Inspection on 25/02/06 for Salisbury Road

This inspection was carried out on 25th 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 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Salisbury Road 15/01/09

Salisbury Road 15/01/08

Salisbury Road 10/10/06

Salisbury Road 07/02/05

Salisbury Road 25/11/04

Salisbury Road 22/03/04

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 Salisbury Road 22-23 Salisbury Road Leyton London E10 5RG Lead Inspector Sheelagh Doherty Unannounced Inspection 25th February 2006 09:50 Salisbury Road DS0000007264.V284661.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 Salisbury Road DS0000007264.V284661.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. Salisbury Road DS0000007264.V284661.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Salisbury Road Address 22-23 Salisbury Road Leyton London E10 5RG 020 8556 8147 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) t.tucker@mcch.org.uk Maidstone Community Care Housing Society Limited (MCCH) Mr Richard Tucker Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Salisbury Road DS0000007264.V284661.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st November 2005 Brief Description of the Service: 23 Salisbury Road is registered to provide personal care and support to up to seven residents of either sex. The home is now operated by MCCH, having been taken over in 2002. The home is located in a residential area of Leyton, North East London. It is close to shops, community facilities and is well served by public transport. All residents have complex needs and require a high level of support and supervision. Residents are encouraged to maintain family relationships and some have regular visits home, including for overnight/ weekend stays. Since the home was taken over by MCCH there have been a number of operational changes which staff feel have improved the service to residents. Salisbury Road DS0000007264.V284661.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on a Saturday morning and lasted throughout the morning and into the afternoon, including the lunchtime meal. There were five residents at home with two being on weekend leave. The staffing level was sufficient to meet the needs of the service users and the atmosphere of the home was relaxed and homely. Residents were moving freely about the home and activities had been planned for the afternoon. The weekend routine is less structured than the weekday one, when most residents attend day centres or colleges or have one to one activities with their support worker. Staff were very familiar with the needs of the residents and were able to meet these in accordance with National Minimum Standards. The manager was not on duty but arrived at the home do pick up some paper work and stayed for a short time to assist with the inspection especially as to the progress in implementing the requirements of the previous inspection. Thanks are extended to all those residents and staff who assisted with the inspection. What the service does well: What has improved since the last inspection? What they could do better: Staff records were not available for inspection as these are kept at head office; control sheets are used to show that the required records and checks have been undertaken – those examined had not been fully completed. This is an unmet requirement from the last inspection. Staff were reheating sausages to make sandwiches for lunch but were unaware of the correct temperature to Salisbury Road DS0000007264.V284661.R01.S.doc Version 5.1 Page 6 which food must be re-heated to make it safe for consumption. Information and training must be provided to ensure that staff are aware of their responsibility in relation to food safety. 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. Salisbury Road DS0000007264.V284661.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 Salisbury Road DS0000007264.V284661.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, 5 No new service users have been admitted since the last inspection so standards 2, 3 and 4 were not tested. Not all service users have a statement of terms and conditions of occupancy. EVIDENCE: Both a Statement of Purpose and a Service User Guide are available for prospective service users and their family/ care givers. These provide sufficient information to allow an informed choice. Examination of personal files relating to residents showed that not all of them have a statement of terms and conditions of occupancy. Staff were also unfamiliar with the content and lay out of the personal files and struggled to find information readily. Salisbury Road DS0000007264.V284661.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): 6,7,8,9,10 Individual care plans reflect resident’s needs and preferences. Residents receive support to make decisions about their lives and are consulted about issues that affect them. Personal files were not well kept and there was no evidence of systematic reviews of care. Residents are supported to engage in activities which may include some risk with appropriate plans in place to minimise risk. Confidential information is stored and handled appropriately. EVIDENCE: MCCH has a comprehensive care plan system in place which includes detailed assessments and individual plans to meet personal and care needs. However, examination of files showed that some sections had not been completed; that regular reviews of care are not held and/or documented; that information was duplicated and old records had not been archived. This could lead to confusion and a lack of continuity of care from the care team. Salisbury Road DS0000007264.V284661.R01.S.doc Version 5.1 Page 10 Residents are involved in care planning as much as they are able and written information is supported by pictures and/ or signs according to the individual needs/abilities of residents. Individual activity plans are drawn up showing what each resident is engaged in throughout the day. These include both in-house activities such as watching videos or tidying their bedroom and external activities such as going for a walk, attending college or going for a family visit. Weekly meetings are held at which activities and menus for the week are discussed/ decided. There was evidence that residents were involved in personal decision-making, e.g. what to have for lunch, and there was further evidence of decision making recorded in the personal files. Staff have a good awareness of the needs and preferences of individual residents and use this knowledge to provide appropriate support. MCCH has a policy about confidentiality and staff were aware of this. A statement on the front of each file reminds users to respect confidentiality. Records are held in the office and staff were aware of the need to maintain confidentiality and in what circumstances they may need to divulge information to a more senior member of the team. Salisbury Road DS0000007264.V284661.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, 14, 15, 16, 17 Residents receive support to access their local community and to take part in activities of their choice. They receive good support to maintain and develop friendships and to remain in contact with their relatives. Staff take into account the preferences of residents when planning the menu and a varied, well balanced diet is provided. Basic food hygiene practices need to be improved. Staff were not aware of the correct food preparation practices to use when re-heating food for lunch. EVIDENCE: Each resident has a weekly activity planner which shows the time and place of organised activities. These show both in-house activities and those taking place in the community. Two residents have their own support worker who works with them on a one-to-one basis. Residents attend college and other day services activities. As the inspection took place at the weekend less formal plans were in place to allow residents the opportunity to relax at home. Salisbury Road DS0000007264.V284661.R01.S.doc Version 5.1 Page 12 Residents are supported to maintain and develop friendships through involvement in the local community and to maintain family relationships through visits to the home. Two residents were on weekend leave visiting the family home. Staff kept relatives informed about events affecting the residents and relatives’ input is sought at care reviews. Interactions between staff and residents was positive during the inspection and staff were observed to treat residents with respect and as individuals. Residents have unrestricted access to the all the communal areas of the home including the staff office. They are also able to spend time in their rooms if they wish for privacy. Staff used appropriate forms of address when speaking to residents. Responsibility for preparing and cooking meals is shared amongst the staff group and, although staff said they had had basic food hygiene training, the staff member preparing sausage sandwiches for lunch was not aware of the correct temperature required to render re-heated food safe. [The sausages had been prepared for breakfast and were being re-heated for those residents who wanted them, for lunch.] Other residents chose other sandwiches and received these. The main meal of the day is in the evening. Salisbury Road DS0000007264.V284661.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, 19, 20 Residents receive personal support according to their needs and wishes. Residents receive support to access both general and specialist health services. The standard of medication administration and recording was satisfactory. EVIDENCE: Personal care is detailed in each individual’s care plan and this includes aspects of care that residents are encouraged and supported to undertake themselves and also those which need, for a variety of reasons, to be carried out by staff. Staff on duty demonstrated a good knowledge of residents’ healthcare needs and an awareness of each resident’s preferences in this area. Residents are encouraged to select their own clothing each day and also to go out with staff to purchase clothing and other personal items. All residents are registered with a local general practitioner and are encouraged to attend for an annual health review. The home does not provide nursing care and any that may be required is carried out by the staff from the local primary health care team. Residents are supported to attend appointments with the specialist healthcare professionals involved in their care. Salisbury Road DS0000007264.V284661.R01.S.doc Version 5.1 Page 14 There is an organisational policy and procedure which covers all aspects of medication handling and administration. Staff were knowledgeable about correct medication practices and had received appropriate training. No residents are able to manage their own medication. Medications were appropriately stored in a locked cupboard in the office. Salisbury Road DS0000007264.V284661.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 Action has been taken to provide accurate information about the complaints procedure to relatives and stakeholders. Training and guidance is provided to staff in the recognition, prevention and reporting of abuse. EVIDENCE: Complaints are generally made on behalf of residents by their relatives. Evidence on file showed that complaints are responded to in an appropriate manner and that action is taken to resolve any issues raised. No visitors were in the home during the inspection so the inspector was not able to fully test this standard, as communication with residents was difficult. Staff said that, because of their knowledge of residents, they are able to determine when a resident is not happy through observation of behaviour and facial expression. Action is taken to try to determine the cause and to resolve it. There is an organisation wide policy and procedure on protection of vulnerable adults. This links in with the local authority policy and procedure. Staff have received training from MCCH on how to recognise abuse and what action they should take if abuse is suspected. Staff spoken with were able to discuss the action they would take and this was appropriate to their level of responsibility. Salisbury Road DS0000007264.V284661.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 Residents’ bedrooms are homely and comfortable and reflect their individual preferences. Further work needs to be done to make the communal areas more homely and comfortable. The standard of hygiene needs to improve. EVIDENCE: The home is made up of two older-style terraced houses which have been converted for the purpose. A number of issues relating to the building have been dealt with since the last inspection. These include replacement of rotting window frames and assessment of the ‘DoorGuard’ devices fitted to bathroom doors. The registered manager said that MCCH intends to carry out further refurbishment of the home including refurbishing the kitchen. All residents have their own single room and they are able to decorate and arrange this as they wish with the assistance and support of staff. Those rooms seen showed evidence of personalisation. Salisbury Road DS0000007264.V284661.R01.S.doc Version 5.1 Page 17 The communal areas include a lounge, dining room/ kitchen, a quiet/activity room which holds a computer for use by residents and staff, two bathrooms and three toilets. Staff said that the quiet room is also used once a week by an aromatherapist who brings her own equipment and provides treatments to residents if they wish and who benefit from it. The registered manager must make sure that the therapist is professionally qualified, insured and that a criminal record check has been carried out. Documentary evidence must be available. This was not checked at the time of the inspection as the registered manager had left the premises when the inspector was given this information. The inspector was shown a toilet which had clearly recently been used and which required cleaning to make it hygienic for the next user. Staff made no attempt to undertake this task whilst the inspector was in the home. Salisbury Road DS0000007264.V284661.R01.S.doc Version 5.1 Page 18 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, 35, 36 There is a stable staff and management team who know the residents and their needs well. MCCH provide in-house training and support staff working towards NVQ awards. Staff have regular supervision sessions. EVIDENCE: The home was appropriately staffed at the time of the visit with three support workers and five residents. One support worker was acting as shift leader. Staff were very familiar with the needs of the residents and used this knowledge to deliver personal support to them. Interactions between staff and residents were appropriate. Staff files are kept at head office and only a control sheet was available to show what information had been obtained about staff employed in the home. According to the control sheets not all required information had been obtained, including no evidence that all staff had two references. Copies of references were not attached to the control sheets. The manager said that application had been made to the Criminal Records Bureau for all staff who did not yet a disclosure. Salisbury Road DS0000007264.V284661.R01.S.doc Version 5.1 Page 19 Staff reported that they have supervision sessions every six weeks with the deputy manager, that records of these sessions are kept and that both the supervisor and the supervisee keep copies. MCCH provide in-house training and courses attended by staff include motor sensory training, diabetes awareness, minute taking, food handling [see also standard 17], medication training and adult protection. A number of staff have completed NVQ training and eleven members of staff are enrolled in NVQ courses ranging from levels 2 – 4. Salisbury Road DS0000007264.V284661.R01.S.doc Version 5.1 Page 20 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, 42 Management systems need to be effective and fully implemented. Standards of health and safety need to be improved. EVIDENCE: The manager has been in post for over a year and has completed registration with the Commission. He has completed the Registered Manager’s Award and has previous experience of managing services for people with a learning disability. The home is still implementing changes brought about by the transfer to MCCH and the manager is aware that further work needs to be done to ensure that effective management systems are in place and working properly. Staff spoken to felt that the atmosphere within the staff team was generally good and said that they felt able to raise concerns with the manager should they need to. Salisbury Road DS0000007264.V284661.R01.S.doc Version 5.1 Page 21 Although generally the health and safety of residents and staff is promoted two areas for improvement have been noted earlier in this report – food safety and general hygiene. [See standards 17 and 30]. No other aspects of this standard were tested during this inspection, as the manager was not available to provide information. However, it was noted that fire safety equipment had been tested in the previous month. Salisbury Road DS0000007264.V284661.R01.S.doc Version 5.1 Page 22 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 3 2 X 3 X 4 X 5 2 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 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X X X X 2 X Salisbury Road DS0000007264.V284661.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? NO 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 3 Standard YA5 YA6 YA6 Regulation 5 15 15 Requirement All residents must have a costed statement of terms and conditions of occupancy. Residents care needs must be regularly reviewed and changing needs/ aspirations met. Old records no longer in use must be removed from care files to avoid confusion in delivery of care. Safe food preparation standards must be adhered to. All food being reheated must be probed to ensure that it has been heated to the correct temperature and a record kept. The communal areas of the home to be made more homely in a manner which suits the needs and preferences of the residents. Staff to ensure that basic hygiene standards are maintained and to carry out such tasks in a timely manner. The registered manager to ensure that required information about all staff, including the therapist who visits the home has been obtained and is DS0000007264.V284661.R01.S.doc Timescale for action 31/07/06 30/06/06 31/07/06 4 YA17 16 15/05/06 5 YA24 16 31/07/06 6 YA30 16 15/05/06 7 YA34 17 30/05/06 Salisbury Road Version 5.1 Page 24 8 YA37 24 satisfactory. Control sheets must be fully completed. The registered manager to ensure that effective management systems are in place and are adhered to. 31/07/06 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 Salisbury Road DS0000007264.V284661.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford London E15 4BQ 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 Salisbury Road DS0000007264.V284661.R01.S.doc Version 5.1 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. 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. 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