Inspection on 21/09/05 for Vicarage Road (1&3)

This inspection was carried out on 21st September 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Vicarage Road (1&3) 07/01/08

Vicarage Road (1&3) 06/12/06

Vicarage Road (1&3) 05/08/05

Vicarage Road (1&3) 22/02/05

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Vicarage Road (1&3) 1&3 Vicarage Road Dagenham RM10 9SX Lead Inspector Joanna Moore Unannounced Inspection 21 September 2005 14:00 Vicarage Road (1&3) DS0000060786.V256300.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 Vicarage Road (1&3) DS0000060786.V256300.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. Vicarage Road (1&3) DS0000060786.V256300.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Vicarage Road (1&3) Address 1&3 Vicarage Road Dagenham RM10 9SX 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 8592 8734 The Avenues Trust Limited Janet Frances Kedgley Care Home 8 Category(ies) of Learning disability (8), Physical disability (8) registration, with number of places Vicarage Road (1&3) DS0000060786.V256300.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th August 2005 Brief Description of the Service: 1 to 3 Vicarage Road is a newly purpose built 8 bedded unit comprising of two connected bungalows set on a housing development. The home is registered to provide care for service users with learning disabilities and/or physical disabilities and current residents have very high care needs, staff use their knowledge of service users means of communication to efectively undertsand their needs as the range of verbal communication that service users are able to use is limited. All of the current service users previously resided in Little Highwood Hospital, a long stay instititution due for closure. the home is operated by Avenues Trust which is a registered Charity. All the bedrooms are en-suite, there are two large dining/sitting areas, two kitchens, two laundrys and two garden areas. The home also has its own custom built vehicle, which staff drive to take service users out on outings. At the time of the inspection there was one vacancy and one service user who was in hospital and not likely to return to the home. Vicarage Road (1&3) DS0000060786.V256300.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out as part of the annual inspection program. It was the second inspection carried out within some six weeks firstly to ensure that some requirements from the previous inspection such as the heating had been effectively addressed. Secondly in response to concerns raised by the speech and language team that a service user was not being provided with a pureed diet in line with speech and language therapy recommendations. This was a short focused inspection and to have a fuller understanding of the home and its ability to meet the national minimum standards as a whole please refer to the report of the inspection carried out in August 2005. Requirements and recommendations from the previous report have been repeated in this report unless the inspector was shown directly that they had been addressed, it should be noted that the timescales for addressing the majority of requirements had not been reached when this inspection was carried out. At the time of the visit the home was experiencing staffing difficulties, an investigatory visit from managers within Avenues trust and a visit from a prospective service user in addition to the inspection. It is acknowledged that the visit was carried out at a difficult and busy time for the home and should be noted that the manager and staff managed to deal with the difficulties they faced in a professional and helpful manner. What the service does well: What has improved since the last inspection? The heating has been repaired. Vicarage Road (1&3) DS0000060786.V256300.R01.S.doc Version 5.0 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. Vicarage Road (1&3) DS0000060786.V256300.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 Vicarage Road (1&3) DS0000060786.V256300.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): 1,2,3,4&5 The prospective service users was provided inaccurate information as to whether there was a vacancy within the home which undermined their ability to make a choice as to whether the home was somewhere they would like to move to. The service user with existing rights of residency was in the position of having their room let out before giving notice of whether they indeed wished to return to the home. EVIDENCE: One service user (a) at the time of the inspection was in hospital for assessments and treatment, it was not clear at the time of the visit whether this person would be returning to the home. No notice had been served on the home by the service user or the placing authority to cancel the placement nor had Avenues served notice upon the service user stating that they felt unable to continue to provide care. The minutes of the service users CPA (Care Program Approach) review indicated that no final decision had been made as to whether the service user would return to the home. The service user technically therefore retained the right to return to the home. The manager advised the inspector that they had been told that service user (a) would not be returning to Vicarage road. As a result of this information and Vicarage Road (1&3) DS0000060786.V256300.R01.S.doc Version 5.0 Page 9 with the approval of Avenues Trust an assessment had taken place with a view to a new service user (b) moving into the home. At the time of the inspection service user (b) visited the home as part of the preparation to move in process and the inspector was advised that the intention was that (b) would move in to Vicarage road in three days time. Service user b had been assessed as suitable to move into the ‘vacant’ room in number 1 vicarage road but this was the room service user (a) had previously occupied and if returned to the home would expect to return to. The home would not be over registered numbers if both service users lived at the home but number 1 and 3 cater for different needs and number 3 the inspector was advised would not be suitable for either person. The registered person is required to clarify the status of service user and whether it is intended for them to return to the home. If the placement is to be cancelled then this must be formalised in writing prior to admitting a new service user into the previous service users bedroom. It should be noted that the above situation undermined a large number of minimum standards such as proper information sharing, valuing service users rights, consulting effectively with service users, effectiveness of care planning, rights to privacy and residency however for the purposes of this inspection has purely been applied to the above standards. Vicarage Road (1&3) DS0000060786.V256300.R01.S.doc Version 5.0 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 the following standard(s): EVIDENCE: These standards were not assessed as part of this inspection to have a fuller understanding of the home and its ability to meet this group of standards please refer to the report of the inspection carried out in August 2005. Vicarage Road (1&3) DS0000060786.V256300.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): EVIDENCE: These standards were not assessed as part of this inspection to have a fuller understanding of the home and its ability to meet this group of standards please refer to the report of the inspection carried out in August 2005. Vicarage Road (1&3) DS0000060786.V256300.R01.S.doc Version 5.0 Page 12 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): 19 Service users benefited from being referred to specialist support teams such as speech and language therapy. The home must ensure that all of the recommendations from such specialists are fully put into practice. EVIDENCE: One-service users case files were viewed in relation to specific concerns as to the food management regime. The speech and language therapists (salt) had been regularly involved with the service user since being admitted to the home and their recommendations passed to the home in a report format. These assessments of the service user guided staff in the type of food and drink that should be provided to the service user to prevent them choking and aspirating which could result in serous health consequences for the service user the most serious being death. The speech and language therapy assessment reports consistently recommend that the service user is provided with a soft food diet. A suggested list of foods was provided to the home by the salt team as was a list of prohibited foods. The inspector was advised that all the service users in number 1 are provided with soft food diet. The menu of food provided was compared with the advisory sheets provided by salt and in the main had been developed in line with these. Foods such as sausages and beans the inspector was advised consisted of pre prepared soft frankfurter type sausages, which come in cans, meat is cooked slowly and in gravy to soften it. It was noted on that salad chopped up small and sardines are included on the menu these Vicarage Road (1&3) DS0000060786.V256300.R01.S.doc Version 5.0 Page 13 appear to be contrary to the suggested list of foods and must be removed from the menu until such time as the SALT team advise otherwise. The menu also stated “3 veg” but did not specify which vegetables, which may be interpreted differently by staff and result in inappropriate vegetables such as sweet corn being offered. The inspector was advised that thickened drinks were provided to the service user in line with SALT recommendations. At the time of the inspection the service user was not in the home and was not therefore observed consuming food or drink. The registered person is required to ensure that menus detail specifically the food to be provided. The registered person is required to liaise with the SALT team to review the menus provided and ensure that they fully meet guidelines issued by the SALT team. The home must remove sardines and chopped salad from the menu until the menu review with the SALT team takes place. Vicarage Road (1&3) DS0000060786.V256300.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): EVIDENCE: These standards were not assessed as part of this inspection to have a fuller understanding of the home and its ability to meet this group of standards please refer to the report of the inspection carried out in August 2005. Vicarage Road (1&3) DS0000060786.V256300.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): EVIDENCE: These standards were not assessed as part of this inspection to have a fuller understanding of the home and its ability to meet this group of standards please refer to the report of the inspection carried out in August 2005. Vicarage Road (1&3) DS0000060786.V256300.R01.S.doc Version 5.0 Page 16 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): 33 Sufficient staff were on duty to ensure the safety of service users was maintained. Short term staffing difficulties meant that staff were not at all times supported by people who were familiar to them and who were fully aware of their needs. EVIDENCE: At the time of the inspection the home was experiencing staffing difficulties the inspector was advised due to staff sickness. On the day of the inspection pm shift two regular support workers and two agency staff were deployed across the home ensuring that one permanent and one agency covered each side of the home to ensure continuity of care. The manager was employed on Bank to cover senior care duties. This level is below that which is normally provided in the home but the safety and welfare of service users was maintained and some were able to go for a trip to the local park. Familiarity of staff is a key issue with the service users at vicarage road who have profound disabilities and need staff who are familiar with their ways of expression and needs, some service users also are visibly extremely wary of new people. The registered person is required to keep the staffing situation under review. Vicarage Road (1&3) DS0000060786.V256300.R01.S.doc Version 5.0 Page 17 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): 40 & 42 The Home must ensure that all significant incidents are notified to the Commission. Service users and staff benefit form a safe and attractive environment. EVIDENCE: The inspector was advised that a service user had recently fractured their foot. This incident was not notified to the Commission. As per the last inspection the Registered person is required to notify all significant incidents, which fall in the remit of regulation 37. A valid gas safety certificate is in place. The heating has been repaired since the last inspection and the home is now kept at an ambient temperature. All other matters regarding health and safety were assessed as satisfactory at the previous inspection. Vicarage Road (1&3) DS0000060786.V256300.R01.S.doc Version 5.0 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 “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 1 2 2 3 1 Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X 2 X X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Vicarage Road (1&3) Score 2 X X X Standard No 37 38 39 40 41 42 43 Score X X X 1 X 3 x DS0000060786.V256300.R01.S.doc Version 5.0 Page 19 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 YA3 Regulation Ya14 Requirement The registered person is required to clarify the status of service user and whether it is intended for them to return to the home. If the placement is to be cancelled then this must be formalised in writing prior to admitting a new service user into the previous service users bedroom. The organisation is required to develop a service user contract which includes all matters which are outlined in the national minimum standards and explain it to service users, their families and advocates. The registered person is required to ensure that menus detail specifically the food to be provided. The registered person is required to liaise with the SALT team to review the menus provided and ensure that they fully meet guidelines issued by the SALT team. The home must remove sardines and chopped salad from DS0000060786.V256300.R01.S.doc Timescale for action 23/09/05 2 YA5 5 01/12/05 3 YA18 17 13/10/05 4 YA18 17 13/10/05 Vicarage Road (1&3) Version 5.0 Page 20 5 6 YA23 YA23 17 13 7 YA33 18 the menu until the menu review with the SALT team takes place It is required that a reciept is issued for money paid to avenues. The manager is required to confirm how often Avenues Trust will audit service users personal finances. The registered person is required to keep the staffing situation under review. Immediate and ongoing requirement. The registered person is required to inform the csci of any notifiable incidents in writing within 24 hours. It is required that staff receive a comprehensive induction at the point of employment and through the probationary period. Previous timescale set 7.9.05 It is required that staff receive supervision to carry out their jobs effectively. 01/10/05 01/11/05 01/11/05 8 YA37 37 01/10/05 9 YA35 18 01/10/05 10 YA36 18 01/10/05 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 YA24 YA36 Good Practice Recommendations It is strongly recommended that the organisation review arrangements for storing wheelchairs when not in use. it is recommend that supervsion be carried out at least six times per year. Vicarage Road (1&3) DS0000060786.V256300.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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. 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