Inspection on 20/12/05 for 18, Crescent Road

This inspection was carried out on 20th December 2005.

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 found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

18, Crescent Road 29/11/08

18, Crescent Road 03/07/06

18, Crescent Road 16/08/05

18, Crescent Road 24/01/05

18, Crescent Road 11/05/04

18, Crescent Road 03/02/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Crescent Road, 18 18 Crescent Road Wimbledon London SW20 8EU Lead Inspector Emma Dove Unannounced Inspection 20th December 2005 12:00 Crescent Road, 18 DS0000027208.V275100.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 Crescent Road, 18 DS0000027208.V275100.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. Crescent Road, 18 DS0000027208.V275100.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Crescent Road, 18 Address 18 Crescent Road Wimbledon London SW20 8EU 0208 946 7439 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) www.unitedresponse.org.uk United Response Ms Teresa Jordan Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Crescent Road, 18 DS0000027208.V275100.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17/08/05 Brief Description of the Service: 18, Crescent Road is a registered care home for six adults with learning disabilities. Six people are currently residing at the home. The home is owned by a housing association and managed and staffed by the organisation, United Response. The home is a detached property in a cul-desac off Worple Road in Wimbledon. It is not identifiable as a care home and is in keeping with neighbouring houses. It is close to public transport, local shops, churches and leisure facilities. Accommodation is provided over two floors with five bedrooms and a bathroom available on the first floor and the remaining bedroom, bathroom, lounge, dining room and kitchen on the ground floor. The home has a large garden. There is a car for staff to use. The home is staffed twenty-four hours a day. Crescent Road, 18 DS0000027208.V275100.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 completed over the course of the afternoon of 20th December 2005, by one regulatory inspector. The inspection consisted of examination of records, inspection of communal areas of the home, talking to residents, staff and the registered manager. The inspector had the opportunity to speak with four residents and two members of staff. What the service does well: 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. Crescent Road, 18 DS0000027208.V275100.R01.S.doc Version 5.1 Page 6 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 Crescent Road, 18 DS0000027208.V275100.R01.S.doc Version 5.1 Page 7 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): 1 Prospective residents and their representatives receive information required to make a decision regarding moving into the home. EVIDENCE: The Statement of Purpose has not changed since the last inspection of the home and contains information prospective residents, families and placing social workers require to make and informed decision regarding moving into the home. Crescent Road, 18 DS0000027208.V275100.R01.S.doc Version 5.1 Page 8 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): These standards were assessed and met at the last inspection of the home. EVIDENCE: Crescent Road, 18 DS0000027208.V275100.R01.S.doc Version 5.1 Page 9 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 & 16 Residents are able to participate in community activities. Residents rights are respected and they are enable to make choices regarding their lives. EVIDENCE: The manager and staff reported that residents attend the local church café, go to cinemas, pubs and shopping in the local area. Residents confirmed that they go shopping. Care plans identify resident’s social and leisure needs and include details of activities individuals have participated in. Individuals identify outings and activities they wish to participate in at house meetings, reviews and during individual discussions with staff. Resident’s privacy and dignity are maintained by procedures and staff practices at the home. The manager reported that residents can have a key to their bedroom. Residents at the home during the inspection did not have their own key but did not raise this as an issue. Residents preferred form of address is recorded and staff were observed referring to individuals by their chosen name. Residents can access all communal areas of the home. Crescent Road, 18 DS0000027208.V275100.R01.S.doc Version 5.1 Page 10 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): 19 & 20 Residents health needs are recorded and well met by staff at the home. Medication polices, procedures and practices at the home protect residents, however one issue was identified with the recording systems. EVIDENCE: Care plans contain details regarding resident’s health needs and records are maintained of health issues. Risk assessments are in place regarding residents health care if required and staff demonstrated detailed knowledge of individuals health needs. Residents are all registered with a GP and attend appointments as required with staff support. Appropriate medication policies and procedures are in place at the home. Medication is appropriately stored at the home. Staff administer medication from blister packs filled by the pharmacist. A number of medications are not supplied in blister packs and consideration should be given to storing medication for individual residents in separate containers in the medication cupboard. Medication Administration Record Sheets (MAR) were up to date and signed. One MAR Sheet indicated that a medication should be used two times a day and the container from the pharmacist noted it should be used four times daily. The manager explained that this change in dose had been made following a hospital appointment and would be corrected on the next Crescent Road, 18 DS0000027208.V275100.R01.S.doc Version 5.1 Page 11 prescription. One residents medication was labelled to be taken when required and the MAR Sheet noted one tablet to be taken three times a day or as directed by the doctor. These instructions must be more clearly recorded for staff. Crescent Road, 18 DS0000027208.V275100.R01.S.doc Version 5.1 Page 12 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 & 23 Residents welfare is protected by the complaints and protections of vulnerable adults policies and procedures in place at the home. EVIDENCE: Appropriate complaints procedures are in place at the home. One resident reported that they would speak to staff or the manager if they had any problems at the home. No issues were raised during the inspection. The CSCI has not received any complaints regarding Crescent Road. The manager reported that any allegation of abuse would be taken seriously and investigated following the organisation’s and the local social services departments protection of vulnerable adults policies. All staff have received a leaflet and booklet with information regarding the protection of vulnerable adults and some staff have completed training. New staff will be completed training in the protection of vulnerable adults. The recruitment process ensures residents are protected. Crescent Road, 18 DS0000027208.V275100.R01.S.doc Version 5.1 Page 13 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 & 30 The home is maintained to a satisfactory standard of cleanliness with the exception of the kitchen which requires deeper cleaning. Appropriate policies and practices are in place regarding infection control. EVIDENCE: Most areas of the home were found to be clean with the exception of the kitchen floor, particularly under the fridge and freezer. Policies are in place regarding infection control. The laundry is close to the kitchen but can be accessed without entering the kitchen or dining room. The flooring in the dining room is damaged and requires repairing or replacing to ensure residents and staffs health and safety is maintained. A bed was in the lounge, the manager reported that this was a temporary measure for a resident who had been unwell. Crescent Road, 18 DS0000027208.V275100.R01.S.doc Version 5.1 Page 14 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 Staff receive relevant training to meet residents needs. Appropriate recruitment policies and procedures are in place, however some practices and recording are not in line with the policies. EVIDENCE: The organisation has a training and development programme which is available to all staff including core training covering first aid, food hygiene, medication and manual handling. Three members of staff are in the process of completing the Learning Disability Award Framework and one member of staff is due to commence NVQ training to Level 2 in January 2006. Staff files examined contained application forms, one staff file contained three written references, a Criminal Records Bureau (CRB) check, one staff file contained two references and a CRB check and one staff file did not contain references or CRB check. Crescent Road, 18 DS0000027208.V275100.R01.S.doc Version 5.1 Page 15 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): 42 Residents are protected by health and safety policies and practices at the home. EVIDENCE: Appropriate health and safety policies are in place at the home. Records are maintained of health and safety checks on the building, hot water temperatures, portable electrical appliances, gas safety, and the assisted bath which have been completed at the required intervals. The Environmental Health Officer visited in March 2005 with one issue raised regarding stock rotation of food in the fridge which the manager reported has been addressed. Crescent Road, 18 DS0000027208.V275100.R01.S.doc Version 5.1 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 X 3 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 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 2 X X X X X X 3 X Crescent Road, 18 DS0000027208.V275100.R01.S.doc Version 5.1 Page 17 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 YA20 Regulation 13 (2) Requirement The registered person must ensure that medication is labelled as per the doctors instructions and is in line with the Medication Administration Record Sheet. The registered person must ensure that the flooring in the dining room is repaired or replaced. The registered person must ensure that the kitchen floor is cleaned with particular attention under the fridge and freezer. The registered person must ensure that staff files contain information required. Timescale for action 13/02/06 2. YA24 23 (2) b 13/02/06 3. YA30 16 (2) j 13/02/06 4. YA34 17(2)Sch 2(3,5&7) 13/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA2 Good Practice Recommendations The registered person should ensure that residents identify goals with their care plans. DS0000027208.V275100.R01.S.doc Version 5.1 Page 18 Crescent Road, 18 2. 3. YA20 YA24 The registered person should give consideration to residents medication being stored in individual containers in the medication cupboard. The registered person should move the bed from the lounge. Crescent Road, 18 DS0000027208.V275100.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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 Crescent Road, 18 DS0000027208.V275100.R01.S.doc Version 5.1 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!