Syndrome. The three team leaders and the support workers have also built up their ability to provide close and skilled support which recognises and responds to the very individual needs of each resident. Feedback from both residents and staff was positive about what it is like both to live in and work at Sheringham Avenue. There is a happy atmosphere in the home as a result of the good relationships staff have developed with residents. Residents’ meetings are held regularly and give residents an opportunity to make suggestions about how the home is run, including outings to be made and activities in the home. Residents’ views on the running of the home are Robinia Care (Sheringham Avenue) DS0000061218.V279001.R01.S.doc Version 5.1 Page 20 obtained informally on an ongoing basis, as well as from more formal methods such as surveys and questionnaires. As a result the home has an effective and inclusive process for reviewing and improving the care at the home. Some health and safety issues were inspected. Records, including gas and electrical certificates, fire safety checks and training, were seen and were satisfactory. As a result the home is being run in a way that safeguards both residents and staff. Robinia Care (Sheringham Avenue) DS0000061218.V279001.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 x 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 2 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 2 35 x 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 4 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 X 16 4 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 2 x 3 X 3 X X 3 x Robinia Care (Sheringham Avenue) DS0000061218.V279001.R01.S.doc Version 5.1 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard YA20 YA20 Regulation 13 (2) 13 (2) Timescale for action The registered persons must 24/02/06 ensure that medication profiles are in place for all residents. The registered persons must 24/02/06 ensure that the medication profile for each resident is detailed and up to date. The registered persons must 30/01/06 ensure that all medication obtained or received for residents is documented and signed for on the administration charts. The registered persons must 10/02/06 ensure that the room temperature where the medication is stored is monitored and recorded daily and maintained at 25oC or below. The registered persons must 24/02/06 ensure CSCI is notified of the outcome of the adult protection incident under investigation and action taken. The registered persons must 24/02/06 ensure that the home has the current L.B. of Enfield guidelines DS0000061218.V279001.R01.S.doc Version 5.1 Page 23 Requirement 3 YA20 13 (2) 4 YA20 13 (2) 5 YA23 13 (6) 6 YA23 13 (6) Robinia Care (Sheringham Avenue) (revised May 2005) on dealing with adult protection and that all staff are aware of the procedures to be followed. 7 YA34 19(4)(c) The registered persons must 24/02/06 ensure that the company’s recruitment procedure includes verification of references and sends CSCI a copy of this procedure. 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 YA35 Good Practice Recommendations The registered persons should ensure all staff at the home undertake a substantial course in first aid so that residents are protected at all times by staff with a good knowledge of first aid and the ability to take appropriate action to protect residents. Robinia Care (Sheringham Avenue) DS0000061218.V279001.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Southgate Area Office 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 Robinia Care (Sheringham Avenue) DS0000061218.V279001.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!