Inspection on 11/07/05 for Wadham Avenue

This inspection was carried out on 11th July 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Wadham Avenue 15/03/05

Wadham Avenue 25/03/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Whitworth Lodge

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

CARE HOME ADULTS 18-65 2 Wadham Avenue 2 Wadham Avenue Walthamstow London E17 Lead Inspector Glen Baker Unannounced Inspection 11th July 2005 at 10:00am 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. 2 Wadham Avenue G56 G06 S7299 Wadham Avenue V241777 110705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 2 Wadham Avenue Address 2 Wadham Avenue, Walthamstow, London, E17 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 8527 0341 Mrs Florelda Willis-Barnes Mrs Florelda Willis-Barnes Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 2 Wadham Avenue G56 G06 S7299 Wadham Avenue V241777 110705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th March 2005 Brief Description of the Service: 2 Wadham Avenue G56 G06 S7299 Wadham Avenue V241777 110705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. What the service does well: What has improved since the last inspection? 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. 2 Wadham Avenue G56 G06 S7299 Wadham Avenue V241777 110705 Stage 4.doc Version 1.40 Page 6 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 2 Wadham Avenue G56 G06 S7299 Wadham Avenue V241777 110705 Stage 4.doc Version 1.40 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3,4,5. The home has a Statement of Purpose that meets current standards. The Service User Guide needs to be developed. The home has an admissions policy. Appropriate assessments were undertaken in respect of the most recently admitted resident. Care plan documentation did not show how residents needs would be met. A contract/statement of terms and conditions must be issued to all residents. EVIDENCE: The home has recently reopened after a long period of refurbishment. The Statement of Purpose reflects the changes that have been made. The Service User Guide requires considerable updating and improvement. The home currently has one resident. Care plans for the resident indicated that a full assessment of the residents needs was undertaken. Assessment documentation included report form a number of medical professionals. The reports supported the referral to the home. Assessment documentation had not been translated into detailed care plans showing how the needs of the resident were to be met. Care plans must be developed and completed. Care plans must be reviewed and kept up-to-date. The resident confirmed that the needs were being met and that they were happy with the services that were offered at the home. Records showed that a number of other professionals were involved in meeting the needs of the resident. This included a speech therapist, physiotherapist, 2 Wadham Avenue G56 G06 S7299 Wadham Avenue V241777 110705 Stage 4.doc Version 1.40 Page 8 district nurses, the learning disabilities team and a referral had been made for a custom-made wheelchair. The resident confirmed that they were able to visit the home of a number of occasions prior to admission. This includes visits during the refurbishment work. There was no record of a contract/statement of terms and conditions having been given to the resident. This must be undertaken in respect of this resident and for other future residents of the home. 2 Wadham Avenue G56 G06 S7299 Wadham Avenue V241777 110705 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9, 10. Care plans were inadequate and incomplete. Residents are encouraged to make decisions affecting their day-to-day life although this was not recorded in the care plan. The home currently has one resident and the life of the home revolves around that person. Staff understand that information given to them is given in confidence. . EVIDENCE: Care plans and the care planning process is currently inadequate and requires substantial improvements. The care plan must describe the services and facilities to be provided by the home and how the services will meet the changing needs and aspirations of the resident. Care plans must show how the specialist needs of the resident are to be met and identify the resources required to meet those needs. The Service User Guide recognises the right of and encourages residents to make decisions affecting their day-to-day living. The resident confirmed that she was able to make decisions on a day-to-day basis and that staff supported this. Care plans must record support given to residents to regain and retain control over their own lives. The plan must record instances where residents have make decisions and the how those decisions have been reached. The resident has supported the manager of finances and information was available 2 Wadham Avenue G56 G06 S7299 Wadham Avenue V241777 110705 Stage 4.doc Version 1.40 Page 10 about local facilities. Financial details appeared to have the residents former address on them and this issue must be addressed. A record of money spent on behalf of the resident was kept at the home. The resident was involved in the drawing up of menus. Currently the home only has one resident and consequently all activities in the home revolve around her. Due to her care characteristics of consultant has advised a number of periods of rest and these are incorporated into the days activities. Due to the care characteristics of the resident she is unable to leave the home without support. A number of risk assessments have been undertaken. The resident requires a wheelchair assessment and this has been arranged as a matter of urgency. A new wheelchair will increase the residents ability to access the community. Staff have been made aware of the needs for confidentiality. This is referred to in guidelines, the induction programme and the code of conduct and practice set by the General Social Care Council. 2 Wadham Avenue G56 G06 S7299 Wadham Avenue V241777 110705 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, 14, 15, 16, 17. Contact is encouraged with relatives and friends. The resident has only recently been admitted to the home and has not ventured much into the community. A prospectus for the Waltham Forest College was available at the home. The residents access to the community will improve upon receipt of an appropriate wheelchair. A holiday has been arranged for the resident. Personal care is provided in an appropriate way. The resident has access to the ground floor the building, including grounds. Specialist diets are provided. EVIDENCE: The resident confirmed that she was encouraged and supported to maintain contact with family and friends. The resident currently attends a day centre. The wheelchair currently provided for the resident is an appropriate and access to the home and the community will be improved when an appropriate wheelchair is provided. An urgent assessment has been arranged. The resident has only recently moved into the home, and into the area. It is hoped that with the increased access the community afforded by a new wheelchair the resident will be able to make greater use of amenities in the community. 2 Wadham Avenue G56 G06 S7299 Wadham Avenue V241777 110705 Stage 4.doc Version 1.40 Page 12 A prospectus was available for the Waltham Forest College and the resident will be reviewing this. Staff will support the resident on a holiday in the coming weeks. Due to the residents care characteristics the resident requires support for personal care. The resident has confirmed that she is able to verbally assist staff who support her. The resident confirmed that she was happy with the quality of care offered at the home. The ground floor of the home is accessible to wheelchair users. The home has large grounds that are wheelchair accessible. Both menus and records of food provided were inspected and indicated that nutritious and balanced diets were available. Due to the care characteristics of the resident special food preparations are required. The resident confirmed that she was happy with the food that was provided. 2 Wadham Avenue G56 G06 S7299 Wadham Avenue V241777 110705 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, 21. The resident is happy with the care that is provided. The home is in the process of registering the resident with members of the local primary health care team. Medication administration was inspected and found to be satisfactory. Residents in the process of preparing a living will. EVIDENCE: The current resident requires significant levels of personal support but is able to assist staff verbally. The resident is supported by two members of staff for all transfers and moving and handling operations. The manager must ensure that a full moving and handling assessment is undertaken by an occupational therapist. The resident has a single room with ensuite facilities that have been approved by an occupational therapist as being appropriate to meet the needs of the resident. All personal care is provided in the residents room/ensuite facilities. Specialist support and advice has been received from physiotherapists, occupational therapists, district nurses and the resident’s consultant. The resident expressed happiness that the level of support those offered. Staff support the resident in the purchase of clothes and personal grooming items. The home is currently in the process of registering the resident with local members of the primary health care team. Currently medication is received from the pharmacist in standard dispensing containers and it is administered by the manager. The home will be moving 2 Wadham Avenue G56 G06 S7299 Wadham Avenue V241777 110705 Stage 4.doc Version 1.40 Page 14 over to the Boots compliance aid system. The resident requires assistance to take medication buses verbally able to refuse it if she wishes. Currently the manager is undertaking the training of staff but this role will be undertaken by Boots the Chemist in the near future. Medication records were inspected were found to be satisfactory. The home has a policy in respect of ageing, illness and death. The resident is in the process of preparing a living will. 2 Wadham Avenue G56 G06 S7299 Wadham Avenue V241777 110705 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. The home has a complaints procedure that meets current requirements. The home must develop an adequate adult abuse policy. EVIDENCE: The home has a complaints procedure that meets current requirements. The record of complaints was inspected and one complaint was recorded. An investigation of this was found to relate that it relate to care provided at the residents day centre. The manager was working with the day centre to resolve this matter. The home must develop an adult protection policy and procedure,including whistleblowing policy. The adult protection procedures must link and refer to the adult protection procedures of London Borough of Waltham Forest. 2 Wadham Avenue G56 G06 S7299 Wadham Avenue V241777 110705 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, 26, 27, 28, 29, 30. The home provides a good standard of accommodation. The home is registered for three younger adults with learning disabilities. Each resident has a single bedroom. The home has flexible communal accommodation. On a the day of the inspection the home was clean and tidy. EVIDENCE: The home is an end of terrace house in a residential road and is indistinguishable from other houses in the area. The home is currently registered for three younger adults with learning disabilities. The home has recently undergone a long period of refurbishment and the creation of an additional bedroom. The home is currently operating under its original registration and the Commission for Social Care Inspection has been advised that an application will be made for registration of an additional bedroom. The home has been refurbished to a good standard. The home is close to local shops and a sports centre. The home has access to public transport. The home comprises four bedrooms (one of which is not registered), a lounge, dining/kitchen area, separate kitchen, separate laundry facilities and adequate toilet and bathroom facilities. Two of the four bedrooms have ensuite facilities. The lounge and dining area have interconnecting double doors that can be 2 Wadham Avenue G56 G06 S7299 Wadham Avenue V241777 110705 Stage 4.doc Version 1.40 Page 17 closed or left open is desired. The ground floor is accessible to wheelchair users as are the large ornamental grounds to the rear of the home. One bedroom is currently occupied. Bedrooms seen were appropriately furnished in a domestic style. The home is in the process of purchasing a cordless phone, that will allow residents to make and receive calls from the privacy of their own room. The current service user has brought with her personal items of furniture. The home has sleeping accommodation on the upper floor. Toilet and bathroom facilities were inspected and were satisfactory. The grounds to the rear of the home are large and offer a variety of recreational uses including raised flower beds to assist wheelchair users to be able to participate in gardening. A number of fences around the grounds had fallen down. The proprietor must ensure that these are replaced to guarantee the safety and security of our residents. The home has separate laundry facilities which were inspected and were satisfactory. 2 Wadham Avenue G56 G06 S7299 Wadham Avenue V241777 110705 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, 32, 33, 34, 35, 36. Staff at the home have appropriate job descriptions. The manager has arranged weekly training sessions. Staff are undertaking in-house and external training. At least two members of staff are on duty throughout the waking day. Personnel records were inspected and found be satisfactory. Staff are regularly supervised. EVIDENCE: Staff at the home of appropriate job descriptions. Staff spoken to were aware of their roles and responsibilities. Staff are provided with, and are expected to work to, the standards of conduct and practice set by the General Social Care Council. The manager has arranged weekly training sessions that coincide with the current resident attending a day centre. The training day has been used for induction training and for regular team meetings. In addition to in-house training staff are undertaking NVQ levels 2 and 3 training. One member of staff is undertaking a university Health and Social Care foundation course. The home is currently staffed with two members of staff on duty during the waking day and one member of staff sleeping in. The manager must review the night cover for the home to ensure that current cover is able to offer appropriate support to the resident at a night-time. The resident confirmed that her needs were met at all times. 2 Wadham Avenue G56 G06 S7299 Wadham Avenue V241777 110705 Stage 4.doc Version 1.40 Page 19 Personnel records were inspected. Appropriate checks and references had been sought prior to staff commencing employment. The home has a training and development plan. A stretch and induction programme was being undertaken by all staff. Staff or supervised all individual and group basis. 2 Wadham Avenue G56 G06 S7299 Wadham Avenue V241777 110705 Stage 4.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 40, 41, 42, 43. The proprietor is currently registered as the manager. The home has a small staff team. The home has written policies and procedures some of which require updating. A sample of the homes records were inspected and shortfalls were identified. The home has a health and safety policy and has recently been inspected by the local Environmental Health Officer. EVIDENCE: The proprietor is currently the registered manager of the home. The proprietor has submitted an application to register a new manager for the home. The prospective manager works in the home and was present during the inspection. The proprietor works in the home on a day-to-day basis. The home has only recently reopened and has a small staff team that are in the process of training together and getting to know each other. The home has written policies and procedures some of which require improvement and updating. (See standard 23) they proprietor must ensure that all policies and procedures are up-to-date. 2 Wadham Avenue G56 G06 S7299 Wadham Avenue V241777 110705 Stage 4.doc Version 1.40 Page 21 As the home has only been reopened for a small number of weeks quality assurance records were not inspected at this inspection. An area inspection of quality assurance procedures will be made at the next inspection. 2 Wadham Avenue G56 G06 S7299 Wadham Avenue V241777 110705 Stage 4.doc Version 1.40 Page 22 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 2 2 2 3 2 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 2 3 3 Standard No 11 12 13 14 15 16 17 3 3 x x 3 2 3 Standard No 31 32 33 34 35 36 Score 3 3 2 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 2 Wadham Avenue Score 2 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 x 2 x x x G56 G06 S7299 Wadham Avenue V241777 110705 Stage 4.doc Version 1.40 Page 23 N/A Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 5 Requirement The registered person must develop the service user guide to include all of the information required in standard 1.2 of the national minimum standards. The registered person must ensure that the care plan is developed for each resident based on a full assessment of the residents needs. The registered person must be able to demonstrate how the home is to meet the assessed needs of the residents Registered person must develop and agree with each resident a written and costed contract/they will terms and conditions. The registered person must develop and agree with each resident an individual care plan describing the services and facilities to be provided by the home and how the services will meet current and changing needs and aspirations of the resident. The registered person must ensure that a full moving in handling assessment undertaken by occupational therapist in G56 G06 S7299 Wadham Avenue V241777 110705 Stage 4.doc Timescale for action 31/12/05 2. 2 14 31/12/05 3. 3 14 31/12/05 4. 5 5 31/12/05 5. 6 15 31/12/05 6. 16 12 30/10/05 2 Wadham Avenue Version 1.40 Page 24 respect of the current resident 7. 23 12 The registered person must ensure that the home has a comprehensive adult protection policy and procedure. The registered person must ensure that fencing around the grounds to the move property is repaired. The registered person must review the night cover for the home to ensure that the current cover is able to of the appropriate support for the resident night-time. 31/10/05 8. 28 23 31/12/05 9. 33 18 30/10/05 10. 11. 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 Good Practice Recommendations 2 Wadham Avenue G56 G06 S7299 Wadham Avenue V241777 110705 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 2 Wadham Avenue G56 G06 S7299 Wadham Avenue V241777 110705 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!