Inspection on 14/04/10 for Beatrice Road, 36

This is the latest available inspection report for this service, carried out on 14th April 2010.

CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Beatrice Road, 36 09/11/06

Beatrice Road, 36 08/02/06

Beatrice Road, 36 09/08/05

Beatrice Road, 36 08/02/05

Beatrice Road, 36 29/09/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 29/06/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Beatrice Road, 36 Beatrice Road, 36 London SE1 5BT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Alison Pritchard     Date: 1 4 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Beatrice Road, 36 Beatrice Road, 36 London SE1 5BT 02072520302 02072520302 jo.morgan@choicesupport.org.uk www.choicesupport.org.uk Choice Support Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Olajumoke Ewuoso Type of registration: Number of places registered: care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 3 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 category: Learning disability Code LD Date of last inspection Brief description of the care home The home is registered to provide accommodation and care for 3 people learning disabilities. It is one of a number of homes operated by Choice Support Southwark, which provides staffing and daily operational support services. The building is owned and maintained by Habinteg Housing Association. The property is similar in design to others in the street and is indistinguishable as a care home. As the home is a bungalow it is accessible throughout and there are a number of adaptations for people with disabilities. The home is located in a residential street in South East London, close to a shopping area with banks, cafes, pubs and public transport routes. The Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 3 Brief description of the care home building has 3 single bedrooms, a lounge, dining area, kitchen, WC /laundry room, bath, shower room and a garden at the back of the house. There is an additional room that is used as an office. Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: Our visit to the home was unannounced. While we were there we met the service users and talked to staff and spoke to the Registered Manager on the telephone two weeks after the inspection. We looked around the building and at a range of records. In advance of the inspection we sent surveys to a range of people, service users, relatives, staff and involved professionals to ask for their views. We received six completed surveys and one person sent comments by e-mail. We are grateful for their contributions which have been taken into account when writing this report. We took into account information provided by a member of the CQC National Provider Relationship Team. The annual quality assurance assessment (AQAA) was sent to us by the Registered Manager in advance of the inspection. The AQAA is a self assessment that focuses on Care Homes for Adults (18-65 years) Page 6 of 26 how well outcomes are being met for service users. It also gives us some numerical information about the service. Care Homes for Adults (18-65 years) Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Potential service users and people acting on their behalf are given good information about the home so that they can decide whether it is suitable. Assessments are made to make sure that the home can meet a potential service users needs. Evidence: There have been no admissions to the home since the last inspection. The admission policy ensures that both the potential service user and the home gather sufficient information on which to make a decision about the suitability of a placement. Professionals involved with potential service users are consulted for their views about the suitability of the placement. Each of the current service users has a service user guide which has been designed using symbols, photographs and plain English. There is a trial period included in the admission arrangements. Care Homes for Adults (18-65 years) Page 10 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care planning documents were clear and accessible. Care planning goals are decided in consultation with people of importance to the service users. Service users views are important to the organisation and there are a range of mechanisms for consultation. Evidence: We looked at individual care plans and associated documents. We found a significant improvement in the documents since our last visit. The information about guidelines for caring for service users were clear and in one case had been signed by the persons next of kin, indicating their agreement. An advocate is involved with the service users and is consulted about important issues to do with their care. Choice Support has a variety of ways to ensure that service users are involved in the running of the organisation. On the day after our visit a service user conference, organised by Choice Support, was taking place in Leicester and one of the service users was due to attend with a member of staff. Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: Service users may join a group called Surprise which is consulted by the organisation, although none of the service users from this home are involved. The home is working towards making all of the information accessible to service users. The documents that we saw were written using a range of formats to make them accessible. Risk assessments are on files to ensure that the service users are not unnecessarily restricted, but that risks are managed properly. Choice Support is registered under the Data Protection Act. A filing cabinet is stored in the living room, although this is locked its presence is not appropriate. This is dealt with further below in the section on the environment. Care Homes for Adults (18-65 years) Page 12 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users follow a range of activities which are suitable for their ages and interests. The meals provided take into account their particular needs. Evidence: The residents have high care needs and the staff support them to follow a range of leisure activities appropriate to their ages, needs and interests. The activities for the week are displayed pictorially on an activity plan. The activities include cycling (using adapted bicycles) in Dulwich Park; attending a sensory room; hydro pool sessions; massage; eating out; attending social clubs such as Pop-In and Gateway; shopping and going to Church. Last summer day trips were arranged to Brighton and Littlehampton and also to the London Aquarium and Madame Tussauds. The staff demonstrated their knowledge of service users interests. They told us that one of them particularly likes classical music and another likes computer games. They Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: also have a range of equipment to assist them with sensory activities. The service users are supported to keep in touch with people who are important to them. We also heard that they inform relatives of important events such as reviews of their care plans and invite them to attend if they wish. An advocate has known the service users for a long time and she also maintains contact with the service users. The menu that we saw was compiled with reference to the service users preferences and particular needs. for example to have a soft diet, and to have drinks thickened. The service users are encouraged to eat regularly items of fruit, vegetables and roughage to assist with their health conditions. The meals take into account the service users cultures. Care Homes for Adults (18-65 years) Page 14 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users health care needs are looked after well. We have made a requirement that nutritional assessments are carried out, referrals made to dieticians as necessary and recommended frequent weight monitoring to ensure that this aspect of their health is informed Evidence: The service users have high support needs and staff have to be alert to their communication methods to ensure they are met. The consistent staff team helps to achieve this. We heard from a professional involved with the service users that they are well supported by the staff who generally have a good understanding of them both. The service users have health action plans which describe their health care needs and we saw records to confirm that they attend appointments with health care professionals such as the GP, the chiropody service, physiotherapist and other members of a multi-disciplinary team for people with learning disabilities. We discussed one of the service users with members of staff, including his key worker. We were concerned that his build on the health action plan was described as average and Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: that this did not accurately reflect his weight which we considered rather low. We found that the last recording of his weight was in early February 2010. We found no notes relating to the service users nutritional status although the staff that we spoke to and the manager felt that felt that he ate well. We have made a requirement that nutritional assessments are conducted for the service users and, if found to be advisable, a referral is made to a health professional who can give specialist dietetic advice. We also recommend that weight monitoring is carried out more frequently so that changes can be responded to quickly. We noted that the staff at the home have worked hard to increase the fresh items of food and fluid in the service users diets. This has had a positive outcome for the service users, one of whom no longer needs an item of medication he was previously prescribed. When a service user requires surgical attention, as recently, the home has followed the correct procedure as required by the Mental Capacity Act. Both of the service users need assistance with medication. The stocks of medication were well stored and overall medication is managed effectively. Weekly checks are carried out and recorded. Each service user has had a review of medication recently, items of medication used on an as needed basis have been agreed by the GP and appropriate instructions available for when and how they should be used. The records of medication administration are in good order and there are no unexplained gaps. Care Homes for Adults (18-65 years) Page 16 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are protected by effective complaints and safeguarding procedures and staff who are trained in their use. Evidence: The complaints procedure of Choice Support meets the required standards and includes details of the timescales within which complaints will be investigated.No complaints have been made to the service for more than three years and CQC have not received any expressions of concern. There have been no safeguarding issues at the service over the previous year. All staff receive training on safeguarding issues and Team Managers attend annual refresher training. In order to safeguard service users financial interests the Team Manager carries out weekly finance checks. These are checked every three months by the Service Manager and on a monthly basis on visits by managers of other registered homes. In addition checks of cash balances are made at each shift handover. Liaison with Choice Support early in 2009 showed that it is working with RESPOND, a specialist organisation which assists people with learning disabilities. Workshops are planned for staff and service users on issues including feeling safe and disability and hate crime. Senior staff within Choice Support have received training in Deprivation of Liberty Safeguards. Care Homes for Adults (18-65 years) Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The building is suitable for the needs of the service users but at the time we visited there were two problems. Firstly a metal filing cabinet in the living room detracted from the otherwise homely appearance. An adapted bath was unavailable for use as a part was needed, service users had been unable to bathe for the previous two weeks. We have since been informed that the bath is now working and available to service users. Evidence: The home is a bungalow, accessible to both of the service users. Each service user has his own bedroom which is suitable for their needs. The communal areas are a living room, a dining room and a kitchen. There is a bathroom and an additional separate WC which adjoins the laundry. At the rear of the home is an attractive garden. The home was comfortable, clean and tidy at the time of our visit and there were no unpleasant odours. The otherwise homely appearance of living room was spoiled by the presence of a grey metal filing cabinet in which papers were stored. We recommend that the storage arrangements are reviewed so that the cupboard is moved. An adapted bath has been fitted in the bathroom but at the time of the inspection was Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: not working as a part was not available. We heard from staff that service users had been unable to have a bath for the previous two weeks. Since the insepction the Registered Manager has informed us that the part has now been fitted and the bath is in operation. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing levels mean that the service users can have individual care. The staff are well trained and supported. Recruitment is safe and thorough and protects service users. Evidence: The rota is arranged so that there are two people on duty during the day. This allows the service users to have individualised care during the day, and one person sleeps in the home at night time, additional assistance is available through the on call system. All six of the staff have achieved NVQ level 2 or higher. Additional training undertaken by the team include a range of health and safety courses, safeguarding and communication. Staff are supervised regularly, and staff meetings held each month. In March 2009 a check of the recruitment procedures of Choice Support services located within London and South East Regions was completed. The majority of files checked were staff that had recently been recruited to the organisation and were a cross section of all grades and posts. The overall judgement was that the procedures were robust and contribute towards protecting service users from harm. Care Homes for Adults (18-65 years) Page 20 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management arrangements are good and there are a range of quality assurance systems in place. Health and safety measures ensure the safety of the service users and staff. Evidence: The Manager has been registered since January 2010 although she has worked at the home for a longer period. She is appropriately qualified, holding the RMA and NVQ4. The manager is also responsible for another registered home in a neighbouring street. The suitability of this arrangement was assessed by CQC and we do not have concerns about it. The feedback that we received about the management style was positive. We heard that the Manager is a good listener, she involves the team with management routine and is ready to help when necessary. Choice Support has a number of Quality Assurance processes in place. These were judged in March 2009 to be robust and very thorough. A Lead Analyst analyses all of Care Homes for Adults (18-65 years) Page 21 of 26 Evidence: the information, producing regular reports for senior management to ensure that areas of concern are tackled at the earliest opportunity. The QA process consists of: yearly service audits, finance audits, Regulation 26 reports, health and safety audits, REACH data, whole service reviews and annual external audits. Quarterly reports are made to the local authority which funds the service users placements and these contribute to the monitoring of the service. We saw records to confirm that regular and appropriate checks are carried out to ensure safe conditions in the home. The fire risk assessment was last reviewed in June 2009. The most recent fire drill was in February 2010 and weekly checks are made of the fire safety systems. Staff have undertaken training in health and safety issues, including moving and handling; fire safety; first aid and food hygiene. Care Homes for Adults (18-65 years) Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 13 Nutritional assessments must be conducted for the service users and if they indicate that further dietetic advice is necessary referrals must be made to an appropriate professional. To ensure that service users benefit, where necessary, from treatment, advice and other services from any health care professional. 04/06/2010 2 29 23 Equipment provided for use 10/06/2010 by the service users must be maintained in good working order. So that service users have access to the specialist equipment they require. Care Homes for Adults (18-65 years) Page 24 of 26 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 19 Weight monitoring should be carried out at regular and frequent intervals to ensure that changes can be addressed without unnecessary delay. Office furniture should not be stored in service users communal areas because it is not homely. 2 24 Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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