CARE HOME ADULTS 18-65
Russell Lane, 42 Whetstone London N20 0AE Lead Inspector
Tom McKervey Unannounced Inspection 10th January 2006 10:30 Russell Lane, 42 DS0000065437.V269821.R01.S.doc Version 5.0 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 Russell Lane, 42 DS0000065437.V269821.R01.S.doc Version 5.0 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. Russell Lane, 42 DS0000065437.V269821.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Russell Lane, 42 Address Whetstone London N20 0AE 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) 020 8361 6500 020 8361 6500 CareTech Community Services (No.2) Ltd Mrs Jackie Kit-Chun White Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Russell Lane, 42 DS0000065437.V269821.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 19th August 2005 Brief Description of the Service: 42 Russell Lane, also known as The Oaks, is a registered residential care home for six adults with a learning disability. The home was opened in 1998 by CareTech Community Services Limited, a company which also owns other residential homes in Barnet. The home is divided into two units: a ground floor flat and a first floor flat. Each flat has three bedrooms, a kitchen, dining room, quiet room, a separate toilet and bath and a toilet and shower. There is a front garden which is paved and used for parking, and a back garden which is maintained by the company’s gardener. The home has its own 7-seater vehicle for taking the service users out on trips and appointments The home is located on a busy road, with easy access to shops, cafes, restaurants and public houses. There is a bus stop in front of the home. The current residents are all men. Russell Lane, 42 DS0000065437.V269821.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a period of two-and-a-half hours. The registered manager was present throughout the inspection and offered fully cooperated in the process. A tour of the premises was carried out, including visiting the residents’ bedrooms. The residents’ case files, staff records and documents relating to the running of the home were examined. The inspector spoke to two residents who had verbal skills and met one other service user. Two members of staff were also spoken to. What the service does well: What has improved since the last inspection? What they could do better:
A requirement made at the last inspection has not yet been met and has been restated in this report, with a new timescale for compliance. In the “Timescale for Action” column, the date in ordinary type relates to the timescale given at the last inspection. The date in bold type relates to the new Russell Lane, 42 DS0000065437.V269821.R01.S.doc Version 5.0 Page 6 timescale. Further information about the unmet requirement can be found in the relevant standard. Unmet requirements can impact upon the welfare and safety of service users. Failure to comply by the revised timescale may lead to the Commission for Social Care Inspection considering action to secure compliance. The residents must be fully consulted about their views when the annual quality assurance audit is carried out. This requirement is restated in the report. The paved areas need to be made level to prevent accidents, and the old furniture in the downstairs lounge needs to be replaced for the comfort of 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. Russell Lane, 42 DS0000065437.V269821.R01.S.doc Version 5.0 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 Russell Lane, 42 DS0000065437.V269821.R01.S.doc Version 5.0 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): EVIDENCE: No new service users have been admitted to the home; therefore, none of these standards was examined at this inspection. Russell Lane, 42 DS0000065437.V269821.R01.S.doc Version 5.0 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, 8, & 10 The needs of the residents are clearly documented in individual care plans and appropriate risk assessments enable staff to support the residents to be as independent as possible. EVIDENCE: Two care plans were sampled. They were individually compiled and they provided detailed objectives of care. There was guidance for staff about the actions required to achieve the goals. The plans were reviewed six monthly and an annual review was held with the service user’s social worker and relatives. The residents are dependent on staff support to varying degrees, but there are good risk assessments in place to ensure that reasonable risks can be taken to allow residents to be as independent as possible. There were risk assessments in place to ensure that the residents are supported to be as independent as possible. Daily records were made about individual’s progress and significant events. The residents who were spoken to, gave examples of the decisions they make from day-to-day, mainly about activities they wished to undertake on days
Russell Lane, 42 DS0000065437.V269821.R01.S.doc Version 5.0 Page 10 when they don’t attend their day centre. They also expressed their preference about holidays. Residents’ case files were observed to be securely stored, and the staff who were spoken to, were aware of the need for confidentiality about information concerning the residents. Russell Lane, 42 DS0000065437.V269821.R01.S.doc Version 5.0 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): 11, 13, 15 & 17 The residents access good educational and leisure activities, both in the home and the community. These activities provide stimulation and interest, and enable residents to attain daily living skills. Meals are nutritious and offer a varied diet. EVIDENCE: The residents are supported by staff to clean their own rooms, do the weekly shopping and to cook. They also have opportunities at day centres and colleges to develop life skills. There were various certificates of achievement attained at these facilities. Individual activity programmes were on display to guide staff, and there were daily records of residents spending significant time accessing amenities in the community, for example; pubs and restaurants, going for walks and going to the bank. Each person had a holiday last summer. Two residents said that they had a lot of contact with their families, including overnight stays and weekends. The visitors’ book also had records of relatives visiting the home.
Russell Lane, 42 DS0000065437.V269821.R01.S.doc Version 5.0 Page 12 The menus showed a good variety of food, with evidence of choice. There was fresh fruit in evidence. Russell Lane, 42 DS0000065437.V269821.R01.S.doc Version 5.0 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 residents’ healthcare needs are being met and medication is stored and administered safely. EVIDENCE: The case files of two residents were examined. They contained records of appointments with the G.P and a range of health professionals. One resident had been seen by a consultant because he was reacting poorly to his medication. This was reviewed and altered by the consultant. All residents have an “O.K health check” each year by the Community Learning Disability Team, to which relatives are invited. All residents had the flu jab this winter. Medication was appropriately stored and there were good records that the administration of medicines was carried out safely. Russell Lane, 42 DS0000065437.V269821.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 The residents’ interests and welfare are being safeguarded by good practice and staff training. EVIDENCE: There were no complaints in the past year. The complaints procedure is in pictorial format for the benefit of the service users, and a copy of each was seen in the residents’ files, which is good practice. The residents said that they were very happy with their care and described how they would express themselves if they had any concerns. The manager is accredited to train staff in adult protection, and there was evidence of staff training in these procedures. Russell Lane, 42 DS0000065437.V269821.R01.S.doc Version 5.0 Page 15 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, 26, 28 & 30 New carpets and redecoration has greatly improved the appearance of the home and contributed to the comfort of the residents. The home is very clean and tidy. The downstairs lounge furniture is old and worn and should be replaced and the paved area needs to be levelled. EVIDENCE: A tour of the home was carried out. New carpets had been laid in the downstairs dining room and corridor, and these areas had also been redecorated. A resident invited the inspector to visit his bedroom. It was very comfortable and the many personal items reflected his interests and there were photographs of his family. New kitchen units were on order for the upstairs kitchen. The furniture in the downstairs lounge is old and worn and needs to be replaced. There were some uneven slabs in the paved area at the rear of the building, which could cause accidents. Requirements are made regarding these matters. The home was generally very clean and tidy, and cleaning materials were stored safely.
Russell Lane, 42 DS0000065437.V269821.R01.S.doc Version 5.0 Page 16 Russell Lane, 42 DS0000065437.V269821.R01.S.doc Version 5.0 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): 31,32, 33, 34 35 & 36 There are sufficient staff on duty at all times to meet the residents’ needs. Staff are well trained and supervised, and there are appropriate systems in place for recruiting staff and supporting them in meeting residents’ needs. EVIDENCE: The rotas showed that there were always sufficient numbers of staff on duty to meet residents’ needs, including supporting them on outings. All staff undergo an extensive written induction programme, and a new member of staff who was on the programme, was spoken to independently. They showed the inspector how they were progressed through the induction workbook, and they were able to describe their duties in caring for the residents. The staff records showed that proper checks had been carried out on new staff, including Criminal Record Bureau. Staff had received training in all areas relevant to the care of service users. The manager is an assessor for the National Vocational Qualifications programme, and four staff have attained NVQ level 2. There was evidence that all staff have formal supervision every month. Russell Lane, 42 DS0000065437.V269821.R01.S.doc Version 5.0 Page 18 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, 38, 39 & 42 EVIDENCE: Russell Lane, 42 DS0000065437.V269821.R01.S.doc Version 5.0 Page 19 The registered manager has been in post since the home opened in 1998. She has achieved the Registered Manager Award at NVQ level 4. Through observation of and discussion with the manager, residents and staff, the inspector was satisfied that the home is well managed. The staff stated said that there was a good team spirit and their morale was high. Senior managers carry out monthly unannounced visits to the home for the purpose of quality assurance and copies of the reports are sent to the Commission for Social Care Inspection. At the last inspection, the inspector saw a very detailed audit of the quality of the service. However, it was not clear from the document, that the residents had been consulted during this audit. The manager said that the audit was to be repeated soon, with this in mind. This requirement is restated in this report. There were records of fire alarm tests and regular fire drills. No health and safety issues were identified at the inspection. Russell Lane, 42 DS0000065437.V269821.R01.S.doc Version 5.0 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X
X Standard No 22 23 Score 4 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X 3 X 3 Standard No 24 25 26 27 28 29 30
STAFFING Score 2 3 3 X 3 X 3 LIFESTYLES Standard No Score 11 3 12 X 13 3 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Russell Lane, 42 Score 3 X 3 X Standard No 37 38 39 40 41 42 43 Score 4 3 3 X X 3 X DS0000065437.V269821.R01.S.doc Version 5.0 Page 21 Yes 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 3 Standard YA24 YA28 YA39 Regulation 23(2)(o) 16(2)(c) 24(3) Requirement The registered person must ensure that the paving at the rear of the building is level. The registered person must replace the worn furniture in the downstairs lounge. The registered person must include the views of the residents about the service in the quality audit. This requirement is restated, the previous timescale was 31/12/05 Timescale for action 28/02/06 30/04/06 31/03/06 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 Russell Lane, 42 DS0000065437.V269821.R01.S.doc Version 5.0 Page 22 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
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