Inspection on 11/08/05 for Trumpington Road 130

This inspection was carried out on 11th August 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Trumpington Road 130 05/05/09

Trumpington Road 130 06/05/08

Trumpington Road 130 14/06/07

Trumpington Road 130 29/07/06

Trumpington Road 130 20/11/05

Trumpington Road 130 15/02/05

Trumpington Road 130 02/11/04

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

CARE HOME ADULTS 18-65 130 Trumpington Road 130 Trumpington Road Forest Gate London E7 9EQ Lead Inspector Robert Sobotka Unannounced Inspection 11 August 2005 at 9:00am 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. 130 Trumpington Road G56 G06 S36677 Trumpington Road V248603 110805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 130 Trumpington Road Address 130 Trumpington Road, Forest Gate, London, E7 9EQ 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) 020 8496 1440 London Borough of Waltham Forest Mrs Irene Luton Care Home 15 Category(ies) of Learning disability (15) registration, with number of places 130 Trumpington Road G56 G06 S36677 Trumpington Road V248603 110805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 15th February 2005 Brief Description of the Service: Trumpington Road is a purpose built 15-bed respite unit managed by the London Borough of Waltham Forest. The design of the building is different from the others in the locality and sets users apart from the adjacent domestic properties. The home is divided into four units. One of the units can accommodate people with physical disabilities. At present there are still some service users who have been staying at home for an extended period of time whilst attempts are made to find appropriate alternative accommodation. The service caters for people with a wide range of learning disabilities and a wide range of support needs. The length of stay also varies. The establishment does not provide nursing facilities. 130 Trumpington Road G56 G06 S36677 Trumpington Road V248603 110805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 1 day and included speaking to the service users staying at the respite service, some of the staff and the registered manager. The inspector also conducted a tour of the premises and viewed various records. The aim of this visit was to check the home’s progress towards full compliance with the legislation. What the service does well: What has improved since the last inspection? The inspector remains concerned that very little progress has been made since the last inspection to ensure that the outstanding requirements from the last inspection were met. It was noted that the some of the service users who were using the project whilst more appropriate accommodation was sought have now moved on. The project has now got the registered manager in place. Beds on the unit used by people with high mobility needs have been replaced with nursing beds with pressure relieving mattresses. 130 Trumpington Road G56 G06 S36677 Trumpington Road V248603 110805 Stage 4.doc Version 1.40 Page 6 What they could do better: 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. 130 Trumpington Road G56 G06 S36677 Trumpington Road V248603 110805 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 130 Trumpington Road G56 G06 S36677 Trumpington Road V248603 110805 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) 2, 3, 5. No progress has been made to improve the admission procedure to ensure that there is a proper assessment prior to people moving into the service. Without it there is no assurance that care needs will be met. EVIDENCE: As part of this visit, the inspector chose to check the file of the service user who had recently been admitted to the home. The person’s file contained an old assessment, which was produced in November 2002. At the time of this visit the person did not have a care plan. Another file chosen contained the assessment, which was not dated and it was unclear whether this assessment reflected the actual needs of the service user prior to admission to the project. This failure could potentially lead to the health and welfare of the residents being put at risk. The inspector was therefore unable to assess whether the assessed needs of the service users were being met. This situation was also noted during the last inspection visits when a requirement was made and subsequently repeated for action to be taken to ensure that care plans are further developed. There was no evidence of this action being taken. In addition the requirement for each service user to have contract and terms and conditions issued to them by the home remains outstanding and must be met without any further delay. 130 Trumpington Road G56 G06 S36677 Trumpington Road V248603 110805 Stage 4.doc Version 1.40 Page 9 130 Trumpington Road G56 G06 S36677 Trumpington Road V248603 110805 Stage 4.doc Version 1.40 Page 10 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, 9, 10. Limited progress has been made on improving arrangements to ensure that the needs and goals of residents are identified and met. These shortfalls could have a potential to place those who use the service at risk. EVIDENCE: The inspector viewed five care plans, which were chosen at random. Individual plans of care were available for the majority of the service users, but little progress has been made to the requirement that all aspects of health, personal and social care needs are identified and planned for. Plans remain basic, are not up to date and in some cases had not been reviewed. In addition up-to-date risk assessments were not available in respect of all service users. Some of them have not been reviewed or updated for a considerable length of time. This required improvement. Files were appropriately stored and kept confidential. 130 Trumpington Road G56 G06 S36677 Trumpington Road V248603 110805 Stage 4.doc Version 1.40 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 standard(s) 11, 12, 13, 15, 16, 17. Those who use the service are encouraged and supported to lead active lifestyles within the local community and develop and maintain friendships and family links. Their rights and choices were respected and they had opportunities for personal development. Service users enjoyed food in the home, however food storage required improvement. EVIDENCE: This is a respite unit and therefore the main responsibility for finding employment and education does not lie with the project. Those who have lived in the home for considerable length of time were receiving support in moving onto other projects. Service users were consulted about finding jobs or to continue education and training. Staff offered support to those living in the home to maintain and develop social, emotional, communication and independent living skills. Some people were encouraged and supported in cooking sessions. 130 Trumpington Road G56 G06 S36677 Trumpington Road V248603 110805 Stage 4.doc Version 1.40 Page 12 Service users are also supported by staff to become part of, and participate in, the local community. Some of the service users were able to go out independently, however to meet the standard relating to promoting service users’ independence, the registered person must ensure that all risk assessments are in place and kept under review. Those who lived in the home told the inspector that they liked the food served in the home. Breakfast and lunch meals are prepared in the individual units. The evening meal is prepared in the main kitchen by the cook and is taken to the units in heated trolleys. The inspector was invited to share a meal with the service users in one of the units. Meal served was appetising and nutritionally balanced. Individual records of food offered to the service users were kept. Kitchen premises were clean and well maintained. It was noted that some of the food kept in small fridges in units was not labelled. This may pose a health and safety risk and must be addressed without delay. The registered manager must ensure that all opened food in labelled. 130 Trumpington Road G56 G06 S36677 Trumpington Road V248603 110805 Stage 4.doc Version 1.40 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 standard(s) 18, 19, 20. Limited progress has been made to ensure that that staff have clear information about the service users preferences as to how they should be supported in receiving personal support. Where required service users’ physical and emotional needs were being met. Medication systems required improvement. EVIDENCE: The requirement for detailed individual preferences in relation to receiving personal care to be recorded on the service users file remains unmet and must be met without any further delay. As mentioned before, Trumpington Road is a respite unit and the main reposnsibility for meeting healthcare needs of the service users remains with their primary carers (parents/relatives). Those service users who have been staying in the project for longer period are registered with the local General Practitioner and are supported by staff to attend appointments and check ups. Records from those were available for inspection. Where staff required any additional training in relation to healthcare needs of the service users, this was provided to them. Records viewed showed that where needed, service users were able to access input from other healthcare professionals. 130 Trumpington Road G56 G06 S36677 Trumpington Road V248603 110805 Stage 4.doc Version 1.40 Page 14 Medication systems required improvement. The requirement for individual protocols/guidelines to be in place for the administration of “as required medication” remains outstanding and must be met without delay. In addition, record of medication brought into the home must be maintained at all times, as records seen on the day of this visit were incomplete. 130 Trumpington Road G56 G06 S36677 Trumpington Road V248603 110805 Stage 4.doc Version 1.40 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 standard(s) 22, 23. Recording on the way complaints are dealt with required improvement. Those who lived in the home were protected from abuse. EVIDENCE: The home had appropriate complaints procedure in place. Records of complaints made to the home were examined. They did not show how the complaint was resolved and what action was taken by the home. This required improvement. The registered manager must ensure that there is a clear record kept to evidence that all complaints have been appropriately dealt with and resolved. The home had a copy of the CSCI adult protection protocol and staff have received adult protection training. Staff spoken to were aware of the adult protection issues. Accident/incident records were monitored by the manager. 130 Trumpington Road G56 G06 S36677 Trumpington Road V248603 110805 Stage 4.doc Version 1.40 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 standard(s) 24, 25, 27, 30. The premises were meeting the needs of the people using the service, apart from the detected odour in one of the bedrooms. EVIDENCE: The home was purpose built 13 years ago and is different in design from other properties on the same street. The home is close to local shops, amenities and transport. There are four separate units each with lounge, dining room and small kitchen areas. The home is accessible for people with physical disabilities and one unit has specialised bathing facilities. The premises appeared to be clean and hygienic at the time of the inspection, with exception of one bedroom, which had unpleasant odour. Twelve of the bedrooms are approximately 7 square meters in size. The three bedrooms in the unit designed for people with physical disabilities are approximately 10 square meters. The rooms are all small and therefore the amount of furniture provided is limited, as is the space for service users to move around their rooms. 130 Trumpington Road G56 G06 S36677 Trumpington Road V248603 110805 Stage 4.doc Version 1.40 Page 17 Some of the rooms were viewed. They were generally clean and hygienic, however one of the rooms had a strong urine odour. This must be eliminated. Each unit has a bathroom and a shower room and there are appropriate facilities to meet the needs of people with physical disabilities. As stated in the previous inspection reports, although attempts have been made to make bathrooms more homely, they are in general institutional and unwelcoming. The recommendation that all bathrooms and shower units are made less institutional and more in keeping with the homely environment therefore remains outstanding. 130 Trumpington Road G56 G06 S36677 Trumpington Road V248603 110805 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 34, 35. Staff recruitment practices required improvement. Service users are supported by staff who are appropriately trained. EVIDENCE: The inspector viewed duty rosters, which showed that there were sufficient numbers of staff on duty. At the time of this inspection there were 5 posts vacant (2 for the deputy managers and 3 for care staff). The registered manager told the inspector that the recruitment was underway. Staff working in Trumpington Road are employed by the London Borough of Waltham Forest and staff files are kept in the Social Service’s main office. Following last inspection, the inspector forwarded a form for the home to use to show that all documentation was collected prior to staff being employed in the home. Forms viewed by the inspector were incomplete and did not evidence that references were collected for some of the staff employed in the home. This must be addressed without delay. It was noted that all staff have received Criminal Record Bureau enhanced checks. Members of staff working in the home received regular training. Staff training profiles and copies of certificates from courses attended by staff were available for inspection. 130 Trumpington Road G56 G06 S36677 Trumpington Road V248603 110805 Stage 4.doc Version 1.40 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 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, 39, 40, 41. Little progress has been made to ensure that the service user’s needs were being met. These shortfalls have a potential to place residents at risk. EVIDENCE: The manager’s post is currently filled by the person on secondment from another Local Authority (Redbridge). She has been registered with the Commission as “fit” to run the home. The registered manager has a Social Work Qualification and sufficient managerial experience. She informed the inspector that she was in the process of obtaining her National Vocational Qualification in Management (Registered Managers Award). Those who spoke to the inspector said that the manager was friendly and approachable. The home received regular unannounced visits from the responsible individual, reports from which are forwarded to the Commission on a monthly basis. Regular meetings with service users and their relatives were organised. 130 Trumpington Road G56 G06 S36677 Trumpington Road V248603 110805 Stage 4.doc Version 1.40 Page 20 During this visit, the inspector asked a member of staff for some policies and procedures, however these could not be located/found. The requirement in relation to policies and procedures being in place has therefore been repeated and must be met without delay. As previously mentioned, some of the records kept in the project required improvement. This included care plans, risk assessments, personal care guidelines, clear record of complaints and how these have been resolved, and records in relation to staff employed in the home. All of those shortcomings have been identified during previous inspection visits and must be met without any further delay. At the time of this visit some contents of the home’s First Aid Box kept on one of the units was out of date. It is therefore required that appropriate systems are in place for checking and restocking First Aid Boxes in the home. 130 Trumpington Road G56 G06 S36677 Trumpington Road V248603 110805 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 2 2 x 1 Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 2 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 x 3 x x 2 Standard No 11 12 13 14 15 16 17 3 3 3 x 3 3 2 Standard No 31 32 33 34 35 36 Score 3 x x 2 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 130 Trumpington Road Score 2 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 2 2 2 x G56 G06 S36677 Trumpington Road V248603 110805 Stage 4.doc Version 1.40 Page 22 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. Standard 3 Regulation 14 Requirement The registered provider must demonstrate how residents assessed needs are met. (Previous timescales of 30/01/04, 30/06/04, 31/01/05 and 30/04/05 were not met). Each resident must have a contract/terms and conditions as specified in Standard 5 of the National Minimum Standards. (Previous timescales of 28/11/03, 30/06/04, 31/06/04 and 30/04/05 were not met.) Care plans must be more detailed and include clear objectives and must cover all appropriate areas to meet individual assessed needs. (Previous timescales of 30/01/04, 30/06/04, 31/01/05 and 30/04/05 were not met.) Comprehensive risk assessments must be undertaken for all residents and strategies put in place to minimise identified risks. (Previous timescales of 31/10/03, 30/06/04, 31/01/05 and 30/04/05 were not met.) Each service users preference about how they are guided, moved, supported and Timescale for action 15 November 2005 2. 5 5 15 October 2005 3. 6 15 15 November 2005 4. 9 13 01 October 2005 5. 18 12, 13 15 October 2005 Page 23 130 Trumpington Road G56 G06 S36677 Trumpington Road V248603 110805 Stage 4.doc Version 1.40 6. 40 Appendix 3 7. 41 17 8. 20 13 9. 10. 17 20 16(2) 13(2) 11. 22 22 12. 30 16(2)(k) transferred must be explained and recorded. (Previous timescales of 22/10/03, 30/06/04, 31/01/05 and 30/04/05 were not met.) All policies and procedures identified in Appendix 3 of the National Minimum Standards must be made available in the home. They must be up-to-date and readily available. All staff should be familiar with these policies and procedures. (Previous timescales of 31/11/03, 31/07/04 and 28/02/05 were not met.) An up-to-date photograph of each service user must be kept on their files. (Previous timescales of 31/10/03, 31/05/04, 31/01/05 and 30/04/05 were not met.) Individual protocols must be in place for the administration of as required medication. (Previous timescales of 31/05/04, 31/12/04 and 31/03/05 were not met.) The registered manager must ensure that all food is labelled when opened. The registered manager must make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. The registered manger must ensure that there is a clear record kept to evidence that all complaints have been appropriately dealt with and resolved. The registered person musy ensure that all parts of the home are kept free from offensive odours. 15 November 2005 15 November 2005 01 October 2005 15 September 2005 15 September 2005 01 October 2005 01 October 2005 130 Trumpington Road G56 G06 S36677 Trumpington Road V248603 110805 Stage 4.doc Version 1.40 Page 24 13. 34 7, 9, 19 Schedule 2 14. 15. 37 42 9(2)(b)(i) 13 The responsible person must be able to demonstrate that appropriate checks are undertaken on all staff prior to commencing employment in the home. The registered manager must obtain relevant qualification in management. Appropriate systems must be in place for checking and restocking First Aid Boxes in the home. 01 October 2005 31 December 2005 01 October 2005 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 27 Good Practice Recommendations It is strongly recommended that all bathrooms and shower rooms are made less insitutional and more in keeping with the homely environment. 130 Trumpington Road G56 G06 S36677 Trumpington Road V248603 110805 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Gredley House 1-11 Broadway 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 130 Trumpington Road G56 G06 S36677 Trumpington Road V248603 110805 Stage 4.doc Version 1.40 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. 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!