Inspection on 08/08/05 for The Homesteads

This inspection was carried out on 8th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Homesteads 23/11/07

The Homesteads 07/11/06

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 The Homesteads 216 Southend Road Stanford Le Hope Essex SS17 7AQ Lead Inspector Ann Davey Unannounced 8 August 2005 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Homesteads I56-I06 S60828 Homesteads V240957 080805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Homesteads Address 216 Southend Road Stanford Le Hope Essex SS17 7AQ 01375 402444 01375 401937 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Category(ies) of registration, with number of places Mr S Monaghan & Mr J OConnor Ms Janice Tyrrell Care Home Learning Disability (6) The Homesteads I56-I06 S60828 Homesteads V240957 080805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: The Homesteads is a corner plot establishment on the main Stanford le Hope road. The home provides personal care for 6 young adults with a learning disbility. It is situated within a reasonable distance of local fcailities and there is a bus stop outside the home. The home has 2 floors and provides 6 single bedroom ensuite facilities. There is a good sized patio/garden area to the rear of the property. The Homesteads I56-I06 S60828 Homesteads V240957 080805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a 3-hour period. A tour of the home took place. Staff, a resident and a visiting professional were spoken with. Records were selected at random and inspected. A notice was displayed in the main entrance area advising all visitors to the home that an inspection was taking place with an open invitation to speak with the inspector. The findings at the inspection were disappointing as this was the home’s first inspection since registration took place on 4th March 2005. Only 2 residents were accommodated at the time. The home has 4 vacancies. The inspector gave a full and detailed ‘feedback’ to the manager with opportunity for clarification and/or further discussion. Assurances were given by the manager that the registered person would be contacted, and the most serious shortfalls identified would be addressed without delay. As a direct result of the inspection, arrangements have been made for the registered persons to attend a meeting with the Commission to discuss the current situation. What the service does well: What has improved since the last inspection? What they could do better: The findings of the inspection were disappointing as the home has only been functional for 5 months. Prior to registration, environmental standards in particular were discussed with the registered persons and assurances were given that national minimum standards would be maintained. This was not evidenced at the inspection. Staff recruitment records and staff rotas were either not available and/or inadequate. Communication systems with the Commission are not effective, the Statement of Purpose is not accurate and the medication and residents personal monies recording processes require review. Infection control measures and processes require review. The report The Homesteads I56-I06 S60828 Homesteads V240957 080805 Stage 4.doc Version 1.40 Page 6 also details other documents, documentation systems and records that require review to ensure compliance with regulatory requirements and/or the national minimum standards. The registered person(s) must also review the systems and manner in which communicate is made with the Commission. At present, communication is not effective and/or reliable. 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 Homesteads I56-I06 S60828 Homesteads V240957 080805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Homesteads I56-I06 S60828 Homesteads V240957 080805 Stage 4.doc Version 1.40 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 standard(s) 1 Details within the Statement of Purpose are not accurate and provide misleading information. EVIDENCE: The Statement of Purpose states that the home provides a craft room and sensory stimulation equipment. These were not available. Other statements within the document such as ‘day care coordinator, physiotherapist and visiting aromatherapist’ were also discussed. It is recommended that mention of the manager’s dogs being on the premises when she is on duty be made. (The Commission has no objection to dogs being on the premises providing they are under control and managed properly at all times, infection control measures are in place, residents are not inconvenienced as it is their own home, there is no inappropriate use of the home facilities which are designated for residents use and residents are comfortable about dogs being present. To ensure that all parties are aware of the situation, it is advisable to refer to these matters within the home’s Statement of Purpose & Service User’s Guide) Copies of residents contracts were seen on files. The Homesteads I56-I06 S60828 Homesteads V240957 080805 Stage 4.doc Version 1.40 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 standard(s) 6,7,8,9 & 10 Records held on residents were current and detailed providing staff with sufficient information to provide effective care. Some development work is recommended to ensure that all documentation is correctly dated and signed. EVIDENCE: The care plan system in general was well ordered and presented well. Pre admission assessments and care plans seen were detailed and evidenced the respective resident’s involvement. It is important that the home reviews all risk assessment to ensure that they are correctly dated and signed. Staff on duty had a good understanding of residents care needs. The Homesteads I56-I06 S60828 Homesteads V240957 080805 Stage 4.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16 & 17 Opportunities are available for residents to participate in appropriate external & internal leisure/social activities, adult day/education facilities and maintain family links. A review of the nutrition recording system is needed to ensure accuracy. EVIDENCE: One resident already attends a day centre and arrangements are in place for the other resident to start in September. The home has established links with day centres and adult education facilities. Residents are able to maintain and enjoy an appropriate social life and the home encourages links with families. Records evidenced that families and advocates are involved. Records evidenced that residents are involved in menu planning. As only 2 residents are accommodated it is relatively easy for the home to provide exactly what is requested by residents on a daily basis. It was noted that although desserts were available, none were recorded on the nutrition records. The Homesteads I56-I06 S60828 Homesteads V240957 080805 Stage 4.doc Version 1.40 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 & 20 EVIDENCE: A visiting advocate from the local Primary Health Care Trust spoke positively about her experiences of the home. It was noted that 1 resident is attempting to reduce their smoking habits. The culture amongst staff is that they too smoke. Smoking is undertaken in the garden area which is also occupied by residents. The home must be sensitive to the situation and respect the wishes of residents and provide every encouragement and incentive to help residents achieve their personal goals. Records identify residents full care needs and these are reflected in care plans. Only 1 resident is on medication. Records seen were orderly, but the practice of staff not signing entries when the manual transcribing of medication instructions takes place, is a potential risk. This must be addressed. The Homesteads I56-I06 S60828 Homesteads V240957 080805 Stage 4.doc Version 1.40 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 Staff have received adult protection training and know what to do should an incident be suspected. Residents have inaccurate information about how to make a complaint. The home’s practice of safekeeping resident’s personal monies requires review to include signatures for all transactions. EVIDENCE: Staff on duty had a good base understanding of what process to follow should an incident of abuse be suspected. They also understood the term ‘whisleblowing’. Unfortunately, the home does not hold any staff training records to demonstrate that appropriate training has taken place. The information and detail within both residents contracts about how to make a complaint, is inaccurate and/or does not say that the person can approach the Commission without prior reference to the home. Since registration, 2 concerns have been raised concerning environmental standards within the home and also the practice of the manager bring her 2 large dogs into the home when she is on duty. Both concerns are related to basic hygiene standards. The home safe keeps personal monies for 1 resident. There were no staff signatures for the last 27 transactions. The amount in the ‘record’ did not equate with the actual money held. Although monies were in excess of the record, it is further evidence of poor management. Other records were not viewed. The Homesteads I56-I06 S60828 Homesteads V240957 080805 Stage 4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27 & 30 The home did not have an acceptable standard of order, hygiene and cleanliness in the communal areas. EVIDENCE: Only 1 occupied bedroom was seen (accompanied by the manager). It was adequately furnished and contained many personal items. The room was comfortable and the resident had made it homely. Prior to registration, the Commission had spoken with the registered persons about the intentions to create a more ‘homely’ environment. The premises prior to registration was a hotel, and there still remains a ‘commercial’ feel about the home. Corridors lack natural light and the décor is some areas is still quite dark. The home did not smell clean and fresh. Prior to registration assurances were given that decoration and some identified repair would be ‘finished’ off, there was little evidence that much work had been undertaken. The 1st floor bathroom wc had no soap or towel. The light in the ground floor bathroom did not work (the manager said that there was a fault), there was no The Homesteads I56-I06 S60828 Homesteads V240957 080805 Stage 4.doc Version 1.40 Page 14 soap or towel. Within the fridge, there were packets of food unwrapped and undated. There was no evidence of a deep cleaning schedule in place. Dog hairs were noted along skirting boards in the lounge and dining areas and there was evidence that the dogs are allowed to sit on furniture used by residents. There was dog excrement in the residents garden area and cigarettes ends had been left on the patio floor and in surrounding shrub areas. The manager agreed that the office area was cluttered, very untidy and disorganised. Desks were overflowing with paperwork, there were cardboard and plastic contains all over the floor which contained a manner of different things. The floor space was limited because of the area being used to store unrelated items. The lighting within this room is inadequate. This was raised prior to registration. The inspector had to utilise a broken chair. A formal complaint has already been made to the home concerning environmental standards. Assurances were given to the Commission by the registered persons that standards would be monitored for compliance. The registered persons must undertake an immediate environmental audit to identify shortfalls, how they are to be addressed and what measures will be put in place to ensure compliance with the national minimum standards. A copy of this audit must be sent to the Commission within 28 days. The Homesteads I56-I06 S60828 Homesteads V240957 080805 Stage 4.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34 The home’s recruitment processes are poor and residents are potentially at risk. EVIDENCE: Staff records seen did not contain POVA 1st checks, CRB checks, references, induction, training or supervision records. These staff are left unsupervised with residents. The current rota did not show sufficient staff to cover for the end of the week, the manager said that she had to check whether or not the registered person was going to cover the vacant shifts. The rota format said that ‘*’ indicates the member of staff responsible ‘house checks’ and the senior responsible for the shift would be identified in red. Neither practice was evidenced. The inspector asked a support member of staff about his understanding of the rota, he said that he hadn’t seen it. When asked how he knew whether or not he should have been on shift that morning, he said that the manager had told him. The rota previous to the current weeks was not completed in full and/or dated. The manager was unable to locate any other rotas. The Homesteads I56-I06 S60828 Homesteads V240957 080805 Stage 4.doc Version 1.40 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,42 & 43 Since registration, there has been little evidence that the registered persons are managing and conducting the home in an effective, competent manner. EVIDENCE: The home has been registered for 5 months. During this period of time, the registered persons have not communicated with the Commission in an effective and competent professional manner regarding the following aspects in particular. • • • • The registered person(s) required reminding that the regulatory Regulation 26 visits were not being undertaken (and supplied to the Commission). The registered person did not inform the Commission of his change of address which is required by regulation. There was an unacceptable delay by the home in respect of a complaint. The registered person(s) did not pay the annual fee on the due date. I56-I06 S60828 Homesteads V240957 080805 Stage 4.doc Version 1.40 Page 17 The Homesteads • Since registration, written communication from the home to the Commission has not been efficient and/or effective. It is disappointing that after only 5 months of operation, the shortfalls as detailed within the report were discovered. These shortfalls have a direct impact on the health, safety and welfare of residents. The Homesteads I56-I06 S60828 Homesteads V240957 080805 Stage 4.doc Version 1.40 Page 18 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 “ ” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 1 x x x 3 Standard No 22 23 ENVIRONMENT Score 2 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 3 3 3 x x 1 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 2 Standard No 31 32 33 34 35 36 Score x x x 1 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Homesteads Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 1 1 x x x 1 1 I56-I06 S60828 Homesteads V240957 080805 Stage 4.doc Version 1.40 Page 19 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 1 Regulation 4,5 & 6 Requirement The registered person(s) must ensure that the content of the Staement of Purpose & Service Users Guide is an accurate reflection of current practice and is compliant with the requirements of regulation. Amended copies must be sent to the Commission. The registered person(s) must ensure that records are available to demonstrate that residents are provided with an appropriate diet. The registered person(s) must ensure that the practice of manual transcribing medication instructions to MAR sheets is endorsed by 2 members of staff for the protection of residents. The registered person(s) must ensure that the complaints procedure within residents contracts is accurate and compliant with regulation. The registered person(s) must review the current practice of record keeping concerning residents monies to ensure compliance with regulation. Timescale for action 8/9/05 2. 17 16 8/9/05 3. 20 13 8/9/05 4. 22 22 8/9/05 5. 23 16 8/9/05 The Homesteads I56-I06 S60828 Homesteads V240957 080805 Stage 4.doc Version 1.40 Page 20 6. 24 & 25 13,16 & 23 7. 34 18 & 19 8. 37,38,42 & 43 10 The registered person(s) must carry out a full audit of the premesis (and outside grounds) and identify aspects which do not meet regulatory and/national minimum standards. This includes all aspects environmental and infection control. A copy of the audit should be sent to the Commission within 28 days identifying the issues, how they are to be addressed (and who by) and what monitoring measures are in place. The registered person(s) must ensure that staff recruitment procedures and practices are in place which are compliant with regulation and the national minimum standards. The home must also have accurate rotas in place. The registered person(s) must demonstrate that the home is being conducted and managed with sufficient care, competence and skill. 8/9/05 8/9/05 8/9/05 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 9 18 Good Practice Recommendations The registered person(s) should ensure that all risk assessements are signed and dated. The registered person(s) should ensure that residents are fully encouraged and enable to reach their chosen personal goals. This is in respect of staff smoking in the presence of residents. The Homesteads I56-I06 S60828 Homesteads V240957 080805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 The Homesteads I56-I06 S60828 Homesteads V240957 080805 Stage 4.doc Version 1.40 Page 22 - 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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