Inspection on 03/07/06 for 18, Crescent Road

This inspection was carried out on 3rd July 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 found no outstanding requirements from the previous inspection report, but made 3 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 20/12/05

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 18, Crescent Road Wimbledon London SW20 8EU Lead Inspector Emma Dove Unannounced Inspection 3rd July 2006 11:00 18, Crescent Road DS0000027208.V302642.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 18, Crescent Road DS0000027208.V302642.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. 18, Crescent Road DS0000027208.V302642.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 18, Crescent Road Address Wimbledon London SW20 8EU 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) 0208 946 7439 United Response Ms Teresa Jordan Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 18, Crescent Road DS0000027208.V302642.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th December 2005 Brief Description of the Service: 18, Crescent Road is a registered care home for six adults with learning disabilities. Six people are currently living at the home. The home is a detached property in a cul-de-sac off Worple Road in Wimbledon and 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. Information regarding the CSCI is included in the Statement of Purpose and Service Users Guide to the home. 18, Crescent Road DS0000027208.V302642.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 carried out over the course of seven and a quarter hours during the day on the 3rd July 2006, by one regulation inspector. The inspection included the examination of records, inspection of communal areas of the home and three residents bedrooms, talking to residents, staff and the manager. The inspector spoke with four residents and two members of staff. Questionnaires were sent to one relative, four health and social care professionals and two members of staff. Five questionnaires have been received and comments from these are included in each relevant section of this report. What the service does well: What has improved since the last inspection? What they could do better: The development of person centred plans for residents would provide more details of their care needs and how to meet them. Raise awareness within the staff team to make sure residents cultural needs are understood and met. Medication Administration Record Sheets must be signed at the time medication is administered. The kitchen requires attention to the work surfaces and units to provide a good environment for residents. Quality assurance systems must be developed to ensure residents and their representatives can give their views about the services provided. 18, Crescent Road DS0000027208.V302642.R01.S.doc Version 5.2 Page 6 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. 18, Crescent Road DS0000027208.V302642.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 18, Crescent Road DS0000027208.V302642.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): 1, 2 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents have access to information to help them make an informed choice about moving into the home. EVIDENCE: The Statement of Purpose and Service Users Guide contain satisfactory information for prospective residents and their representatives to make an informed choice about moving into the home. Changes have not been made to these documents since the last inspection in December 2005. Assessments are completed before admission and are kept under review to make sure residents current needs are known and developed into care plans. Residents have a ‘service agreement’ which is their contract of residence with the home. 18, Crescent Road DS0000027208.V302642.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 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans are kept under review with further work required to develop Person Centred Plans (PCP). EVIDENCE: Case files contain detailed assessments of residents needs and how staff should meet them. One case file contained a communication profile which had been developed with speech and language therapists and staff at the home. These profiles should be kept up to date to ensure staff are working with residents to meet their needs. Information for annual reviews is detailed. Further work is required to develop PCP for individuals. Residents were seen to be offered choices in food and activities during the inspection. Records confirmed that residents are involved in making decisions about their future. Risk assessments make sure that residents health and safety is maintained and balanced with participating in daily living tasks and activities. 18, Crescent Road DS0000027208.V302642.R01.S.doc Version 5.2 Page 10 Staff feel that residents receive a good service but they could develop equality and diversity issues within the home to improve the care and support provided to individuals. 18, Crescent Road DS0000027208.V302642.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 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Residents attend day centres, clubs and classes which meet their social and educational needs. EVIDENCE: Residents attend various day centres and classes and clubs depending on their needs and choice. Two residents confirmed that they like attending their day centres and club. Residents were preparing to go on holiday in a few weeks time. Residents attend community facilities including a local church, café and shops. Residents are supported by staff to maintain contact with family and friends. Questionnaires indicated that the home is very good at supporting contact with family members which is very important to relatives. 18, Crescent Road DS0000027208.V302642.R01.S.doc Version 5.2 Page 12 Residents reported that their Birthdays are celebrated with parties which they enjoy. A ‘world cup’ sweepstake was being held and residents were enjoying this friendly competition. A varied menu is provided which reflects residents dietary needs and their likes. Residents said they choose their lunch. Residents were seen enjoying their lunch and evening meal during this inspection visit with positive comments received about the food provided. 18, Crescent Road DS0000027208.V302642.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 & 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. Residents receive appropriate support with personal care. Good records are maintained of health needs with the exception of Medication Administration Record Sheets. EVIDENCE: Residents are registered with a GP and their health needs are well documented. Questionnaires confirmed that staff at the home are quick to seek medical advice appropriately when needed. One questionnaire suggested keeping a running in house medical record to ensure consistency of care for all residents. The manager and staff at the home had offered a resident additional support during a difficult time in their life and questionnaires confirmed that this support was appropriate and above and beyond what was expected. Medication is appropriately stored, labelled and administered with two exceptions in the recording on the Medication Administration Record Sheets (MARS). One gap in the signing on one MARS was noted, the medication was missing from the monitored dosage system in place, indicating that the medication had been given. On one MARS a gap was noted for a short course 18, Crescent Road DS0000027208.V302642.R01.S.doc Version 5.2 Page 14 of medication and it was not possible to check if the medication had been administered at the correct time. Systems to check medication administration should be reviewed to ensure any gaps are identified and appropriate actions taken. 18, Crescent Road DS0000027208.V302642.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 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Residents and their representatives have access to the complaints procedures. EVIDENCE: The complaints policy is included in the Statement of Purpose and Service Users Guide to the home and is available in pictorial format which is accessible to some residents. One complaint had been recorded since the December 2005 inspection. This had been satisfactorily documented with appropriate actions taken. The CSCI has not received any complaints about the home since the last inspection in December 2005. Appropriate protection of vulnerable adults policies and procedures are in place. Four members of staff have completed training in prevention of harm. 18, Crescent Road DS0000027208.V302642.R01.S.doc Version 5.2 Page 16 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, 25, 26, 27, 28 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. Residents live in a well maintained home with the exception of the kitchen which requires attention. EVIDENCE: The home provides a good quality and well maintained accommodation for residents with the exception of the kitchen. This is showing signs of wear with work surfaces, tiles and kitchen units needing replacing. Bedrooms are single and have been personalised to individuals tastes. They are all furnished with a single bed, wardrobe and chest of drawers and have a wash hand basin. Two residents were choosing colours for their bedrooms to be painted in the near future. Questionnaires confirmed that the home provides a homely environment for residents. All areas of the home were clean. Appropriate systems are in place for infection control with an improved cleaning schedule. 18, Crescent Road DS0000027208.V302642.R01.S.doc Version 5.2 Page 17 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, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Residents needs are met by a small group of long standing staff who have good training opportunities. EVIDENCE: The rota identified that two members of staff are on duty during the day with one member of staff asleep but on call at the home at night. The staff team do not reflect the ethnicity of residents, this was not raised as an issue at the inspection or in questionnaires. The deputy post has been empty for over a year and staff noted that they miss the support. Staff recruitment practices are good with appropriate checks made and records maintained at the home. Staff have good training and development opportunities and have completed training in: food hygiene; prevention from harm; Health and Safety; managing challenging behaviour; First Aid; Manual Handling; fire safety and medication administration. Staff have not completed training in PCP. Staff questionnaires confirmed that staff have completed an induction to the home, relevant training and receive sufficient support. Other comments included ‘more support would be useful’ and ‘to be fully staffed’ would ensure better support for residents and staff. 18, Crescent Road DS0000027208.V302642.R01.S.doc Version 5.2 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): 37, 39 & 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. Residents are involved in the day to day running of the home with further work required to seek their views on the services provided with quality assurance systems. EVIDENCE: The manager has been at the home for a number of years and has a good knowledge and understanding of residents needs and how to meet them. A representative from the organisation visits the home every month and completes an audit of records, finances and speaks with residents and staff about their experiences at the home. Further work is required to develop quality assurance systems to obtain residents and their representatives views of services provided at the home. Good health and safety policies, procedures and practices are in place with records maintained and up to date. 18, Crescent Road DS0000027208.V302642.R01.S.doc Version 5.2 Page 19 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 3 3 X 4 X 5 3 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 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 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 2 X 3 X 2 X X 3 X 18, Crescent Road DS0000027208.V302642.R01.S.doc Version 5.2 Page 20 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 staff sign for medication at the time it is administered. The registered person must ensure that the kitchen cabinets are replaced, the damaged work surface is replaced and the broken wall tiles are repaired or replaced. The registered person must ensure that a quality assurance system is developed which enables residents and their representatives the opportunity to give their views on the services provided at the home. Timescale for action 04/09/06 2. YA24 23 (2) b 02/10/06 3. YA39 24 04/09/06 18, Crescent Road DS0000027208.V302642.R01.S.doc Version 5.2 Page 21 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. 2. Refer to Standard YA6 YA35 Good Practice Recommendations The registered person should give consideration to developing Person Centred Plans for all residents. The registered person should provide staff training in the development of Person Centred Plans. 18, Crescent Road DS0000027208.V302642.R01.S.doc Version 5.2 Page 22 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. 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