Inspection on 16/01/06 for 129 London Road

This inspection was carried out on 16th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

129 London Road 12/06/06

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 16th January 2006 14:00 London Road (129) DS0000013446.V277354.R01.S.doc Version 5.1 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.V277354.R01.S.doc Version 5.1 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.V277354.R01.S.doc Version 5.1 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.V277354.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age/age range of the persons to be accommodated will be: 20-65 YEARS 28th November 2005 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. London Road (129) DS0000013446.V277354.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the second inspection to be carried out during the Commission for Social Care Inspection (CSCI) year April 2005 to March 2006. Mrs Sandra Holland, Lead Inspector for the service carried out the inspection over a period of four and a half hours. Ms Maria Fernandez, Senior Support Worker was present representing the service and Ms Angella Chimenya, Senior Support Worker arrived later. As the designated responsible person (DRP), Ms Chimenya provided most of the records and information. A full tour of the premises was undertaken and a number of documents and records were examined, including individual plans, service user financial records and food safety records. All five of the service users living at the home were spoken with. The inspector thanks the service users and staff for their time, hospitality and assistance. To fully assess how the home is meeting the National Minimum Standards for Care Homes for Adults, it will be necessary to read the reports of both inspections. What the service does well: What has improved since the last inspection? What they could do better: London Road (129) DS0000013446.V277354.R01.S.doc Version 5.1 Page 6 Individual plans must be reviewed on a regular basis and kept up to date. Service users must be involved in the review of their individual plans and this should be recorded. Assessments of risks to service users must be clearly updated, after they have been reviewed. Staff must be on duty in sufficient numbers at all times, to meet the needs of the service users and to ensure the safety of service users and staff. Out of date food must be discarded and all food must be labelled and dated when opened and suitably wrapped for storage. Dry foods should be stored in sealed and lidded containers to prevent contamination. Daily temperature records of hot food served and of fridges and freezers, must be maintained. Substances hazardous to health must be kept in a locked provision. 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.V277354.R01.S.doc Version 5.1 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.V277354.R01.S.doc Version 5.1 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): These standards were not assessed at this inspection. EVIDENCE: London Road (129) DS0000013446.V277354.R01.S.doc Version 5.1 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 and 9. A comprehensive individual plan has been drawn up for service users, but these need to be updated to show service user’s current needs. Assessments of risks to service users are in place but are not clear, because they have been updated a number of times on the same forms. EVIDENCE: Detailed individual plans have been compiled to guide staff to the support needs of service users and these included care assessments, contacts and personal information, photograph and description, personal support needs and healthcare support needs. Behavioural guidelines, tenancy and support agreements and consents to personal care were also included and had been signed by the service user where appropriate. It was observed that a number of visits to healthcare professionals or health checks had not been recorded on the appropriate form in the individual plan, although these had been recorded elsewhere, the DRP stated. An area of the individual plan had been allocated for assessments of risks to service users, but it was noted that these were not included. The DRP supplied the risk assessments from a separate file in the office, which she advised were accessible to all staff. The DRP stated that the individual plans are stored in a London Road (129) DS0000013446.V277354.R01.S.doc Version 5.1 Page 10 locked cabinet in the office and the key is held by the person in charge. It is recommended that all records and documents relating to service users are contained within their individual plan, as this should be an holistic document and for ease of reference. The DRP stated that she had been recently allocated as a key-worker to support two service users and was aware that their individual plans needed updating. From the risk assessments seen, it was difficult to know the current risks to service users, as the original forms had been signed on a number of occasions to indicate a review. Alterations had been handwritten onto the risk assessments, but it was not clear which of these matched the dates and signatures that were also present. It is recommended that these are reviewed and replaced where appropriate, to ensure that staff are fully aware of any risks and the measures that are in place to minimise them. Requirements have been made. London Road (129) DS0000013446.V277354.R01.S.doc Version 5.1 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): 13 and 15. Service users are actively supported to be part of their local community and to enjoy appropriate relationships. EVIDENCE: It was pleasing to see that a service user is enabled to attend a local workshop independently and other service users are able to go to a local shop alone. The risks involved in these activities have been assessed, any risks identified and minimised wherever possible. Service users spoke enthusiastically of activities that they are involved in including going on holiday, going to the pub, having days out to places of interest and going bowling. They spoke of visiting their friends and friends being invited home, one of whom visited on the day of inspection. Staff advised that two service users attend a local church and are collected by the church minibus if space permits, or by car with staff if necessary. Two service users visit their families most weekends. Staff support service users by transporting them to and from their activities as required and assisting service users to make their choices and arrangements. London Road (129) DS0000013446.V277354.R01.S.doc Version 5.1 Page 12 London Road (129) DS0000013446.V277354.R01.S.doc Version 5.1 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. Personal support is provided to service users in the way that they prefer. EVIDENCE: Staff were seen to provide personal support to service users in a tactful and discreet manner, using verbal prompts and gentle encouragement, whilst respecting service user’s choices. Service users had chosen their own clothes and styles and these reflected their individual personalities. Service users stated that they were free to go to bed or get up at the times of their choosing and knew how to find the sleeping in member of staff if required at night-time. Staff spoke to service users in a informal but respectful way and service users were seen to be relaxed and comfortable in the company of staff. One service user has a degree of difficulty with communication, staff advised, and a book to assist him is available in a number of rooms for the service user and staff to refer to. London Road (129) DS0000013446.V277354.R01.S.doc Version 5.1 Page 14 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): 23. Staff are aware of their responsibilities in the protection of service users. EVIDENCE: The staff present stated that they had undertaken training in the protection of vulnerable adults and would report any concerns they had to the manager or the on-call manager. The DRP was aware of the Surrey Multi-Agency procedure, a copy of which is kept in the home. Monies are held for safekeeping on behalf of service users the DRP stated, and an effective system of record keeping was seen. Service users are supported to make deposits and withdrawals from their accounts and a record of all transactions is kept. All expenditure is logged on petty cash receipts, which are entered on a record sheet. The amounts of monies held were checked with the record held and these accurately matched. Staff stated that the monies held are checked each day at the shift handover and a record is kept. An assessment has been carried out regarding the safekeeping of monies and associated risks and these detail the amount of support, if any, that each service user requires. London Road (129) DS0000013446.V277354.R01.S.doc Version 5.1 Page 15 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): These standards were not assessed at this inspection. EVIDENCE: London Road (129) DS0000013446.V277354.R01.S.doc Version 5.1 Page 16 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 and 33. Service users are supported by a small team of staff, but only one member of staff was at the home at the start of the inspection. EVIDENCE: Staff advised that a small team of full-time support workers are employed to support service users, and carry out all the roles in the home. Staff support service users with cooking, shopping, laundry, household tasks and activities. It was pleasing to see service users being supported in tasks around the house and in preparing the evening meal. Service users moved about the home freely and were making hot drinks for themselves and others, independently. A service user returned from his daily activity and brought a friend home and the friend was made welcome. It was of concern that one member of staff was alone in the home with service users at the beginning of the inspection even though aggressive behaviours by a service user have recently been reported under Regulation 37. (Under this regulation, staff are required to report specific, significant events that occur in the home to CSCI). The staff member on duty stated that a member of staff who had worked on the morning shift had left just before the inspection began, as another member of staff was due to arrive for the afternoon shift. The afternoon shift staff member arrived late, so the lone staff member was unsupported for at least London Road (129) DS0000013446.V277354.R01.S.doc Version 5.1 Page 17 half an hour. The DRP also stated that a lone member of staff sleeps over at the service and that service users wake them if required. This creates a potential risk to the service users and to the staff. It is required that staffing is reviewed to ensure the safety of service users and staff, and to ensure service user’s needs can be met. Staff were seen to interact with service users in a friendly but appropriate manner and were quick to respond to any issues that arose. A service user has one to one support from staff for a specified number of hours per week and these were allocated separately on the staff rota. Any vacant shifts arising because of holidays or sickness, are covered by a small number of bank support staff the DRP advised. The DRP stated that she and another member of staff had both achieved National Vocational Qualifications (NVQ) to level 3 in care and the manager had achieved NVQ level 4 and the Registered Managers Award. A requirement has been made. London Road (129) DS0000013446.V277354.R01.S.doc Version 5.1 Page 18 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): 39, 41 and 42. A system of reviewing the quality of the service provided must be set up and maintained. The standard of record keeping and shortfalls in aspects of health and safety place service users at risk. EVIDENCE: The information available indicated that the home does not have an effective policy or system for quality assurance. The only document that could be found was a short questionnaire, but this was not signed or dated, referring only to “during 2003”. Quality assurance is the regular review of all aspects of the service provided, which is analysed to see where improvements can be made. It is required that a system is established and maintained and asks the views of service users and their representatives. The report of the outcome of any review must be provided to service users, their representatives and to CSCI. London Road (129) DS0000013446.V277354.R01.S.doc Version 5.1 Page 19 A number of hazards to the health and welfare of service users were noted during the inspection: - Whilst touring the premises it was observed that the cupboard containing a number of products hazardous to health was locked, but the key was left in the door. In the kitchen, a cleaning fluid and an air freshener spray were stored openly on the worktop and on top of the fridge; - gaps were noted in the recording of temperatures of hot food served and in the temperature records of the fridge and freezer. The record for hot food served, indicated that some items had not been heated to a sufficiently high temperature, although the member of staff present knew the correct temperature food should be heated to; - out of date food was stored in the fridge and other food had not been labelled or dated when opened. Food that was not suitably wrapped was seen in the fridge and the freezer and one item in the fridge did not have its original label, so was unidentifiable; - open packets of dry goods, including biscuits and cereals, were not covered or sealed; - In two service user bedrooms, magazines or records were stacked in tall piles, which were a potential hazard. It was of concern as noted at Standard 33, that only one member of staff was initially present at the home with a number of service users, one of whom is known to be aggressive at times. An immediate requirement and another requirement have been made. London Road (129) DS0000013446.V277354.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 x 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 3 ENVIRONMENT Standard No Score 24 x 25 x 26 x 27 x 28 x 29 x 30 x STAFFING Standard No Score 31 x 32 3 33 2 34 x 35 x 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 x x 2 x LIFESTYLES Standard No Score 11 x 12 x 13 3 14 x 15 3 16 x 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 x x x x x 2 x 2 2 x London Road (129) DS0000013446.V277354.R01.S.doc Version 5.1 Page 21 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 15 (2) (ad) Requirement Timescale for action 24/03/06 2 YA9 13 (4) (b & c) 3 YA33 18 (1) (a) 4 YA39 24 (1 – 3) The registered person must make the service user’s plan available to the service user, keep the service user’s plan under review. Where appropriate and, unless it is impracticable to carry out such a consultation, after consultation with the service user or their representative, revise the service user’s plan and notify the service user of any such revision. The registered person must 20/02/06 ensure that (b) any activities in which service users participate are so far as reasonably practicable free from avoidable risks and that (c) unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. The registered person must 20/02/06 ensure that at all times suitably qualified, competent and experienced staff are working at the home in sufficient numbers as are appropriate for the health and welfare of the service users. The registered person must 21/04/06 establish and maintain a system DS0000013446.V277354.R01.S.doc Version 5.1 London Road (129) Page 22 5 YA41 17 (2) & (3) (a) 6 YA42 13 (4) (a) for reviewing at appropriate intervals and improving, the quality of care provided at the care home. A copy of a report in respect of any review must be supplied to CSCI and made available to service users. The reviewing system must provide for consultation with service users and their representatives. The registered person must maintain in the care home the records specified in Schedule 4 and must ensure that these are kept up to date. The registered person must ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety. 20/02/06 16/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations London Road (129) DS0000013446.V277354.R01.S.doc Version 5.1 Page 23 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. 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