Care Home: Chase (The)

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What the care home does well The service provided a comfortable and pleasant environment for the residents. There was a good focus upon understanding individual needs and offering an individualised approach to meeting these needs. Staff presented a clear knowledge of the residents, regarding likes and dislikes, personal history and how to manage any challenging behaviour. There was an interesting programme of activities and outings within the local community and further afield. What has improved since the last inspection? All of the requirements issued in the previous inspection report have been met. The registered manager had commenced work shortly before the last inspection, hence there has been a noticeable change of approaches across all aspects of the service delivery, which has introduced new and positive ideas. What the care home could do better: One requirement has been issued for the service to ensure that the service provider undertakes monthly unannounced monitoring visits every month, in accordance to Regulation 26 of the National Minimum Standards Key inspection report Care homes for adults (18-65 years) Name: Address: Chase (The) 165 Capel Road Forest Gate London E7 0JT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Sarah Greaves     Date: 1 0 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Adults (18-65 years) Page 2 of 21 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 21 Information about the care home Name of care home: Address: Chase (The) 165 Capel Road Forest Gate London E7 0JT 02084787702 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): tom@roselock.com Alpam Homes Name of registered manager (if applicable) Mr Robert Steer Type of registration: Number of places registered: care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 8 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 The Chase is a residential home, which is registered for up to eight service users, with a learning disability. The home is situated within a short walking distance of Manor Park over ground station, and some local shops and amenities. The home is comprised of an older end of terrace house with a new double story extension at the rear. The home is owned by Alpam Homes, a local provider of care services. Fees at the home range from #1,250 - #2,000. Care Homes for Adults (18-65 years) Page 4 of 21 Over 65 0 8 1 6 0 4 2 0 0 9 Brief description of the care home Care Homes for Adults (18-65 years) Page 5 of 21 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 key unannounced inspection was conducted over two days. We spent the first day speaking to the registered manager and checking policies and practices within the care home (such as the safety of the premises, medication, care plans, and staff files for training, supervision and recruitment). The residents had gone out for the day with staff, so we returned the next day to speak to residents and staff, and to make other observations. Care Homes for Adults (18-65 years) Page 6 of 21 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 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 0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 21 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 8 of 21 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 demonstrated that prospective residents (and their supporters) are assured that admissions will be arranged in a thorough and supportive manner. Evidence: At the time of this inspection there were six residents living at the care home and two vacancies. The Statement of Purpose and Service Users Guide were comprehensively presented, including clear information regarding how to make a complaint. We noted that the service sought multi-disciplinary assessments for prospective residents, such as reports by social workers, psychologists, community nurses and other relevant professionals. The service also undertook its own pre-admission assessments and offered prospective residents opportunities to visit before moving in for a trial period. Care Homes for Adults (18-65 years) Page 9 of 21 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 are assured that they will be well supported to lead a lifestyle that reflects their identified needs and aspirations. Evidence: We read two of the care plans, inclusive of the risk assessments. We also spent time speaking to and observing the residents, in order to establish if the care plans truly reflected the very unique needs and wishes of individuals. It was noted that a great deal of work had been undertaken with the care plans, which were detailed, descriptive and useful documents for the delivery, monitoring and improvement of care. We observed that staff consulted residents about their choices throughout the inspection. For example, staff asked a resident if he would be willing to show us his room; this was an activity that this person was known to enjoy but it was clearly recognised that residents had an entitlement to agree or decline. The promotion of other choices were observed, such as snacks, beverages, planning of outings and activities within the household, and initiating contact with family members. Care Homes for Adults (18-65 years) Page 10 of 21 Evidence: The risk assessments were specific to the needs of individuals and demonstrated a balanced approach to enabling people to take risks whilst promoting their safety. Care Homes for Adults (18-65 years) Page 11 of 21 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 provided with opportunities to pursue a fulfilling lifestyle. Evidence: We gathered information regarding lifestyle choices through reading two care plans, and speaking to residents, staff and the registered manager. Important information was also obtained through observations as some of the residents were not able to verbally express their views due to their disabilities. Residents were supported to engage in a wide range of external activities such as swimming, bowling, trampolining, grocery shopping and visiting a community farm. We observed that staff supported residents with meaningful activities at home, which varied in accordance to individuals but included reading, using musical instruments and assisting with daily chores. The registered manager stated that the service was planning to create a sensory garden in the existing rear garden. On the second day of this inspection residents and staff were planning a visit after Care Homes for Adults (18-65 years) Page 12 of 21 Evidence: lunch to a forest country park in Essex. A regular programme of interesting and entertaining trips was offered, which were planned through speaking to residents and their supporters, and through making close observations of the residents that could not verbally express their views. Via observations, looking at care plans and speaking to residents and staff, we found that the service actively promoted residents to maintain and develop important relationships with families and friends. We observed that there was a balanced and healthy range of food available, which took into account specific dietary needs and individual preferences. Fresh vegetables and fruits were noted to be readily available; we were informed that the residents regularly visited a farm shop to buy these items. Care Homes for Adults (18-65 years) Page 13 of 21 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. The service suitably supported residents to meet their health and personal care needs. Evidence: The care plans evidenced that residents received appropriate support to meet their health and social care needs, including support to attend medical and health care appointments. We checked the storage and administration of medication, which was found to be safe and well organised apart from one refrigerated medication that needed to be stored in a more secure manner. This was effectively addressed by the registered manager during the course of this inspection. We have advised that the service clearly records whether a resident has an allergy or not on their medication administration chart. It was recognised that this information was held elsewhere within the individual documentation for each resident but this action should be taken as an additional measure to promote safety. Care Homes for Adults (18-65 years) Page 14 of 21 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. The service demonstrated safe practices in order to listen to and protect residents. Evidence: The service produced an appropriate complaints procedure and there were no concerns in regard to the management of complaints (there had not been any complaints since the last inspection). Independent advocacy information was made available to residents and their supporters. Staff had received Safeguarding Adults training and were able to competently discuss issues such as Whistle blowing. The service had obtained Safeguarding Adults procedures; we advised that a more recent policy could be accessed from the local Safeguarding Adults department, which was achieved during the inspection visit. Care Homes for Adults (18-65 years) Page 15 of 21 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 comfortable and welcoming environment with sufficient space for their leisure and support needs. Evidence: The service occupies an ordinary domestic property in a residential street, which overlooks a pleasant green open space. There is a well sized communal lounge with a dining area and a rear garden. We noted that the premises was in good condition, and offered a relaxing and homely ambience. The registered manager stated that plans had been agreed for a significant programme of re-decorations to take place this year. The care home was found to be clean and free of any offensive odours. Care Homes for Adults (18-65 years) Page 16 of 21 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 are assured that their needs will be competently met by suitably recruited, trained and supervised staff. Evidence: We checked two staff files in order to check for safe recruitment, training and development, and regular formal supervision. There were no issues of concern noted. We provided advice in regard to a specific matter concerning appraisals and supervision, which the registered manager will now be incorporating into managerial practices. Staff were provided with opportunities to undertake mandatory training as well as training that was directly related to the needs of the current residents. We found that staff presented a good knowledge of how to effectively support residents, taking into account their disabilities, unique strengths and weaknesses, and life circumstances. All staff were supported to gain qualifications within the National Vocational Qualifications framework. Care Homes for Adults (18-65 years) Page 17 of 21 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. Overall, good improvements had been achieved with the management of the service. Evidence: The registered manager demonstrated that considerable work had been undertaken to both meet the requirements of the previous inspection report and to progress further improvements. We noted that the service was not able to produce a monthly monitoring visit report for all of the months since the last inspection. A requirement has been issued in this report. We checked the records for the finances of two of the residents, which were maintained in a detailed and open manner. The health and safety records were up-to-date apart from the electrical installations, which has appeared to have expired. The registered manager was asked to look into this finding. Care Homes for Adults (18-65 years) Page 18 of 21 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 19 of 21 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 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 1 41 26 The registered person must ensure that the monthly unannounced monitoring visits are conducted every month. For the safety and welfare of the residents. 30/06/2010 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 20 of 21 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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. 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