Inspection on 12/06/06 for 129 London Road

This inspection was carried out on 12th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

129 London Road 16/01/06

129 London Road 15/08/05

129 London Road 18/10/04

129 London Road 21/06/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 London Road (129) 129 London Road Redhill Surrey RH1 2JQ Lead Inspector Sandra Holland Unannounced Inspection 12th June 2006 13:35 London Road (129) DS0000013446.V295481.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 London Road (129) DS0000013446.V295481.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. London Road (129) DS0000013446.V295481.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service London Road (129) Address 129 London Road Redhill Surrey RH1 2JQ 01737 779552 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) Prospect Housing and Support Services Mr Simon Churcher Care Home 5 Category(ies) of Learning disability (5) registration, with number of places London Road (129) DS0000013446.V295481.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age/age range of the persons to be accommodated will be: 20-65 YEARS 16th January 2006 Date of last inspection Brief Description of the Service: 129 London Road is owned and managed by Prospect Housing Association. The home is an older style property situated on a busy residential road close to Redhill town centre and provides support to five men who have a learning disability. The home benefits from a number of communal areas including a lounge, dining room, kitchen, conservatory and a large garden. One bedroom is situated at ground floor level with the remaining four being on the first floor. All bedrooms are a good size. There is a downstairs shower room and toilet and further bathroom facilities upstairs. There is also a very small office / staff sleeping-in facility at first floor level. The range of fees at the service is from £……… to £……… London Road (129) DS0000013446.V295481.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the first “key” inspection to be carried out at the service under the Commission for Social Care Inspection’s (CSCI’s) Inspecting for Better Lives programme. As the inspection was unannounced, no-one at the home knew it was to take place. Mrs Sandra Holland, Lead Inspector carried out the inspection over five hours. Ms Angella Chimenya, Senior Support Worker was present representing the service. As the designated responsible person (DRP), Ms Chimenya provided most of the records and information. The inspector met and spoke with all five of the gentlemen who live at the home and spoke to two members of staff. A number of records and documents were examined, including individual plans, staff files, service user’s financial records and health and safety records. A pre-inspection questionnaire was supplied to the home. This was completed and returned to CSCI within the requested timescale. Some of the information in this report was obtained from the pre-inspection questionnaire. The inspector would like to thank service users and staff at the home for their welcome, hospitality and assistance. What the service does well: Service users continue to be supported to be as independent as possible and to maintain and develop their daily living skills. Staff provide a high level of effective and individual support, respecting the choices made by service users and enabling service users to live their lives as they would wish. The home is decorated in a colourful way and is comfortably furnished in a homely style to meet the needs of service users. Service users are actively supported to maintain contact with their families and friends and to be involved as members of the local community. Some of the service users at the home present with challenging behaviours which are very well managed by staff. London Road (129) DS0000013446.V295481.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. London Road (129) DS0000013446.V295481.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection London Road (129) DS0000013446.V295481.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All service users are assessed prior to admission to the home. EVIDENCE: All of the service users have lived at the home for a number of years and were fully assessed prior to admission under the care management process. Copies of the assessment have been obtained and retained by the home. London Road (129) DS0000013446.V295481.R01.S.doc Version 5.2 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed individual plans are maintained for and with each service user and these include assessments of risks to service users. EVIDENCE: Comprehensive individual plans have been drawn up with the involvement of service users, to guide staff to the support needs of each service user. These detail the level of support required with all aspects of service users’ lives, including specific behaviours, personal care, communication and occupational and social needs. The individual plans have recently been reviewed with service users, to ensure that service users current needs are reflected Service users have signed these to indicate their involvement. Service users spoke of going on holiday in the coming weeks and told of receiving support from staff in making decisions about this. The service users advised that they are going holiday in pairs or groups of three, which enables them to have time away from each other and allows for individual choices of holiday destination to be accommodated. London Road (129) DS0000013446.V295481.R01.S.doc Version 5.2 Page 10 It was clear from speaking to service users that they are encouraged and supported to make their own decisions and choices. Service users spoke of handling their own finances, of their involvement with friends and of attending a local church. The assessments of risks to service users have been reviewed and updated recently to include any changes and to ensure that these accurately reflect the present needs of service users. The risks to service users include handling their own finances, going out alone and challenging or inappropriate behaviours. London Road (129) DS0000013446.V295481.R01.S.doc Version 5.2 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users take part in appropriate activities and are active members of their local community. Service users are supported to have appropriate relationships and staff respect service user’s rights and responsibilities. A well balanced diet is offered. EVIDENCE: From speaking to service users, it was clear that they take part in a range of fulfilling activities. One service user was attending a workshop during the time of the inspection and walked home alone at the end of the day. Other service users had attended a day service for activities during the morning of the inspection day. Service users were animated as they spoke of activities that they are involved in including going to the pub, having days out, going bowling and attending a local church. They spoke of visiting their friends and friends being invited home and were eagerly looking forward to their forthcoming holidays. One service user showed his diary, which had a picture of his holiday resort on the London Road (129) DS0000013446.V295481.R01.S.doc Version 5.2 Page 12 appropriate date and which enabled him to refer to it. Service users were keen to advise that they were going on holiday with their key-workers. The service user group is entirely male, but the staff group is made up of male and female staff. There is racial and cultural diversity amongst the staff group. Staff advised that two service users go to visit their families each weekend and staff support service users with transport to their activities as required. Staff also offer and provide practical assistance such as phone calls and making bookings, to enable service users to make their choices and arrangements. From the information included with the pre-inspection questionnaire, it was clear that service users are offered a healthy and well-balanced choice of meals. Service users were enjoying their evening meal in the cheerful dining room during the inspection and the meal looked and smelt appetising. Service users were actively involved in preparing the table for the meal, making drinks and clearing up afterwards. London Road (129) DS0000013446.V295481.R01.S.doc Version 5.2 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive personal support in the way that they prefer and require, and their healthcare needs are well met. Medication appears to be administered appropriately. EVIDENCE: The service users living at the home are fully mobile and able to carry out most of their activities of daily living with minimal support and guidance. When assistance or prompting was required, staff were observed to offer personal support in a discreet manner which respected service user’s dignity and privacy. Staff encouraged service users to be independent and to make their own choices, wherever possible. Service users said that they could express a preference if they preferred to be assisted with personal care by either a male or female member of staff and this would be accommodated wherever possible. From the individual plans, other records and speaking to service users, it was clear that service users’ healthcare needs are well met. Service users spoke of going to visit the doctor if they were unwell or to the dentist, optician and chiropodist for appointments. Other specialists such as psychologists and London Road (129) DS0000013446.V295481.R01.S.doc Version 5.2 Page 14 consultants are involved as required and are accessed through the general practitioner (GP) service. Records of visits to specialists and outcomes from these, were seen in the individual plans. It was clear that referrals had been promptly made to the GP in the event of a change in a service user’s health. The senior support worker stated that apart from one service user’s inhaler, all other medication in the home is retained in a medication cupboard and is administered by staff to safeguard the service users. Service users were seen to present themselves at the appropriate time for their medication, bringing a suitable drink with them. Staff advised that the service user with the inhaler is supported by staff to ensure it is administered correctly. Medication was seen to be administered appropriately to service users, to be stored suitably with accurate records maintained. Stock levels were checked with the record held and accurately matched. London Road (129) DS0000013446.V295481.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users feel their views are listened to and acted on and staff are aware of their responsibilities in the protection of service users. EVIDENCE: From speaking to service users, it was clear that they would tell the manager or staff if they were unhappy about anything or wished to make a complaint. Service users advised that a book is available in the entrance hall for complaints or compliments to be recorded. This was shown to the inspector by service users and no entries had been made for a long period. A copy of the complaints procedure is available in pictorial format on the notice board in the main hallway. Staff advised that a monthly service user’s meeting is held and that service users are reminded during these meetings, that they should advise staff if they have any complaints. The senior support worker stated that she was aware of the Surrey MultiAgency procedure, a copy of which was available in the office. This procedure had been implemented since the last inspection and the inspector had been informed of this at the time. New guidelines and strategies have been implemented for the management of one service user’s behaviour as a result, with good effect, the senior support worker stated. Other staff stated that they would inform the manager or area manager if they had any concerns regarding the abuse or possible abuse of service users. Staff London Road (129) DS0000013446.V295481.R01.S.doc Version 5.2 Page 16 advised that they would not hesitate to report any concerns, as it is their role to protect service users, and that they are aware of the organisation’s “whistle blowing” policy. A whistle blowing policy allows staff to raise concerns, anonymously if preferred, to alert the home’s management to look into the concerns. The manager and two other staff have undertaken training in the safeguarding of adults in recent months, the senior support worker advised. Monies are held for safekeeping for service users the senior support worker advised and the amounts held are checked by staff at each shift handover. The amounts held were checked against the records held and these accurately matched. Service users are encouraged by staff to obtain and retain receipts for their purchases to ensure that their monies are fully accounted for. London Road (129) DS0000013446.V295481.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home presents as a comfortable place to live and appears clean and hygienic. EVIDENCE: The home is attractively presented, being cheerfully decorated in a range of bright colours. It is furnished in a comfortable, homely style and all areas were clean, tidy and appeared to be safe, with no obvious hazards. The home is situated on a main residential road leading into Redhill town centre, and is in keeping with other properties in the area. The town has a comprehensive range of shops and facilities and is within walking distance. Buses also pass the home and a mainline train station is available in the town. All areas of the home appeared clean and hygienic, with suitably placed handwashing facilities. It was noted that fabric towels are used in the bathrooms which are changed daily, staff advised. It is strongly recommended that paper towels are supplied and used, as these reduce the risks of spreading infection. A recommendation has been made regarding Standard 30. London Road (129) DS0000013446.V295481.R01.S.doc Version 5.2 Page 18 London Road (129) DS0000013446.V295481.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by an effective staff team and are protected by the recruitment policies and procedures. Staff are trained to enable them to meet service users’ needs. EVIDENCE: It was clear from observing the interaction between staff and service users, that staff listen to service users, are approachable and respond appropriately. Staff and service users were relaxed and informal in each others company, showing interest and respect for each other. The senior support worker stated that she and another member of staff have achieved a National Vocational Qualification (NVQ) level 3 in care and another member of staff is currently undertaking this. A member of the bank staff, who works in the home as and when required, has also achieved NVQ level 3. The senior support worker advised that it is an organisational policy to hold staff recruitment documents and records at the local head office. A member of the head office staff brought the requested files to the home during the inspection and returned with them once they had been examined. The required records and documents had been obtained and retained. London Road (129) DS0000013446.V295481.R01.S.doc Version 5.2 Page 20 From the records seen and speaking to staff, it was clear that staff are well trained to enable them to meet service users’ needs. Staff had undertaken training required by law, such as fire safety, first aid and food hygiene and other training to develop their knowledge and skills, such as equality and diversity and values training. London Road (129) DS0000013446.V295481.R01.S.doc Version 5.2 Page 21 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users benefit from a well run home and the health, safety and welfare of service users are promoted and protected. EVIDENCE: It was clear from the standard of record keeping and the open and helpful approach of staff that the home is well managed. In the absence of the manager, the senior support worker was able to provide the information, records and documents required. The senior support worker advised that an audit of the quality of the service provided had recently been carried out by the manager of another home within the organisation, but the result of the audit had not yet been supplied to the home. The member of head office staff who delivered the staff files advised that a copy of the quality audit would be sent to the home and a copy sent directly to the inspector at CSCI, as is required. London Road (129) DS0000013446.V295481.R01.S.doc Version 5.2 Page 22 A number of records relating to health and safety in the home were seen, including fire protection records, hot water temperature records, fridge and freezer temperature records and records of the temperature of hot food served. These had been carried out appropriately, to the correct frequencies and were within the appropriate ranges. A gas leak from the home’s heating boiler had been recently detected and the home had been evacuated. This had been reported to CSCI under the requirements of Regulation 37, which requires the home to report a number of specific, significant events, which affect the health and welfare of service users. The senior support worker stated that this has now been repaired and a record of this was seen. A certificate confirming the safety of the gas supply is awaited and it is requested that a copy of this is forwarded to CSCI. London Road (129) DS0000013446.V295481.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 2 STAFFING Standard No Score 31 x 32 3 33 X 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x London Road (129) DS0000013446.V295481.R01.S.doc Version 5.2 Page 24 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 YA30 Good Practice Recommendations It is strongly recommended that paper towels are supplied and used in the home to reduce the risk of the spread of infection. London Road (129) DS0000013446.V295481.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 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 London Road (129) DS0000013446.V295481.R01.S.doc Version 5.2 Page 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. 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. 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