Inspection on 20/11/08 for Shalom Homes

This is the latest available inspection report for this service, carried out on 20th November 2008.

CSCI 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

Shalom Homes 08/12/05

Shalom Homes 15/08/05

Shalom Homes 14/03/05

Shalom Homes 08/09/04

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Shalom Homes 110 Griffin Road Plumstead London SE18 7QD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lorraine Pumford     Date: 0 3 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. the things that people have said are important to them: They reflect 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Shalom Homes 110 Griffin Road Plumstead London SE18 7QD 02088558673 02088558673 b.fadojutimi@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Bode Fadojutimi care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia 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 (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home Shalom Homes is located at 110 Griffin Road in a terraced house on two floors in a residential area of Plumstead, a short distance from the town centres of Woolwich and Plumstead with their shops and markets. Plumstead train station is at the end of the road, and the 53 bus passes close by. The Home offers care for three adults between the ages of 18 and 65 who have a mental disorder. Service users are supported in their daily living and encouraged to live as independently as possible. 3 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 28 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: We met with the people who live in the home, the manager and staff on duty. In addition surveys were sent to staff, residents advocates and health care professionals that meet with people living and working in the home and some of their comments have been included in this report. We looked at the Annual Quality Assurance Assessment, AQAA, sent in by the provider. This self-assessment document focused on the outcomes for people using the service and plans the provider is making for the future operation of the service over the forth-coming months. The last inspection report was viewed. We looked at what the provider had told us about events that Care Homes for Adults (18-65 years) Page 5 of 28 have happened in the service, these are called notifications and are a legal requirement. During the time we spent at the home we examined a number of policies, procedures and documents and undertook a tour of the buildings. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 28 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. Standards 1,2,4 were inspected. People using this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home benefit from their individual needs being assessed prior to being offered a place. The Statement of Purpose must include restrictions within the home. Evidence: The manager stated that one person has been admitted to the home since the last time we undertook an inspection and records were examined in relation to the persons pre admission assessment. The assessment included participation by relevant health and social care professionals, the resident and their advocates. The manager stated that the person had been able to visit the home with their care manager prior to being offered a place on a trial basis. We met with the resident who said he felt comfortable and settled in his new home. Feedback in one persons satisfaction survey voiced concern that the front door is kept locked. Staff stated that one person had left the home without staff knowing on more than one occasion and following a meeting with Care Homes for Adults (18-65 years) Page 9 of 28 Evidence: the persons care manager and the police it had been agreed this was best course of action to minimise the risk of the person being harmed out side of the home. Discussion took place regarding the need fro this information to be included in the homes Statement of Purpose also see standard 7. Care Homes for Adults (18-65 years) Page 10 of 28 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. Standards 6,7,8 and 9 were inspected. People using this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. There must be a risk assessment in place with regards to the decision to lock the front door. People living in the home can be confident that they will be supported to have an individual care plan and risk assessments which helps facilitate the residents to make choices in their daily lives. Evidence: Care plans were examined for two people, one who had lived in the home for more than a year and one for less. We also spoke to the manager and care staff about the care plans. Both people had comprehensive care plans in place. These were clearly laid out and covered all aspects of each persons needs and were written using appropriate language. The care plans had also been reviewed. Each resident had a named key worker. The staff were asked about their role as a key-worker and this showed the support they provided was very comprehensive including helping with personal Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: shopping, attending healthcare appointments, organising leisure activities and updating care plans. We read the risk assessments for the same two people who live in the home. It was possible to see that staff had identified areas of personal risk, the manager stated that one person had on occasions eft the premises without informing staff and has subsequently become lost and returned by the police at a later date. The manager stated that a meeting had been held with the residents care manager and the police and it had been agreed that the door should be kept locked to reduce the risk of resident being harmed outside of the home. On the first day that we visited the kitchen was also locked and we discussed the need for these restrictions to looked at in relation to each person living in the home and included in peoples care plans. The manager stated that the Kitchen should not be locked and the matter would be discussed with the staff member concerned. Each person living in the home had individual behavioural guidelines as part of their individual profile, assessment and care plan and these were clearly written and gave appropriate guidance to the staff. The two residents assessments and care plans clearly stated what arrangements were in place to support them to manage their personal finances including who acts as their appointee and how they can access their monies. Care Homes for Adults (18-65 years) Page 12 of 28 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. Standards 12,13,14,15,16 and 17 were inspected. People using this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home are supported to develop their daily living skills. Residents benefit from a range of activities. Residents have a healthy and varied diet. Evidence: The manager stated that due to the level of residents mental health difficulties none of the current people living in the home attend further education or are in employment. We spoke to the residents and staff and looked at the activity programmes to get an understanding of the activities that are taking place. Staff record activities that have taken place in the general activities record, this indicated that people living in the home regularly go out shopping and for meals out. Residents also attend a coffee Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: morning at the local church and exhibitions in the local library. One person told us he did not like to go out very much and enjoyed staying in and watching sports on TV with his key worker. All of the people living in the home benefit from having an annual holiday and staff have made plans for residents to go away for Christmas. The record also indicates activities that residents had declined to participate in. Staff stated that peoples disabilities restricted their ability to manage day to day household tasks however staff endeavour to encourage residents to be independent by supporting staff with some domestic duties such as cleaning their bedroom. From information provided in the AQQA and discussion with staff and residents it is apparent that the staff support people to maintain contact with family and friends. We met three of the residents in their rooms which were individually personalised. Resident said they had been able to bring in some personal effects from their previous homes such as TVs and music centres. Staff have also taken a number of photographs of residents on holiday, outings and parties and these are on display. A record is kept of food provided for residents, this showed that people receive a very nutritional diet. People spoken with said that the food was okay and they have no complaints. Staff stated that they shop on a weekly basis. Care Homes for Adults (18-65 years) Page 14 of 28 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. Standards 18, 19, 20 were inspected. People using this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home are supported in a manner that protects their privacy and dignity. Each person benefits from access to professional healthcare input based on their individual needs. Medication procedures help safeguard people in the home. Evidence: We looked at the healthcare records for two people living in the home. They had all been supported to access a range of healthcare professionals including the GP, psychiatrist and other appointments according to their individual needs. Two health care professionals completed surveys and stated that staff took on board the guidance provided regarding residents health care needs. Staff maintain a record of residents healthcare appointments. We looked at the homes medication practices, storage, recording and administration records.Medication was found to be securely stored. A record of staff signatures was being maintained, this enables persons inspecting the records to undertake an effective audit. A photograph of each resident was attached to Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: their MAR sheet. Medication for residents comes from two sources, consultants that prescribe medicine for residents and is dispensed from the hospital pharmacy in boxes and medicine that has been prescribed by GPs from the community pharmacist in Dosettes boxes. On the day we first visited the manager had decanted tablets from the boxes into Dosettes which staff then administered. Although the boxes had been individually labelled with the residents name there was no indication as to what the tablets were. This system of administering medication is not good practice as it increases the risk of error. This was discussed with the manager who stated that she would discuss the matter with healthcare professionals in order to establish a safer system. Following this inspection the manager contacted us to say that the hospital pharmacy department had agreed to arrange for future tablets to be dispensed in Dosette boxes and she would no longer need to decant medicine. A copy of the homes medication policy was seen, this provides staff with guidance on different types of medication, recording and maintaining records. Staff undertake a competence based assessment before being able to independently administer medication to residents. Discussion took place with the manager regarding the fact that pharmaceutical guidelines have been updated which means that a medicine profile should be kept on an ongoing basis for all medicine prescribed to residents, also that staff responsible for administering medication must have an annual competency test to ensure they remain competent to administer medication. We observed during the inspection that staff spoke to residents in a respectful manner and address them by their preferred name. Staff knocked on residents bedroom doors and waited to be invited in before entering. Care Homes for Adults (18-65 years) Page 16 of 28 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. Standards 22 and 23 were inspected. People using this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people living in the home have access to an appropriate complaints procedure. Procedures and training on safeguarding vulnerable adults are in place to protect and safeguard residents. Evidence: The AQAA stated that there have been no written complaints since the last inspection and we have received none. People living in the home who completed surveys stated they knew who to speak to if they were unhappy. Staff stated that regular house meeting take place and residents are encouraged to express their views and if they have any concerns. There have been no adult protection issues since the last inspection. Copies of the organisations procedures and social service procedures are available in the home. The manager stated she knew whom to contact in social services in the event of needing to make an adult protection referral. All staff have received training in relation to Protection of Vulnerable Adults. We checked the personal finances for two residents including their cash record, cash Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: and receipts. These two residents are supported by staff to manage their monies. There is an individual finance record for each person and their cash is held in a lockable filing cabinet. All expenditure is recorded and receipts are available. The record of expenditure was inspected and money had been spent appropriately and receipts were available, money held tallied with the records seen. Care Homes for Adults (18-65 years) Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 24 and 30 were inspected. People using this service experience good outcomes in this area.This judgement has been made using available evidence including a visit to this service. people who use this service continue to benefit from the ongoing redecoration program. The home is kept clean and hygienic and is a pleasant environment for the people who live here. Evidence: The home is spread over three floors and would not be suitable for people who have a physical disability. The kitchen, dining room and a toilet are situated on the lower ground floor. One bedroom and a room used by people to smoke in is on the ground floor, on an upper mezzanine level there is another bedroom and bathroom and there is a third bedroom and office situated on the top floor. There is a well maintained garden to front and rear of the property. A requirement was made at the time of the last inspection regarding the need to investigate cracks which had appeared in walls to the rear of the building and additionally a number of rooms within the home were identified as needing Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: redecoration. The manager stated that some remedial works have been undertaken in relation to the cracks as an interim measure however they intend to move to another premises in the neighbourhood, subject to planning permission in the near future. It was evident that action has been taken to redecorate the communal areas and some bedroom furniture has also been replaced. The lower ground floor toilet would benefit from a deep clean, this room is still awaiting decoration and the addition of new flooring would help keep the room clean and hygienic. A requirement was made at the time of the last inspection in relation to a wardrobe that was unstable and action has been taken to address this. Residents spoken with stated they were happy with their bedrooms and accommodation provided. We visited the home a few weeks before Christmas and decorations had been put up. The house was warm, comfortably and homely. Care Homes for Adults (18-65 years) Page 20 of 28 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. Standards 32,,34,35 and 36 were inspected. People using this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from being supported by a committed and stable team of staff. Staff receive a range of training and are supported by regular supervision sessions. Sound recruitment procedures help safeguard people living in the home. Evidence: We checked the rota for the home and this showed that in addition to the manager there is a team of four staff working in the service. During the day there is at least one staff on duty and at night there is one waking member of staff. We talked about the need for there to be a risk assessment in place for staff working alone with people in and outside the home. The staff turnover has been low and all of the current staff group have worked at the home for than year, the manager also works regular shifts in the home. The AQAA prepared by the home indicates that all care staff working in the home hold an NVQ2 qualification in care. In addition one person also holds an NVQ3 and other Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: staff are working towards attaining level 3 and 4 in care. The manager stated that no new staff have been employed to work in the home since the last inspection. We looked at the recruitment records for two people who have been working in the home for more than twelve months. It was found that all the staff had two references, ID, POVA check and a CRB disclosure and completed health declaration forms. The staff had completed and signed contracts of employment. Copies of staff training certificates were seen and these indicated staff had undertaken all mandatory training as well as specific training to support staff to work effectively with the residents they care for. Staff said the training they had received was of a good standard and very useful in their work. We looked at supervision records. All staff received regular individual supervision. The manager and care staff stated that staff team meetings take place on a monthly basis. Care Homes for Adults (18-65 years) Page 22 of 28 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. Standards 37,39 and 42 were inspected. People using this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well qualified and permanent manager. Health and safety measures are in place to safeguard the people living in the home. The quality improvement system seeks the views of people involved in the service however regulation 26 reports must be kept in the home and available for inspection. Evidence: The home continues to benefit from a permanent manager and staff group. The manager has qualifications in nursing, care and management and a number of years experience working in a care setting. The manager explained that a quality assurance system is in place including regulation 26 monitoring visits. Copies of reports written in relation to these audits were not available for inspection and must be kept in the home and be available. The company has questionnaires which seek the views of residents, Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: relatives and other care professionals as part of a quality improvement plan. The fire alarm and fire extinguishers had been serviced. The fire alarm records showed the alarm is checked weekly and fire drills have been taking place regularly. The staff training records show that staff have completed health and safety training, food hygiene and infection control. The AQAA showed that all the health and safety maintenance checks had taken place. Care Homes for Adults (18-65 years) Page 24 of 28 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 25 of 28 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 1 4 The responsible person must 02/03/2009 ensure that the Statement of Purpose covers the current arrangements in relation to the front door being locked. People need to know this information when choosing a home. 2 39 26 Copies of the monthly audits 27/02/2009 must be kept in the home and available for inspection. This is to show that the provider is monitoring the care and service provided in home they are responsible for. 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 20 An ongoing medicine profile must be maintained for each resident. Staff are required to have an annual competency Page 26 of 28 Care Homes for Adults (18-65 years) assessment in relation to the administration of medication. Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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