Care Home: Wick Road ( 302, Flat 1 & 2)

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 Service users are involved in the running of the home. The home facilitates choice making and implements the organisation`s policies and procedures to ensure compliance with the National Minimum Standards. Staff support service users appropriately to ensure their needs are well met. There is an established, experienced and stable staff team. Despite not having a full staff team, there is no disruption to quality service delivery. Each service user has a comprehensive and well-written care plan, risk assessments and health action plans tailored to meet each individual`s needs. Service users are supported to take responsible risks. There is a good quality assurance system, which ensures feedback from the people living at Wick Road (where possible), their families and significant others is obtained to inform service provision. The home is well maintained, clean and comfortable. People who use the service are supported to live safely and they are safeguarded from abuse. Heritage Care equips the staff with relevant and suitable training both to effectively carry out their job as well as for their own personal development. The home is managed by a committed and knowledgeable manager, who has demonstrated her awareness of each service user`s assessed needs. What has improved since the last inspection? The home has made a very good progress since the last inspection and all previous statutory requirements have been met since the last inspection. The registered manager has ensured that each person who used the service had a signed contract in place. Progress has been made in order to ensure that those living in the home have access to their finances, which are being kept with the local Primary Care Trust. Since the last inspection, the home has purchased a new set of scales and as a result each service user`s weight was now monitored and recorded in accordance with their individual care plans and dietician`s recommendation. At the last inspection, a requirement was issued for any eyedrops to be labelled once opened and that they are stored in line with the manufacturer`s instructions. As at the time of this inspection, no eye drops were being kept in the home, the requirement has therefore been lifted. The home`s medication administration records have been improved, so that clear administration directions are given in respect of any "as required" (PRN) medication. The registered manager has ensured that no loyalty cards are used when making purchases on behalf of a service user, unless the cards are in the service user`s name, in order to protect service users from financial abuse. Since the last inspection, the home has ensured that the Commission is informed of any significant events in line with the Regulation 37 of the Care Homes Regulations. The home`s clinical waste is now locked when not in use, as previously required. The registered manager has ensured that equipment such as the service user`s walking frames, hoists and any other equipment is discreetly stored when not in use, in order to provide less institutional environment. Some of the staff have been offered refresher courses in mandatory fields, as well as areas such as sexuality and diversity, in order to ensure that staff posess all necessary skills and knowledge to be able to support all service users appropriately. Appropriate staff recruitment systems were in place and staff are now receiving regular supervision sessions. All substances hazardous to health were securely locked away when not in use, as previously required. CARE HOME ADULTS 18-65 Wick Road ( 302, Flat 1 & 2) 302 Wick Road Hackney London E9 5DQ Lead Inspector Robert Sobotka Unannounced Inspection 22nd April 2008 10:30 Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.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 Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.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. Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wick Road ( 302, Flat 1 & 2) Address 302 Wick Road Hackney London E9 5DQ 020 8986 4958 020 8502 3543 teresa.okeke@heritagecare.co.uk www.heritagecare.co.uk Heritage Care 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 Teresa Okeke Care Home 8 Category(ies) of Learning disability (8), Physical disability (8), registration, with number Sensory impairment (8) of places Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd July 2007 Brief Description of the Service: The Wick Road project was registered in February 2003. The care home provides personal care, support and accommodation for a maximum of eight service users who have learning disabilities, physical disabilities and/or sensory impairment and are between the ages of 18 and 65 years old. The project is a jointly commissioned venture, via Hackney Primary Care Trust, Heritage Care, North East London Advocacy Project and the Peabody Trust. All current service users were transferred from another residential establishment, managed by NHS. Staff from the former NHS home have also transferred and now work at Wick Road. The purpose built accommodation, is a three storey building based at a very busy intersection in the Victoria Park area of the London Borough of Hackney. The project occupies the first two floors of the building. The third floor is an unregistered space designed for supported living, managed separately from the Wick Road Project. The building has an operating lift and the home is fully accessible to wheelchair users. The home overlooks Victoria Park and has a small garden space and a car park to the rear of the building. Local bus services run along the main road, local shops and amenities are short distance away by vehicle. The project owns a van, which is wheelchair accessible. The home fees range between £1391.49 and £1454.83 per week. Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.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 star. This means the people who use this service experience good quality outcomes. This inspection took place over one day and was unannounced. The inspector spoke to some of the staff working in the home, including the registered manager and he spent some time with the service users observing the way they were supported by staff within the home environment. He also conducted a tour of the premises and viewed various records. Prior to this inspection the home was asked to complete the Annual Quality Assurance Assessment. Some of the information provided in the assessment has been incorporated into this inspection report. The aim of this announced inspection was to check the home’s progress towards full compliance with the National Minimum Standards for Younger Adults (18-65) and the Care Homes Regulations. The inspector would like to thank everyone who contributed to this inspection. What the service does well: Service users are involved in the running of the home. The home facilitates choice making and implements the organisation’s policies and procedures to ensure compliance with the National Minimum Standards. Staff support service users appropriately to ensure their needs are well met. There is an established, experienced and stable staff team. Despite not having a full staff team, there is no disruption to quality service delivery. Each service user has a comprehensive and well-written care plan, risk assessments and health action plans tailored to meet each individual’s needs. Service users are supported to take responsible risks. There is a good quality assurance system, which ensures feedback from the people living at Wick Road (where possible), their families and significant others is obtained to inform service provision. The home is well maintained, clean and comfortable. People who use the service are supported to live safely and they are safeguarded from abuse. Heritage Care equips the staff with relevant and suitable training both to effectively carry out their job as well as for their own personal development. Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.R01.S.doc Version 5.2 Page 6 The home is managed by a committed and knowledgeable manager, who has demonstrated her awareness of each service user’s assessed needs. What has improved since the last inspection? The home has made a very good progress since the last inspection and all previous statutory requirements have been met since the last inspection. The registered manager has ensured that each person who used the service had a signed contract in place. Progress has been made in order to ensure that those living in the home have access to their finances, which are being kept with the local Primary Care Trust. Since the last inspection, the home has purchased a new set of scales and as a result each service user’s weight was now monitored and recorded in accordance with their individual care plans and dietician’s recommendation. At the last inspection, a requirement was issued for any eyedrops to be labelled once opened and that they are stored in line with the manufacturer’s instructions. As at the time of this inspection, no eye drops were being kept in the home, the requirement has therefore been lifted. The home’s medication administration records have been improved, so that clear administration directions are given in respect of any “as required” (PRN) medication. The registered manager has ensured that no loyalty cards are used when making purchases on behalf of a service user, unless the cards are in the service user’s name, in order to protect service users from financial abuse. Since the last inspection, the home has ensured that the Commission is informed of any significant events in line with the Regulation 37 of the Care Homes Regulations. The home’s clinical waste is now locked when not in use, as previously required. The registered manager has ensured that equipment such as the service user’s walking frames, hoists and any other equipment is discreetly stored when not in use, in order to provide less institutional environment. Some of the staff have been offered refresher courses in mandatory fields, as well as areas such as sexuality and diversity, in order to ensure that staff posess all necessary skills and knowledge to be able to support all service users appropriately. Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.R01.S.doc Version 5.2 Page 7 Appropriate staff recruitment systems were in place and staff are now receiving regular supervision sessions. All substances hazardous to health were securely locked away when not in use, as previously required. 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. Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.R01.S.doc Version 5.2 Page 8 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 Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.R01.S.doc Version 5.2 Page 9 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): 1, 3, 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate information about the home was in place, so that potential service users can make an informed decision whether the home would be suitable for them. The assessed needs of those accommodated in the home were being met. Each service user had a contract in place, so that they can be aware of their rights and responsibilities. EVIDENCE: The home had an up-to-date statement of purpose and the service users guide. The statement of purpose has recently been updated to reflect a recent change of the service manager within Heritage Care. There have not been any admissions to the service since the home opened in 2003. The registered manager stated that if there were any admissions in future, she would ensure that proper assessment of needs is carried out before agreeing any admission. The service will carefully consider the needs of the person and ensure the capacity of the home to meet the assessed needs. Heritage Care has a referral and admissions criteria to guide the service. Standards relating to the home assessment and admissions systems could not therefore be fully assessed and will be reviewed when any new admissions have taken place. It was noted however that all service users who are Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.R01.S.doc Version 5.2 Page 10 currently living in the home have been appropriately assessed prior to moving to Wick Road. Following the review of documentation, such as care plans and risk assessments, direct and indirect observation of staff interaction with the service users and discussion with care staff, the inspector was satisfied that the needs of those accommodated in the home were being appropriately met. Care plans of each person are regularly updated to reflect any changing needs of the people accommodated at Wick Road. Each service user had a written costed contract in place. At the last inspection the inspectors were informed that as the service users living in the home were unable to sign the documents, no other person has been prepared to sign contracts on their behalf. Since the last inspection, a decision has been made that as those living in the home were lacking capacity to sign their contracts/tenancy agreements, there have been signed by the registered manager on behalf of each person accommodated in the home. Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.R01.S.doc Version 5.2 Page 11 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, 9, 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had a very good care planning system in place, so that any assessed needs of each person accommodated in the home are met. Risks were appropriately managed, so that those living in the home can take responsible risks. Confidentiality was being maintained. EVIDENCE: As part of this inspection, 4 service users’ care plans were reviewed. These were chosen at random. All service users had pictorial care plans in place and there was evidence that they were reviewed on a regular basis. Care plans viewed were very thorough and included useful and detailed information about how to support each service user and what their likes and dislikes were. Care plans viewed contained such information as what king of cosmetic products those who lived in the home liked using and what kind of routine each person liked. Documents are prepared in pictorial format and tailored to meet each person’s individual and varied needs to ensure a more Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.R01.S.doc Version 5.2 Page 12 holistic approach to their care. The home’s care planning systems was linked to individual service user’s needs assessments and care plans produced by the placing authority. The registered manager was able to demonstrate that information included in each service user’s care plan was consistent with how each person was supported. This was witnessed by the inspector on the day of this unannounced inspection, as well as evidenced in each person’s daily logs. Service users are supported to the best of their ability to take control of their own lives. The home works with an advocate from the local advicacy group to support the service users to make their own informed choices about their lives, wherever possible. There was evidence that the advocacy service was involved in supporting service users in making a decision about what kind of flooring should be placed in each service user’s bedroom, as previously recommended. Specific needs have detailed information which staff can use to ensure that their needs are meet in the best way possible and at the same time ensuring that the staff team is consistent in its approach. The person centred planning process is also used as a way of enabling servce users to live the life of their choice. The use of risk assessment to underpin person centred planning and to support mental and physical health needs. The home has adopted an attitude to prove that things can be done instead of limiting life chances of people because there is an element of risk involved. Service users invovlement in different aspects of home life varies according to their abilities. The home encourages those who use the service to be invloved in menu planning, food shopping, purchasing their personal clothing, toiletries, laundering their clothes, laying the table for meals. The home consults with the service users on how the home is run, in areas; as staff selection, menu planning, choosing holiday, decoration of the home etc. All the service users are offered a health action plan and they are all in accessible format and are reviewed as and when required. Staff are currently participating in a Quality Network Audit and two people who live at Wick road are having their care plans reviewed as part of this quality assurance project. Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.R01.S.doc Version 5.2 Page 13 Appropriate risk management systems were in place. The registered manager stated that the home recognised that risk taking is an important part of life, which enables people to learn and develop their skills and overcome difficulties and as a result continue to make choices. The service therefore regards responsible risk taking as part of everyday life and service users are not prevented from taking part in certain activities only because there is an element of risk. In this regard, for example, one of the service users who has high needs, and had never flown or travelled outside the United Kingdom has been supported to achieve a lifetime ambition of flying to Antigua for 12 days to visit her parents. The other service users have since then been travelling abroad to holidays of their choice to Spain, Malta, France and Ireland and to other holiday destinations of their choice. The inspector was satisfied that risks were assessed and actions were taken to minimise any effects of the identified risks. All activities are risk assessed before those who live in the home start their activities. Confidentiality was maintained. All confidential documents were kept in the staff room and locked when not in use. Information kept on computers was password protected. Each member of staff was assigned with a password to access relevant information on computers. Information was shared with the inspectors on a need-to-know basis. Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.R01.S.doc Version 5.2 Page 14 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): 12, 13, 15, 16, 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a good range of activities offered by the home and are supported with personal development and maintaining personal friendships/relationships. The service is commended for providing individualised supplies of food to each person living in the home. EVIDENCE: The home ensures that the day service links, which have educational links are kept active and alive. The service ensures that despite profound learning and physical disabilities people who use the service continue to enjoy the life opportunities that they experience. People who use the service are engaged in meaningful activities and are supported to participate and be part of the their local community. Service users are supported by staff to attend local places of worship and visit local pubs, as well as to enjoy various leisure activities. They also make use of Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.R01.S.doc Version 5.2 Page 15 the transport facilities available to access the wider community. People who use the service are supported to go swimming and to attend clubs for people with learning disabilities, and are engaged in other activities as detailed in their ideal and activity plan/person centred plans. Those who live in the home are supported to maintain contact with their families/friends. They are encouraged to forge friendships both with the people who live with them and well as with people outside the home. Families are invited for barbeques and parties. Although those who use the service are not able to communicate verbally, staff working in the home maintain telephone contact with the service users’ relatives. The registered manager stated that the service users’ rights are maintained and respected at all times based on best practice, which meets the contract requirements. Service users are encouraged to choose what happens in the home and are involved in a decision-making as far as it is practicable and possible with support from the local advocacy group. Those who use the service have unrestricted access to all communal parts of the home. Staff working in the home adequately support and encourage service users to be as fully involved as possible, despite their limited capacity. Service users are for example involved in some domestic tasks and as of part of developing or maintaining self-help skills in areas such as cooking, laundry, shopping and menu planning. The home is commended for offering a very individualised and healthy diet, which meets the cultural needs and preferences of the service users. The registered manager stated that those who use the service are involved in the menu planning, shopping as well as food preparation, with staff support. The health and dietary needs of the service users are assessed and reviewed/monitored on a regular basis. This is done in order to minimise risks facing some people who have problem gaining and maintaining weight, as well as those who are prone to obesity. The home works closely with the Dietician and the Speech and Language Therapist. Staff working with the service users are patient and ensure that people who use the service finish their meals at their own pace. At the time of this inspection visit the inspector witnessed service users being supported with preparing and eating individually prepared meals in accordance with their dietary needs and individual menus. Record of food offered to each person was kept in their daily log books. Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.R01.S.doc Version 5.2 Page 16 There were adequate food supplies in the home on the day of this unannounced inspection visit. Fridge/freezer temperatures were being recorded on a regular basis. There was a pictorial menu on display, so that people living in the home could see what food was on offer for each meal. Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.R01.S.doc Version 5.2 Page 17 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service was appropriately meeting personal and healthcare needs of the people accommodated in the home. Satisfactory medication systems were in place. EVIDENCE: All of the people who were using the service required support and assistance with their personal care. Each care plan viewed contained very detailed information about how personal care should be delivered to each person and it included their preferences and likes and dislikes. The registered manager stated that the service users are supported with close attention given to respecting individual needs and maintaining dignity at all times. Personal care is given at flexible times. The home maintains good relationships with the Learning Disabilities Team and has a lot of input from the Physiotherapists, Occupational Therapists and Speech and Language Therapists. Staff ensure that care is person led and person centred and as such is very flexible. Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.R01.S.doc Version 5.2 Page 18 Each person who used the service had an up-to-date and accessible Health Action Plan in place and there was evidence that regular heath checks from the General Practitioner/Nurse were taking place and that any other healthcare facilities were being utilised. At the last inspection visit, the inspectors noted that the weight of the people who use the service was not always recorded, as it appeared that the home was having problems with its weighing scales. The registered manager explained to the inspectors that the weighing scales were frequently out of order and staff members were unable to monitor service users’ weight. Since the last inspection, the home has purchased new weighing scales, which was suitable for wheelchair users. The inspector checked records of weight of the people who use the service and he was satisfied that their weight was now being appropriately monitored and recorded. None of the people who used the service were able to administer their own medication. As part of this visit, the home’s medication systems were checked. All medication was securely locked. Medication stocks were checked and found correct. Medication is reviewed regularly by the service user’s General Practitioner. All medication is stored in a locked cabinet. The registered manager informed the inspector that the home was in the process of obtaining a “controlled drugs” cabinet, in order to comply with the recent change in law. The inspector was satisfied that there were good systems in place for the management of the service user’s medication. All PRN (as required) medication is checked on a regular basis. All directions for administering any PRN medication were now accurately recorded on the service user’s medication administration records, as previously required. There were risk assessments in place to minimise errors in administering medication to the people living in the home. Staff are annually assessed for their competence in administering medication. All medication is regularly checked on daily basis by the manager, they are also checked on a weekly basis by the appointed responsible person, as well as on a monthly basis during the “responsible person’s” visits. Records of pharmacist’s audits were also in place and available for inspection. As at the time of this inspection none of the service users were prescribed any eye drops, the requirement issued at the last inspection that the registered manager must ensure that any eyedrops are labelled once opened and that any eyedrops are stored in line with the manufacturer’s instructions has therefore been removed. Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An appropriate complaints system was in place. Those living in the home are protected from abuse. The inspector was satisfied that the organisation has taken reasonable steps to resolve the ongoing situation regarding service user’s finances, so that those living in the home can have access to their finances. EVIDENCE: The home had both complaints and a compliments policy in place and both documents were in different accessible formats and languages. The registered manager stated that the home welcomes complaints and compliments from service users, families, visitors and external agencies. Any suggestions/concerns are used to improve the service delivery. The home works with an advocate, who lends a voice to the service users to ensure that they are heard and listened to at all times. Regular service users’ meetings are held with the Advocate were issues and concerns can be raised. The home has not received any complaints in the past 12 months. As part of this visit, the inspector checked a random selection of financial records kept on behalf of the service users. As those who use the service are unable to make any decisions in relation to their financial affairs, all purchases on behalf of the service users are made by staff supporting them. The home kept a small amount of money for each person who used the service. Records checked were found to be appropriately maintained and funds kept in respect of individual service users were correct. Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.R01.S.doc Version 5.2 Page 20 At the last inspection a requirement was made for the registered manager to ensure no loyalty cards are used by staff when making purchases on behalf of a service user, unless the cards are in the service user’s name, in order to protect the service user from financial abuse. The inspector was satisfied that this requirement has now been met. The inspector was satisfied that all “significant” events were reported to the Commission without delay, as required by law. Since the last inspection staff have attended POVA (Protection of Vulnerable Adults) Awareness training and managers and senior staff have received Advanced POVA training in addition to the POVA Awareness training. Accidents/incidents records were checked during this inspection visit. These were appropriately maintained and there was evidence that both documents were monitored by the home’s management team. The situation of people who use the service not being able to access some their finances remains unresolved. It was noted however that the Chief Executive of Heritage Care has contacted the Director of Finance of the local NHS trust in order to resolve this issue. The inspector was informed that service users have limited access to the money held by the local NHS Trust and that some have successfully recovered some of their funds. Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Those living at Wick Road benefit from an adequate and suitable environment. The inspector was satisfied that improvements have been made to make the premises more homely. EVIDENCE: Wick Road is located in a purpose built building and is suitable for its stated purpose and aims. The home is wheelchair accessible and has an operating lift. The project occupies the ground floor and first floor of the building. In the Annual Quality Assurance Assessment, the registered manager stated that although the home is currently registered to accommodate 8 service users, it is run as twp separate/independent flats. The residents are involved in choosing the décor in both communal areas and their private bedrooms. The inspector carried out a tour of the premises. He viewed all communal areas, as well as all of the service users’ bedrooms. Bedrooms were personalised and reflected interests and cultural identity of the service users. Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.R01.S.doc Version 5.2 Page 22 The majority of the premises had laminated flooring. Since the last visit some of the carpets in the home has been replaced with laminated flooring. At the last inspection, the inspectors felt that further input was needed from the advocacy team before a decision is made as to what kind of material should be used for flooring in the service users’ bedrooms. There was evidence that the advocacy service was involved in supporting service users in making a decision about what kind of flooring should be placed in each service user’s bedroom, as previously recommended. The home has six WC’s, four bathrooms and five showering facilities. All areas were spacious and clean. Specialist equipment was installed (such as Arjo baths, power chairs, tracking hoists and changing benches), to meet the assessed needs of the service users. In addition grabrails were installed throughout the house. The home had 3 mobile hoists, which service users can use in the home and when they are going on holidays. All bedrooms contain power beds. Since the last visit, the registered manager has liaised with the local Primary Care Trust team to enquire if any specialist equipment could be supplied by the local Primary Care Trust, instead of being purchased by individual service users, as previously recommended. The home was found to be hygienic and free from offensive odours. Since the last inspection, the registered manager has ensured that the home’s clinical waste kept in the wheelie bins in the rear garden is locked to prevent any spread of infections. At the time of this inspection the home was in a process of installing a macerator for the disposal of incontinence pads to replace the use of clinical waste and yellow bags. Laundry facilities were clean and well maintained. Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Those living in the home benefit from a committed staff team, who are appropriately trained, sufficient in number and appropriately vetted and supervised, so that the assessed needs of the service users can be fully met. EVIDENCE: Copies of the duty rosters were maintained in the home. Staff who spoke with the inspector felt that the current staffing levels were satisfactory to meet the needs of the service user accommodated in the home. There are at least 5 members of staff on duty per shift during daytime and 2 members of staff are working in the home during night time (one person doing “waking night” and one person doing a “sleep over”). Members of staff were observed to work in a professional and courteous manner and treated service users with dignity and respect. The registered manager informed the inspectors that one of the challenges facing the home was the retention of staff, due to the heavy physical workload linked to the high level of physical needs of the people who use the service. Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.R01.S.doc Version 5.2 Page 24 The inspector was satisfied that a good level of training was offered to staff working in the home and that any refresher/further training identified during the last inspection in relation to the Protection of Vulnerable Adults, Fire Safety Training and issues around sexuality and diversity has now been met. Since the last inspection, the registered manager has completed her RMA (Registered Managers Award) and NVQ (National Vocational Qualification) Level 4 in Health and Social Care, 5 staff have NVQ Level 2 in Care, 2 members of staff are currently doing NVQ Level 2 and 3 respectively and 1 member of staff is yet to enrol. 4 staff have commenced LDQ (Learning Disability Qualifications) training in February 2008. As part of this visit, the inspectors checked several staff personnel files. The inspectors were informed that each employee’s main file was kept in the organisation’s head office. Copy of the person’s file was also kept in the home. Criminal Records Bureau Disclosures were not checked during this inspection visit, as they were being stored in the Heritage Care head office in Loughton. Pro-forma sheets were kept in the home, which evidenced that each person received a Criminal Records Bureau checks. The recommendation that the Criminal Records Bureau checks are carried out every 3 years has been repeated. The inspector was satisfied that the frequency of supervision sessions has improved, as previously required. Staff also received annual appraisals. There are monthly staff meetings to discuss the management of the home and any challenges experienced in the running of the service. Minutes from these meetings were available for inspection and were viewed by the inspector. Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run by a competent manager, so the people who use the service benefit from living in a well managed home. Good quality assurance systems were in place. Appropriate health and safety checked were in place. EVIDENCE: The home is well run by a competent and qualified manager, who is experienced to work with the service user group and fit to run the home. The manager has NVQ Levels 3 and 4 in Health and Social Care and has just completed her RMA and is awaiting her certificate. She has NVQ Level 4 in Management and holds a Bachelor of Arts Degree in French. The registered manager has over 10 years experience of working with the service user group and has been registered with the Commission as the registered manager since 2005. She undertakes regular training and development to maintain and update her knowledge, skills and competence while managing the home for the Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.R01.S.doc Version 5.2 Page 26 benefit of the service users. Throughout the course of this inspection, the manager was able to demonstrate her good understanding of the service users’ individual needs and knowledge of the relevant legislations. Excellent quality assurance systems were in place. There has been a change in the service manager since the last inspection. The new service manager visits the service one a regular basis. Staff who spoke with the inspectors felt that the new service manager was very supportive. Reports from her monthlyunannounced visits to the home were available for inspection. They were also being forwarded to the Commission on a regular basis. As previously mentioned, staff are currently participating in a Quality Network Audit and two people who live at Wick road are having their care plans reviewed as part of this quality assurance project. There are annual audits undertaken by the organisation, as well as medication audits/checks carried out by a local pharmacist. Since the last inspection the home has produced a Service Development Plan, which included a staff training plan. Appropriate health and safety checks were in place. The inspector checked a random selection of documentation, such as fire safety checks, gas and electrical safety and moving and handling equipment checks, all of which were up-to-date. All substances hazardous to health were securely locked away when not in use, as previously required. The home was appropriately insured for its purpose. Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.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 3 2 X 3 3 4 X 5 3 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 3 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 4 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 4 X X 3 X Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 YA34 Good Practice Recommendations It is recommended that the Criminal Records Bureau checks be undertaken every 3 years. Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection London Regional Contact Team 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 Wick Road ( 302, Flat 1 & 2) DS0000039313.V362397.R01.S.doc Version 5.2 Page 30 - 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!