Inspection on 19/01/09 for Vale Road (1b)

This inspection was carried out on 19th January 2009.

CSCI found this care home to be providing an Good service.

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

Vale Road (1b) 03/01/07

Vale Road (1b) 05/01/06

Vale Road (1b) 30/08/05

Vale Road (1b) 20/10/04

Vale Road (1b) 28/04/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

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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 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Vale Road (1b) 1b Vale Road Vale Road (1b) Forest Gate London E7 8BJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sarah Greaves     Date: 2 0 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 03000 616161 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Vale Road (1b) Vale Road (1b) 1b Vale Road Forest Gate London E7 8BJ 02084713545 02084713545 europa.during@heritagecare.co.uk/ValeRd@heri tagecare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Heritage Care care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 6 The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home 1B Vale Road is a registered care home, which provides 24-hour residential care for 6 people with learning disabilities. The registered provider is Heritage Care, and the property is owned by London & Quadrant, who also provide housing services. 1B Vale Road is a ground floor property, which is specially designed to accommodate people with mobility difficulties. Most of the areas within the home are wheelchair accessible. All service users have single bedrooms with washbasin facilities. The home has a communal lounge and a kitchen/dining area. The lounge overlooks the garden. The garden has a patio area, with garden furniture and a lawn area with flowerbeds. 1B Vale Road is situated off Upton Lane, in Forest Gate. Buses 25 and 86 run along the Care Homes for Adults (18-65 years) Page 4 of 26 Brief description of the care home Romford Road to provide links to Stratford and Ilford. The nearest station is Forest Gate, British Rail Station. A small car park is available for visitors. A range of culturally diverse shops, services and amenities are situated on Upton Lane, Romford Road and Woodgrange Road. Currently four females and one male reside at the home. At the time of the Inspection there was one vacancy. Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was conducted over two days, hence we arrived unannounced on the first date but returned at an arranged date and time for the second visit. We gathered information through speaking to the residents, staff and the registered manager. We also made observations of residents and staff together, such as popping in to join the residents during their pub lunch on the second day of the inspection. We looked at care plans, assessments, risk assessments, health action plans and medication administration records in order to view the evidence of how the service planned and delivered support and care. Staff files were checked in regard to recruitment practices, staff training, supervision and appraisals. Information was also obtained through checking the storage of Care Homes for Adults (18-65 years) Page 6 of 26 medication, touring the internal and external premises, looking at food supplies and checking the health and safety documents. The service submitted an Annual Quality Assurance Assessment, which is a self-audit tool sent by the Commission, for a care home to consider how it has met the National Minimum Standards. This document was comprehensively completed and was used for this inspection and report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –03000 616161. Care Homes for Adults (18-65 years) Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service offered good practices to enable prospective residents (and their supporters) to find out about life at 1b Vale Road. Evidence: We read the Statement of Purpose and the Service Users Guide during this visit. It was noted that these documents were regularly reviewed to ensure that they were accurate, clear and accessible. We suggested a couple of very minor changes; for example, not to use abbreviations such as CO2, as not all readers might be aware of its meaning. We reviewed the actions taken by the service in order to support prospective residents move into the care home. It was noted that prospective residents were offered opportunities to visit prior to moving in for a trial period, and the involvement of representatives of residents (such as relatives, friends and advocates) was encouraged. Each resident was issued with an individualised contract. Information was made available in an accessible pictorial format. Care Homes for Adults (18-65 years) Page 10 of 26 Care Homes for Adults (18-65 years) Page 11 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a service that addresses their entitlements to individualised support and making own choices. Evidence: We read two care plans during this inspection. It was noted that the care plans were well written and individualised; there was a positive focus upon identifying and understanding the unique needs and aspirations of each resident. We observed staff supporting people to make decisions about their lives, such as the option of attending twice weekly pub trips. Residents were offered opportunities to visit a nearby pub for lunch and beverages of their choice; this was noted to be a popular activity that enabled people to feel part of their local community. Residents were able to access independent advocacy services and there were plans for some residents to attend an external advocacy group. The care plans that we looked at were noted to contain comprehensively produced risk assessments that were clearly applied to the individual residents. Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: We found that confidential information was securely stored within the premises. We observed that instructions from a health care professional in regard to one resident was displayed in the kitchen. In accordance to the specific information provided by the registered manager, we were satisfied that this was an acceptable action. Care Homes for Adults (18-65 years) Page 13 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are well supported to participate in meaningful activities at home and in the community, and they benefit from a structured approach to meeting their nutritional needs. Evidence: Through reading two care plans, speaking to the residents and a discussion with the registered manager, we found that residents were offered a wide range of fulfilling activities. On the first day of this inspection, one of the residents was attending a rambling group and on the second visit several residents and staff members participated in a regular pub lunch event. We found that residents took part in a broad range of hobbies and interests including visits to the gym and sauna, movie nights, college courses, in-house art projects and aromatherapy sessions. The service had established a digital photoframe in the communal lounge that Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: displayed photographs of residents taking part in activities; we observed that some residents liked to look back on these visual reminders of outings and entertainments. Residents accessed local and further afield public facilities such as pubs, restaurants, libraries, parks and city farms. We were informed that the service encouraged explorer days; this involved residents and staff taking a trip to an historic, picturesque or stimulating part of London to look around and have lunch. The service supported residents to meet their cultural needs, for example, there were trips to traditional pie and mash shops for people that were familiar with this food as children and for others that were interested. Two of the residents chose to regularly attend places of worship, which was supported by the service. We found that the service supported residents to take holidays that reflected their own choices and interests, such as UK or foreign beach resorts, and entertainment venues such as Butlins and Disney. Through discussion with the registered manager we found that the service encouraged the active involvement of family members and friends. We were pleased to learn that one of the residents was visited by a former resident from their previous care home; staff understood the importance of promoting this ongoing friendship. We noted that the kitchen was satisfactorily stocked with a suitable choice of food items, such as fresh fruits and vegetables, choice of cereals, yoghurts and fruit juices. There were also savoury and sweet biscuits, crisps and chocolate, which recognised that a balanced diet permitted some treats in moderation. We observed that staff were preparing a main meal on the first day of the inspection in accordance to the planned menu; this was a winter stew with a couple of vegetables, which appeared healthy and appropriate for the weather at the time of our visit. Care Homes for Adults (18-65 years) Page 15 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are provided with good support to meet their personal and health care needs; however, further attention needs to be applied to the safe management of prescribed medications. Evidence: Via reading the two care plans and speaking to the registered manager, we found that the service had gathered individualised information in regard to the residents own preferences for their personal care. We noted that there were suitable plans in place to meet individual needs, such as supporting residents to take a bath or shower (depending upon their wish and any specific needs due to a disability), hair care and purchasing clothes. These plans recognised any specific cultural needs relating to personal care and clothing requirements. We looked at the designated health care plans within the two care plans read at this inspection, and also discussed the general arrangements for meeting the identified health care needs of all of the residents. At the time of this inspection the service was supporting a person with a progressive condition; it was noted that staff had received training from within the organisation and from an external source. The registered Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: manager presented a good understanding of the issues related to this condition. We were informed that there were no current concerns in regard to residents accessing the health care that they needed (such as input from GPs, dentists, opticians and chirpodists); it was also noted that there had been recent involvement from a speech and language therapist to support nutritional needs. We checked the services management of residents prescribed medications. The following observations were made: 1) Co-codamol 500mg (as stated on the pharmacy label) had been recorded by staff at the service as being co-codamol 30mg on the medication administration record 2) The prescription label for folic acid did not correspond with the instruction on the medication administration record 3) Epilum had been accepted without a pharmacy label 4) Prescribed topical creams were not securely stored in a bedroom that we viewed. 5) Prescribed build-up drink Ensure (one carton) was stored in the communal refrigerator. Although it was acceptable for this item to be cooled and the service was right to respond to an individuals preference for a chilled drink, this product should be kept in a lockable facility within the refrigerator as the concentration of nutrients could have an unpleasant effect if consumed by a person that was not prescribed a dietary supplement. The service had its own medication procedure, which addressed correct systems for the recording and storage of medication, and staff had received training. We suggested that the local pharmacist might be able to offer additional support, such as an up-date/refresher session or an audit of medication systems, or this could be delivered by the service provider. Care Homes for Adults (18-65 years) Page 17 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are assured that complaints will be well managed and that systems are in place to protect them. Evidence: We found that there was a clearly presented complaints procedure, and information was also presented in a pictorial format. We noted that there had been one complaint since the last inspection, which had been appropriately managed by the service. Residents were supported to access independent advocates and/or family members provided this assistance. The service produced a satisfactorily written Adult Protection procedure, and also had a Newham Safeguarding policy. Information was provided to staff regarding how to whistle-blow, and staff received regular training in Adult Protection. There have been no issues regarding the protection of vulnerable adults since the last inspection. Care Homes for Adults (18-65 years) Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are provided with a pleasant home, although the bathrooms would benefit from some improvements. Evidence: We toured the premises with the registered manager. The property is a ground floor building with six bedrooms and communal facilities, including a rear garden. It is owned by a local housing association, which is responsible for carrying out repairs. We found that the premises were comfortable and homely, and decorated to a satisfactory standard. The communal lounge was welcoming and residents were supported to individualise their bedrooms in accordance to their own preferences. It was noted that some work needed to be undertaken in the bathrooms, which were more prone to everyday wear and tear and incidents such as water leakage. We found that the registered manager was very clear regarding the identified priorities for re-decoration. The premises were clean and free from any offensive odours. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from receiving support from staff that are properly recruited, trained and supervised. Evidence: We checked the files for two members of staff and found that there was appropriate information to demonstrate that they had been safely recruited, in accordance to the National Minimum Standards and Regulations for Care Homes for Younger Adults. Support staff accessed National Vocational Qualifications in Care at levels 2 and 3, in addition to a programme of mandatory (such as moving and handling, fire safety and first aid) and specialist training. The service presented its own annual training analysis plan, which recognised specific training that staff required in order to meet the needs of the current residents, for example, training to understand the needs of people with epilepsy and dementia. The supervision notes checked at this inspection demonstrated that staff received regular supervision of a detailed and constructive nature. We looked at the staffing rota, which demonstrated a flexible approach to ensuring that staff were available to take residents out to favoured activities such as bingo sessions. Care Homes for Adults (18-65 years) Page 20 of 26 Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are assured that their home is managed well, in a manner that listens to their views and strives for on-going improvement. The safety of the residents is addressed, although a more diligent approach is needed regarding food labelling. Evidence: We found that the service was managed with a positive and effective approach, which rightly placed the needs and rights of the residents at the centre of all decisions and practices. The registered manager informed us that she is very close to completing the Registered Managers Award and she has undertaken additional management training courses provided by Heritage Care. It was noted that the service used its own systems for auditing the quality of care, such as the monthly unannounced monitoring visits from the area manager, individual reviews of residents (which involved residents, their repesentatives and relevant external professionals), and on-going communication with residents and their supporters to receive their views about the service. We checked the following health and safety documents, which were found to be Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: satisfactory: 1) landlord gas safety 2) electrical installations inspection by a competent person 3) portable electrical appliances testing 4) fire risk assessment 5) monthly fire drills 6) weekly testing of fire equipment 7) professional maintenance of the fire equipment 8) missing persons files for liasion with police and other services 9) public liability insurance. We checked the storage of items in the refrigerator and observed that ham which needed to be eaten within two days of opening was still present on day 3, and opened fruit juice and tomoto ketchup were not marked with date of opening, taking into account that these products had manufacturers guidelines for time of disposal. Observations regarding an unlocked shed and laundry room cupboard were corrected during the course of this inspection. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 20 13 The registered manager 31/03/2009 must ensure the safe management of medications. To minimise the risk of residents receiving incorrectly administered medications. 2 42 13 The registered manager must ensure that opened food items are appropriately labelled. To promote the safety of the residents dietary intake. 31/03/2009 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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