Care Home: Kingswood Road (47)

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)

What the care home does well There is a pre- admission assessment process, to ensure the service can fully meet the needs of people admitted to the home and trial visits are offered to all prospective residents. Routine risk assessments are undertaken, to ensure residents are supported to take risks, as part of an independent lifestyle. On speaking to the representatives of residents, their comments evidenced that staff were very knowledgeable on the care needs of residents and on what they liked and disliked doing. Residents are supported to be as independent as possible and to be involved in the day to day running of the home. The home is well decorated and furnished and provides a very homely environment for its residents. What has improved since the last inspection? At the last key inspection 2 requirements were made in relation to health and safety. At this inspection these requirements have been complied with. What the care home could do better: 6 requirements have been made at this inspection in the areas of medication leaving the home; the environment; quality assurance and recording residents` wishes in the event of their death; follow of checks of accidents and incidents and notifying the Commission through a Regulation 37 of any events that may affect the well-being or safety of a resident. Failure to act on requirements that relate to the care provided for the people living in the home impacts on the welfare and safety of service users and may lead to the Commission taking enforcement action against the registered person. CARE HOME ADULTS 18-65 Kingswood Road (47) 47 Kingswood Road Goodmayes Ilford Essex IG3 8UE Lead Inspector Harbinder Ghir Unannounced Inspection 24th November 2008 10:00 Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 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 Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 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. Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingswood Road (47) Address 47 Kingswood Road Goodmayes Ilford Essex IG3 8UE 020 8599 7965 020 8270 0925 H3M048Osullivan@mencap.org.uk www.mencap.org.uk Royal Mencap Society 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) Mr Denis O`Sullivan Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is: 5 22nd September 2008 Date of last inspection Brief Description of the Service: 47 Kingswood Road is situated in a quiet residential road in Seven Kings. There is easy access to public transport, shops and leisure activities. Ground floor accommodation comprises a lounge, kitchen/dining area, laundry area, toilet, shower and two bedrooms. Upstairs there are three bedrooms, a bathroom with toilet, a separate toilet and a small office/sleep in room. Residents’ bedrooms are individually decorated and furnished and reflect their interests. There is also a small well-maintained garden with a large summerhouse. This is heated, comfortably furnished and has a TV and stereo. Five adults with learning difficulties live at the home. Three residents have access to day centres and staff support all of the residents to access activities and leisure pursuits. The scale of charges is approximately £1,200.00 per week. Information about the service provided is contained in the service users guide. Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use the service experience good quality outcomes. This was an unannounced inspection undertaken by Regulation Inspector Harbinder Ghir on the 24th November 2008. The first day of the inspection was unannounced and started at 10.00 am. It took place over 5 hours. A second day was spent contacting relatives and family by telephone to seek their views on the service. Their feedback has been included in the report. The registered manager of the home was available throughout the day of the inspection and feedback was provided to him at the end of the inspection. During the inspection the inspector was able to talk to one resident residing at the home who could communicate verbally. The inspector was unable to speak to the other resident at home during the inspection due to their limited communication. Staff on duty during the day were also spoken to and were also observed carrying out their duties. The Commission for Social Care Inspection received a completed Annual Quality Assurance Assessment prior to the inspection. The inspector would like to thank everyone involved in the inspection process. What the service does well: There is a pre- admission assessment process, to ensure the service can fully meet the needs of people admitted to the home and trial visits are offered to all prospective residents. Routine risk assessments are undertaken, to ensure residents are supported to take risks, as part of an independent lifestyle. On speaking to the representatives of residents, their comments evidenced that staff were very knowledgeable on the care needs of residents and on what they liked and disliked doing. Residents are supported to be as independent as possible and to be involved in the day to day running of the home. The home is well decorated and furnished and provides a very homely environment for its residents. Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 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 Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4, People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The service completes comprehensive pre-admission assessments, to ensure they can fully meet the needs of prospective residents. Trial visits are offered to all prospective residents, to ensure residents have information on the services and facilities provided at the home. EVIDENCE: It was not possible to examine up to date pre-admission assessments, as all five residents have resided at the home for several years. However, the service has a comprehensive pre-admission policy and procedure in place and admissions would not be made to the home until a full needs assessment has been undertaken. The policies and procedures highlighted that admissions to the home would only take place if the service is confident that staff have the skills, ability and qualifications to meet the assessed needs of prospective residents. New prospective residents would be able to visit the home as many times as they like and have an opportunity to stay overnight. Relatives and family would also be invited to visit the home. Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 Page 9 When contacting residents’ family and representatives, very positive feedback was received regarding the service. One relative said ‘The care provided at the home is 100 , I just can’t complain about the service. The care is absolutely first call. The staff are brilliant, we couldn’t have wished for a better home. We are so pleased with the care and our loved one is very happy there.’ Another relative informed ‘We have been very impressed, my loved one is very happy at the home and when he visits us, he shows no resistance in returning to the home. We have never had any grounds to complain. We are very happy that our loved one is at the home.’ Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There is a comprehensive care planning system in place, which provides staff with the information needed, to meet the needs of residents. The right for residents to exercise choice and control is promoted by the service and they are actively consulted on, and participate in, all aspects of life in the home. Risk assessments are undertaken routinely, to ensure residents are supported to take risks as part of an independent lifestyle, and are always updated according to residents’ changing needs. Residents’ financial interests are safeguarded, and robust systems are in place to ensure that records of residents’ outgoings and incomings of money are recorded correctly. Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 Page 11 EVIDENCE: Three care plans were closely examined. Care plans seen evidenced that the service involves individuals in the planning of care that affects their lifestyle and quality of life. Care plans were comprehensive; person centred and clearly set out residents’ health, personal and social care needs. Information was found specific to the religious, cultural and social care needs of residents and how the service was to meet these needs. For example one resident’s care plan informed how they wished to lose weight and was supported to join a local weight watchers club. They were also supported to plan their meals, with a focus on healthier eating options. The documents also included information on residents’ likes, dislikes, how they communicate and what they are able to do independently and tasks they require assistance with. Evidence was seen of residents consistently being supported to make choices throughout their daily living. A key worker system also allows staff to work on a one-to-one basis and contribute to the care plan for the individual. Care plans were working documents and are reviewed on a regular basis or as and when required. Evidence was seen of reviews taking place with care managers also involving the resident and their representatives. Reviews focused on asking what has worked for the individual, where progress is being made, achievements, and concerns and identified action points. One relative informed that she is ‘always contacted and invited to attend meetings or reviews at the home, they keep me well informed,’ she added. Risk assessments were completed for residents and identified risk areas in care plans including, the event of a fire, risks that may be presented by the building, mobility, falling or the use of public transport. For one resident who was at risk of becoming anxious when using public transport. Their care plan included clear guidelines for staff to follow in managing the risks posed to the individual. The care plan informed ‘X could become anxious due to not knowing where they are. Staff must chat to X, giving her as much information as possible as to where she is going and on the route of travel. This should be repeated several times throughout the journey.’ Risk assessments were reviewed regularly and amended. Daily case recording notes were examined which are linked to the care plan and focus on the specific needs of residents rather than recording information in a general manner. Each resident has a personalised case recording sheet which may focus on their challenging behaviour, their diet or the risks they are posed to, which provided, which is used to monitor their care needs or their behaviour on an on-going basis. For one resident who’s behaviour had changed in the past weeks, the staff were completing very detailed and comprehensive notes on the behaviour presented which they were going to present to the health professional the individual was seeing. This was very good practice. Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 Page 12 Residents were involved in the daily running of the home as far as their abilities allowed. One resident was observed putting their laundry into the washing machine. Residents’ rights to make choices were actively promoted; by them being supported to choose what to wear, to eat and which activities they would like to participate in, which were also evidenced by daily case recording sheets, which staff completed. The financial records of residents were viewed and the inspector tracked the amount of money the service held for one individual. All amounts were accounted correctly and were in order. There were clear systems to record outgoings and incomings of money, which were audited regularly by the registered manager. Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are provided with support to maintain their independence and in areas of personal development according to their needs and wishes. Residents are engaged in community life, promoting their opportunities to be part of the local community. Residents are offered meals that promote their choices and respect their individual preferences. Residents are supported to maintain family links and relationships inside and outside the home. EVIDENCE: Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 Page 14 Central to the home’s aims and objectives is the promotion of the individual’s right to live an ordinary and meaningful life, appropriate to their peer group, in both the home and the community, and to enjoy all the rights and responsibilities of citizenship. The home understands the importance of enabling younger adults to achieve their goals, follow their interests and be integrated into community life and leisure activities in a way that is directed by the person using the service. Two residents have retired from their day care services and are now supported by the home’s staff team to participate in daily living activities, which include going out shopping, going out to eat, and going out on day trips, or any other activities of their choice. The remaining three residents attend day services during the week. On their days off they are also supported to complete activities of their choice. All residents are supported individually. For example one resident who likes going to the pub is supported to go to the local pub. Another resident is supported to go to the local church on a regular basis and was recently supported by staff to attend a close relative’s marriage ceremony. Another resident who enjoys ‘Strictly Come Dancing’ was supported to go and see the live show. Residents were also supported to go to the theatre and on annual holidays, which included Butlins and Blackpool. Outcomes for people living at the home were very positive, and there was evidence that they are enjoying the life opportunities that they experience. The home provides meals, which are varied and nutritious and meet the dietary needs of residents. There was plenty of fresh fruit and vegetables at the home. Residents choose their meals from pictures of foods, meals and ingredients, which are displayed in the kitchen area. Residents also go out and do the shopping with the support of staff. Evidence was also seen of residents going out to local restaurants and being provided with take away meals of their choice. People who use the service have the opportunity to develop and maintain important personal and family relationships. Residents are supported to contact family by telephone and visit them. One relative stated ‘Whenever I visit I am made to feel very welcomed. If my son wants to see me, they get in touch with me straight away. When I visit, the staff let me have lunch with my son and always give me a cup of tea. The staff have always been very kind.’ Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20, 21 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents receive personal support and care in the way they prefer and require. The service must ensure that procedures and guidelines are in place for any medication leaving the home, to ensure residents are safeguarded when not at the home. Day to day medication practices must also be reviewed, to ensure the safety of people who use the service. The wishes of residents, in the event of their death must be identified to ensure the ageing, illness and death of people who use the service are handled with respect and as the individual would wish. EVIDENCE: Residents at the home receive personal care and healthcare support using a person centred approach with support provided based upon the rights of Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 Page 16 dignity, equality, fairness, autonomy and respect. Each resident has a devised health plan which identifies the healthcare needs of residents including specialist health, nursing and dietary requirements, which are clearly recorded and act as an indicator of change in health requirements. The plan also identified residents’ daily routines including the type of support they need in relation to personal hygiene and according to their level of care needs. All residents have a designated key worker to promote their privacy and dignity, and all personal care is provided in private. Attention is paid to personal preferences in relation to the provision of personal care, for example whether one prefers a shower or a bath. Personal support takes account of individual preferences and residents’ choice of dress and appearance is respected. Residents were well dressed and groomed. Residents are supported by staff to attend appointments with healthcare professionals and their health is closely monitored. There was evidence of staff taking female residents to well women checks and the involvement of multlidisciplinary healthcare professionals where required were made to dentists, chiropodists, GP’s and community psychiatric nurses. Steps have not been taken to find out the wishes of residents in the event of their death, including contacting relatives or representatives where the resident is unable to express their views. There are policies and procedures for staff to follow in the event of a death, however, it will be stated as a requirement that the wishes of residents, in the event of their death are identified to ensure the ageing, illness and death of people who use the service are handled with respect and as the individual would wish. The accident and incident book was reviewed. It was identified that there was no documentation to evidence that residents received follow up checks following an accident or incident, to ensure there were no further healthassociated risks. On the 02/03/08 a member of staff did not give a resident their prescribed medication and no record of any follow up action to seek medical advise could be found. To ensure the safety of residents the relevant health professionals must be contacted promptly. The registered persons must ensure that they evidence what follow up checks they have completed when residents are involved in incidents or accidents, to ensure there are no further health associated risks posed to them. A requirement will be made in relation to these findings. Medication administration records (MAR) were closely examined. Medication records were fully completed, contained required entries, and were signed by members of staff. The medication file contained photographs of each individual, a medication pen picture and information about each medication. All of the residents have regular medication reviews conducted by the General Practitioner, which is very good practice. However, during the inspection of medication, the following issues were identified: Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 Page 17 • The service did not have a policy on any medication leaving the home. In compliance with Care Homes Regulations 2001 and The Administration & Control of Medicine Guidance the home must produce a written policy that includes the procedures to be followed and the precautions to be taken, including a witness to the transfer, when transferring medication to be taken out of the home. If residents are going away, records of signatures by family receiving the medication and staff accepting medication must be maintained. As with any medication taken out of the home a signature of the person accepting receipt and any return is required. The service uses the monitored dosage system where more than one medicine was contained in each container. Although use of these systems in this way is permitted it should be reminded that carers must be satisfied that they are administering the correct medicine by identification from the label on the container dispensed by the pharmacist. This is a basic safety requirement and the CSCI professional advice documents reinforce this point in Training care workers to safely administer medicines in care homes-section 11 bullet point 2: selecting the correct medicine from a labelled container including monitored dosage system and compliance aid, and The administration of medicines in care homes-section 24: this container must have the persons name on the label and the full instructions for the care worker to refer to. If a provider does not feel confident about this issue they should discuss with their dispensing pharmacist the change to a dispensing system that meets their needs and if not satisfied they have the option to change dispensing services to a pharmacist that meets their requirements. One resident takes his lunchtime dose of medication with him which staff at the day centre administer to him. No formal record of the medication being administered from the day centre is obtained by the home. The home must liaise with the day centre and put procedures in place to record the administration of medication. Medication is also secondary dispensed by staff for the resident when leaving the home. If the home fills medicine containers or compliance devises then a written policy is required that includes the procedure to be followed and the precautions to be taken, including a witness to the transfer, as stated above. A fully documented record of the transfer would need to be retained and signed by staff involved. The procedure would need to include the staff trained as being authorised to transfer medication and they will require contacting their pharmacist for advise before transferring medication as the transfer of some medicines from the manufacturer’s packaging is contraindicated. A signature of the person accepting receipt and return is required. • • Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 Page 18 • • The home had also implemented a staff signature list of all staff trained to administer medication. However, not all staff had signed the list. There was hand written entries on the Mar chart, which were not clearly signed and dated. Staff must clearly sign and date in the medication details box when making a handwritten entry, to ensure accountability of those making the entries. A requirement will be made in relation to the above findings. Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured their views are listened to and acted on. The service records all complaints and concerns to ensure any dissatisfactions with the service regardless of source are actioned. All staff have received up to date training in Safeguarding Adults, which ensures the protection of residents. EVIDENCE: People who use the service are supplied with a complaints procedure, which is in picture format. The complaints procedure is clear, concise and easy to follow and was displayed around the home. A complaints logbook is kept by the home, which was viewed. No formal complaints have been received by the home. The registered manager informed that any concerns or niggles residents may have are addressed immediately. These are also discussed with residents during their reviews and on a one to one basis and through resident’s meetings which take place informally, for example during a chat around the table, as residents dislike formal meetings. All staff had attended Safeguarding Adults training which is also covered in the induction programme. The service has comprehensive Safeguarding Adults Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 Page 20 procedures and protocols in place. The service has not obtained Safeguarding Adult procedures devised by The London Borough of Redbridge, which is the host authority for the service. It is recommended that the service obtains these procedures to keep abreast of the protocols to follow and keep updated with the information. Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable environment and décor is of a good standard and provides a homely and pleasant living environment enhancing residents’ comfort. But further health and safety checks would reduce the risks posed to residents. EVIDENCE: The home is a large house located in a residential area of Redbridge, in Seven Kings. The house was comfortable, bright, airy, clean and free from offensive odours. Furnishings and fittings in communal areas were of good quality, domestic and unobtrusive. The home provides a main lounge, a kitchen and two communal bathrooms. Residents’ rooms were seen during the inspection. The rooms were comfortable with good quality furnishings and were also personalised by residents. The service had been very thoughtful in decorating Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 Page 22 the home to meet residents’ needs. The registered manager informed that they are planning to decorate all residents bedrooms and replace the carpets in communal areas. Residents were in the process of choosing colours and carpet textures for the house and carpet samples were seen at the home. Residents had decorated their rooms to their own preferences. One resident liked the Beatles and displayed the bands memorabilia in their room. The front and rear garden was well maintained and the rear garden was equipped with good quality garden furniture and also has a summer house which the service is planning to convert into a sensory room for the residents. Specialist equipment for residents was provided where required and bathrooms and toilets were fitted with appropriate aids and adaptations to meet the needs of people who use the service. During a tour of the building it was identified that the cupboard under the kitchen sink was not kept locked, which stored household cleaning products and could present a risk to residents. The communal bathroom on the first floor was also not equipped with soap or paper towels, which could increase the risks of cross infection. All parts of the home to which residents have access to must be so far reasonably practicable made free from hazards and unnecessary risks to residents are identified and so far as possible eliminated, to ensure the safety of residents and reduce the risks of infection. This will be stated as a Requirement. Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, 36 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Recruitment practices are robust and ensure residents are in safe hands at all times. Adequate staff training is provided to all care staff, to ensure they are equipped with the skills and are competent to do their jobs. The service has a good skill mix of staff, ensuring adequate numbers of staff are on duty to meet the needs of residents. People who use the service, benefit from a formally supervised staff team. EVIDENCE: Two staff files were closely examined, which were the files of two recently recruited members of staff, which were all in good order. References and Criminal Records Bureau checks had been obtained for both members of staff. Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 Page 24 Staff files also contained interview questions and interview notes from the panel. Staff supervision records evidenced that staff were supervised at least six times a year, ensuring staff are provided with the skills, training and knowledge to perform the tasks required by their employment role. Members of staff spoken to also commented that they were supervised regularly. Staff meetings are organised on a monthly basis and staff spoken to confirmed that they always take place, allowing them an opportunity to discuss issues or any concerns they have. One member of staff spoken to spoke very positively about her employers and her colleagues. She stated ‘I received a good induction when I started and I am supervised by Denis (registered manager) at least once a month who is very supportive. The whole team is very supportive and there is always enough staff on. If we are short, we do get relief staff.’ Files viewed all evidenced that staff had been on induction programmes and all received ongoing training, including training in manual handling, POVA, medication administration, fire safety, first aid and person centred care. Staff rotas evidenced there are sufficient numbers of staff on duty to meet the needs of residents during the day. There are always two to three members of staff on duty during the day and this is increased to three to facilitate activities at the home. Mencap’s internal bank staff are used to cover any staff shortages. Staff who cover shifts on a regular basis are chosen, to ensure consistency of service for residents. One sleep in member of staff is on duty during the night; with access to a Life Line pendant and Mencap’s 24-hour emergency on call service. It is recommended that the registered manager completes lone working risk assessments to ensure people working at the home and residents are safeguarded at night. Relatives and family spoken to, also spoke very positively about the staff at the home. The comments received included ‘The staff are brilliant, they are first class,’ ‘The staff are very kind, courteous and very helpful,’ ‘The home has excellent staff, we couldn’t wish for better,’ ‘The staff are always very kind and are very welcoming when I visit.’ Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 Page 25 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from an experienced manager who recognises their needs and adequately manages the home. However, the manager must ensure that the Commission is notified of any events in the home that may affect the safety of a resident, in line with the Care Home Regulations. The systems for service user consultation are in place, but must also include views from stakeholders to ensure the home is run in the best interests of residents. The welfare of staff and residents is promoted by the home’s policies and procedures. Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 Page 26 EVIDENCE: The manager is registered with the Commission for Social Care Inspection and has the necessary skills to run the home. He communicates a clear sense of direction, leadership and openness. The manager trains and develops staff that are generally competent and knowledgeable to care for people who use the service. The service works in partnership with families or close friends, as appropriate and professionals. Which has been evident from the comments received by family and representatives of residents contacted during this inspection. However shortfalls have been identified in the reporting of incidents to the Commission for Social Care Inspection. On the 15/05/08 the wrong medication was given to a resident at the home, and the Commission was not notified through a Regulation 37. However, the service did contact the General Practitioner to seek medical advice and a full incident record was completed. The service, however failed to notify the Commission for Social Care Inspection of an event in the care home, which adversely affects the well-being, or safety of a service user. This is in breach of regulation 37 9 (1) (e). A Requirement will be stated in relation to these findings. Annual quality assurance systems are in place. Survey formats for residents were simple and easy to read and were also in picture format. However, it was identified that family and representatives and stakeholders had not been included in the quality assurance programme. Health professionals, social services and any other stakeholders in contact with the home must also be involved in quality assurance surveys, to ensure their views are sought on how the home is achieving goals for residents. This will be stated as a Requirement. Health and Safety records were inspected. All documentation was in order and appropriately completed. Fire drills were completed regularly. Monthly regulation 26 visit reports were available to view at the home. Visits had been completed on a monthly basis and provided comprehensive information on the day-to-day operations of the home. A completed Annual Quality Assurance Assessment was received before the inspection and was supported by adequate evidence. It informed of the changes the service has made and where they still need to make improvements. Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 Page 27 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 Standard No Score 1 x 2 x 3 3 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 2 2 x 2 x x 3 x Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 Page 28 No 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 YA21 Regulation 12 Requirement The Registered Persons must ensure that the wishes of residents, in the event of their death are identified to ensure the ageing, illness and death of people who use the service are handled with respect and as the individual would wish. The registered persons must ensure that they implement polices and procedures for any medication leaving the premises and prevent where possible of secondary dispensing medication; review the monitored dosage system to ensure that care staff are satisfied that they are administering the correct medicine by identification from the label on the container dispensed by the pharmacist; to ensure care staff clearly sign and date in the medication details box when making a handwritten entry, to ensure accountability of those making the entries; and ensure that the DS0000025907.V373298.R01.S.doc Timescale for action 31/01/09 2 YA20 13 (2) 31/01/09 Kingswood Road (47) Version 5.2 Page 29 staff signature list is completed, to evidence the names of staff authorised to administer medication. 3 YA24 13 (4) (a) The registered persons must ensure that all parts of the home to which residents have access to must be so far reasonably practicable made free from hazards and unnecessary risks to residents are identified and so far as possible eliminated, to ensure the safety of residents and reduce the risks of infection. The registered persons must ensure that they evidence what follow up checks have been completed when residents are involved in accidents or incidents, to ensure there are no further health associated risks posed to them. The registered persons must notify the Commission for Social Care Inspection of an event in the care home which adversely affects the well-being or safety of a service user. The registered persons must ensure that quality assurance systems also seek the views of residents’ family and representatives and health professionals, social services and any other stakeholders in contact with the home to ensure their views are sought on how the home is achieving goals for its residents. 31/01/09 4 YA19 12, 13 31/01/09 5 YA37 37 (1) (e) 31/01/09 6 YA39 24 31/01/09 Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 Page 30 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 YA23 Good Practice Recommendations It is recommended that the service obtains Safeguarding Adult procedures devised by The London Borough of Redbridge, to keep abreast of the protocols to follow and keep updated with the information. It is recommended that the registered manager completes lone working risk assessments to ensure people working at the home and residents are safeguarded at night. 2 YA36 Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Kingswood Road (47) DS0000025907.V373298.R01.S.doc Version 5.2 Page 32 - 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!