Inspection on 25/01/06 for Wortley Lodge

This inspection was carried out on 25th January 2006.

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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Wortley Lodge 27/11/07

Wortley Lodge 29/01/07

Wortley Lodge 15/08/05

Wortley Lodge 08/10/04

Wortley Lodge 28/06/04

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 Wortley Lodge 26 Wortley Road East Ham London E6 1AY Lead Inspector Nurcan Culleton Announced Inspection 25th January 2006 10:00 Wortley Lodge DS0000022874.V271917.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 Wortley Lodge DS0000022874.V271917.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. Wortley Lodge DS0000022874.V271917.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Wortley Lodge Address 26 Wortley Road East Ham London E6 1AY 020 8472 9974 020 8472 9974 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) Mrs Pretim Singh Mrs Pretim Singh Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Wortley Lodge DS0000022874.V271917.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th August 2005 Brief Description of the Service: Wortley Road was registered in July 1995 as a 3 bedded home offering permanent accommodation for 3 adults with learning disabilities aged 18 to 65 years. The home comprises three single bedrooms, two bathrooms, large lounge, dining room fitted kitchen and has a paved garden. It is situated within the Upton Park area of East London, close to amenities and served by many bus routes to the area. The proprietor is also the manager of the establishment. The home excludes adults who exhibit severe challenging behaviour. Wortley Lodge DS0000022874.V271917.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Announced Inspection took place on 25th January 2006. The Registered Manager was present in the home to assist the inspector. At the time of inspection the senior support worker and two service users were in the house. One service user was at their day centre. The inspector spoke with the senior support worker and both service users. The inspector also toured the premises and examined a range of records and files , including staff and service users’ files. The current service users have been residing at the home on a long term basis, since or close to the registration of the home in 1995 and no new service users have been admitted since then. What the service does well: What has improved since the last inspection? What they could do better: Service users’ care plans and risk assessments must be improved to include all key needs identified. The Registered Manager failed to meet the timescale to obtain a water safety certificate. This requirement is restated and compliance is required. Six requirements are given in all where shortfalls in meeting regulations were identified. Wortley Lodge DS0000022874.V271917.R01.S.doc Version 5.0 Page 6 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. Wortley Lodge DS0000022874.V271917.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 Wortley Lodge DS0000022874.V271917.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 home is able to demonstrate that it is positively able to meet assessed service users’ needs. Service users’ needs are assessed by the home. Prospective service users have the opportunity to visit prior to their admission and each service user is provided with a contract. EVIDENCE: The Statement of Purpose and Service Users’ Guide are in order as set out in Standard 1. The Registered Manager informed that service users’ did not receive Local Authority assessments prior to their admission and the home’s completed pre-admission assessments were viewed and were satisfactory. The inspector was shown a policy stating that all service users require comprehensive assessments prior to their admission. Service users confirmed at the last inspection that they had visited the home before their placement. Satisfactory signed contracts were seen in service users’ files meeting a previously made requirement. The home is able to demonstrate that it is able to meet service users’ needs through evidence available in files, discussion with staff, service users and the Registered Manager. Wortley Lodge DS0000022874.V271917.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 Service users are informed and consulted about their needs. Service users are supported to take risks and participate in activities in the home and to develop independent living skills. Staff are familiar with and able to meet service users’ needs however care plans and risk assessments need to be improved. EVIDENCE: Service users’ care plans were were signed by service users or their representatives, as previously required. The format of the care plans were considered to be good, however the content of the care plans were unclear in some files and could be improved, as discussed with the Registered Manager. This is to ensure that 1. Actions are clearly linked to needs identified in assessments and reviews. 2. Actions recommended in multi-disciplinary professional reports are integrated in the care plans wherever possible or cross- referenced where more appropriate. Similarly, not all key risks arising from assessed needs had been identified and incorporated into service users’ risk assessments. The inspector noted for example the case of one service user who periodically had strong emotional needs, for example on special occasions which was not identified in her care plan as a need in its own right and neither were the risks associated with her mental and emotional distress specified in her risk assessment. Wortley Lodge DS0000022874.V271917.R01.S.doc Version 5.0 Page 10 However discussion with staff and case notes evidenced that service users’ are supported to meet their needs and are supported to take risks to encourage the development independent living skills. All service users’ had received statutory reviews as previously required. Wortley Lodge DS0000022874.V271917.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17 Service users are offered opportunities for personal and social development through participation in a range of meaningful social and personal activities. Service users’ rights are respected and their daily routines promote independence and choice, subject to the needs identified in service users’ plans. EVIDENCE: There is no change in the daily routines of service users from the last inspection. Service users follow a full programme of activities to suit their needs, as shown in a chart displayed in the dining room. Two service users attend college in Newham to do courses such as yoga, relaxation, music, art and reading. One service user attends the NuLife day centre on a daily basis. All three service users also engage in a range of social activities programme. These include attendance at Mencap social group, the cinema, library, local pubs, tea dances, cinemas and other local facilities such as shops and restaurants. One service user goes to the local shop independently. Service users are supported to vote and staff support them to attend polling stations in doing this. One service user is able to prepare her own meals with support. Another prepares the dining table and is able to make tea for herself and others. Service users engage in domestic chores like cleaning. Wortley Lodge DS0000022874.V271917.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): 18, 19, 20, 21 Service users are offered personalised support tailored to meet their needs. Service users’ physical, mental and emotional needs are addressed and met in the home. Medication is appropriately administered and controlled. An improved medication policy is required. EVIDENCE: Documents seen by the inspector and observations made showed that the service users had medium to high level needs. Support workers offer full personal care support for one service user to varying levels of direct support, and offered prompting and supervision with personal care to the other two service users. Service users have good access to healthcare services, including their own GP and and the Community Team where service users can access other facilities for their health care including mental health care needs. Medication records were checked against medication administered and deemed to be correct at the time of inspection. However the medication policy needs to be reviewed and improved as the medication policy statements were written on separate paper. Each service user has a signed statement concerning their death and dying personal wishes. Pre-inspection surveys received from staff, other health professionals and relatives show satisfaction with the service. Wortley Lodge DS0000022874.V271917.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Service users’ views are listened to and acted upon, leading to satisfied service users and a lack of complaints. Measures have been taken to protect service users from abuse, neglect and self-harm. EVIDENCE: There were no complaints logged in the complaints book. The lack of complaints and satisfaction felt by service users in the home was supported by documents examined by the inspector. The inspector examined service users’ views expressed in the minutes of the monthly residents’ meetings and the annual quality assurance questionnaires. Positive views were noted. Statements included “I like living here”, “I feel well cared for”, “staff are supportive”, and areas such as respect for privacy, feeling safe were agreed with in the questionnaires. The complaints policy had been updated and was satisfactory. Evidence was seen that staff have received adult protection training as required at the last inspection. The adult protection policy was also satisfactory. Wortley Lodge DS0000022874.V271917.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30 Service users environment is homely, comfortable and suitable for their needs. Rooms reflect the personal tastes and lifestyles of service users. Improved window restrictors are still required in the home. EVIDENCE: The inspector viewed the home with the assistance of two service users. Bedrooms are sufficient to meet service users’ needs. Rooms were clean, tidy and personalised, reflecting individual tastes, including pictures on walls, photographs, other personal effects, including a fish tank in one service users’ room. The chest of drawers in two service users’ rooms were repaired following a previous requirement. The home was generally clean, tidy and homely. Service users are encouraged to maintain their own rooms. The inspector toured the premises and was satisfied that the home meets the needs of the service users. The home is generally in good order. The home has one bathroom on the first floor and one shower rooms on the ground floor. One service user has an electrically assisted bath seat to get in and out of the bath. There is a fitted kitchen, comfortable dining room and lounge with two sofas, television and a music system. There is also a paved garden at the back of the house. Wortley Lodge DS0000022874.V271917.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36 Service users benefit from staff who are clear about their roles and responsibilities and have a clear understanding of service users’ needs. There are sufficient staff numbers and staff are well supported to fulfil their support tasks. The home operates a well functioning team with sound recruitment practices. EVIDENCE: The senior support worker interviewed had a good understanding of the needs of the service users. The service users have been resident for a long period and the staff team in the home have been stable enabling staff to develop intimate knowledge and skills of working with the service users. Service users spoken to had limited communication skills, however when interviewed indicated that staff respect them and respond to their needs. This was evident also in minutes of the residents’ meeting. The support worker informed that she and all other staff had completed NVQ Level 2 courses and that she was undergoing NVQ Level 3 training. The inspector saw a range of other relevant training certificates in staff files. There are currently three permanent staff members employed and one bank staff. Each shift consists of the manager and one support worker. One staff member is on sleep-in duty at night. Supervision is given on a two monthly basis and annual appraisals are given. The support worker informed they received good support from the Registered Manager and there was a good team spirit among staff. Staff files examined contained all required documentation and were in good order. Wortley Lodge DS0000022874.V271917.R01.S.doc Version 5.0 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 42, 43 There is a positive approach to the management of the home. Most records are in place. Systems are in place to safeguard the best interests of service users. A requirement is given for improved window restrictors. An outstanding requirement for a water safety certificate must be complied with within the timescale specified. EVIDENCE: The Registered Manager has qualifications including NVQ Level 4 to support her in her management position. She also has a relevant background in social work. There is a positive management approach to the home, also evident in the outcome of views expressed by staff and in minutes of meetings where service users expressed satisfaction with the staff, the support received and their contentment of living in the home. This was reaffirmed in annual quality assurance questionnaires completed by staff and service users. Most records required by regulations are available and generally in good order and systems are in place for the efficient running of a care home. Health and safety practices are observed. Water temperatures and fridge/ freeze temperatures are taken daily. Certificates of gas and electricity safety were available, Wortley Lodge DS0000022874.V271917.R01.S.doc Version 5.0 Page 17 however a previous requirement for a water safety certificate was not met. The Registered Manager has made arrangements for this to be completed, however this was not within the timescale specified at the last inspection. Windows have been replaced in an attempt to address a previous requirement for improved window restrictors. However the window restrictors open very widely and the inspector considered that the window restrictors were still inadequate as regards health and safety. The safety risk is particularly increased in one service users’ room who has direct access to the roof the window. A business and financial plan is required for the home. Wortley Lodge DS0000022874.V271917.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 3 3 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 3 2 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Wortley Lodge Score 3 3 2 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 2 3 1 1 DS0000022874.V271917.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 YA6 Regulation 15 Requirement The Registered Manager must ensure that service users’ care plans are re-developed and improved. The Registered Manager must ensure that risk assessments are re-developed and improved. The Registered Manager must ensure that the medication policy is revised and improved. The Registered Manager must ensure that improved window restrictors are in place to safeguard the health and safety of service users. The Registered Manager must ensure that a water safety certificate is available. The timescale of 25th November 2005 was not met. 6. YA43 25 The Registered Manager must ensure that a financial and business plan is available in the home. 31/04/06 Timescale for action 31/04/06 2. 3. 4. YA9 YA20 YA42 13(4) 13(2) 13(4) 31/04/06 31/04/06 31/04/06 5. YA42 13, 23 31/04/06 Wortley Lodge DS0000022874.V271917.R01.S.doc Version 5.0 Page 20 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Wortley Lodge DS0000022874.V271917.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford 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. 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