Inspection on 12/07/05 for 39 Townend

This inspection was carried out on 12th July 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 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

39 Townend 08/02/07

39 Townend 17/01/06

39 Townend 07/10/04

39 Townend 16/06/04

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Southfields

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Townend 39 Townend Caterham Surrey CR3 5UJ Lead Inspector Lesley Garrett Announced 12 July 2005 10:00 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 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 Stationary 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. Townend H58-H09 S13814 Townend V226031 120705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Townend Address 39 Townend, Caterham, Surrey, CR3 5UJ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01883 383827 Surrey Oaklands NHS Trust Oaklands House, Coulsdon Road, Caterham, Surrey, CR3 5YA To be confirmed Care home only (PC) 11 Category(ies) of Learning disability (LD), 11 registration, with number Physical disability (PD), 1 of places Learning disability over 65 years of age (LD(E)), 4 Townend H58-H09 S13814 Townend V226031 120705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 Of the 11 (eleven) residents within the category Learning Disability (LD), 1 (one) may also be in the category Physical Disability (PD). 2 The age/age range of the category LD must be between 30-65 years. 3 Of the 11 (eleven) registered 4 (four) may be in the category Learning Disability over 65 years of age LD(E). Date of last inspection 07 October 2004 Brief Description of the Service: Towend is a care home for younger adults located in Caterham within reach of the amenities in the high street. It is a detached property owned by Surrey and Borders Partnership. The home offers ten single rooms and communal spaces. The service users are supported to live as independently as possible with the help of staff and the wider network of community health care professionals. Townend H58-H09 S13814 Townend V226031 120705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over three hours and was the first inspection to be undertaken in the Commission for Social Care Inspection year April 2005 to March 2006. Lesley Garrett lead inspector for the service, carried out this inspection Tracy Tonczynski Registered Manager and Theresa Hunt Shift Leader were present as representatives for the establishment. A full tour of the premises took place and documents inspected included person centred plans, medication records and training plans. The inspector saw most of the service users and spoke with three members of staff. A pre-inspection questionnaire and a number of returned comment cards were also used to write this report. What the service does well: What has improved since the last inspection? Following the last inspection there was five requirements made associated with maintenance and decorating and these were all completed by December 2004. The manager has made changes during her last year in post, encouraging the staff to voice their opinions and ideas and therefore all staff feels valued. The home has a brand new mini bus delivered in the last three weeks it also has an estate car and both vehicles are used frequently. Townend H58-H09 S13814 Townend V226031 120705 Stage 4.doc Version 1.30 Page 6 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. Townend H58-H09 S13814 Townend V226031 120705 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Townend H58-H09 S13814 Townend V226031 120705 Stage 4.doc Version 1.30 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 standard(s) 2 All service users have a full assessment prior to them moving into the home. EVIDENCE: All service users have a pre-admission assessment prior to moving into the home. The manager stated that she always does these assessments. All admissions are through care management and the home receives an initial assessment from social services to aid the manager with her decision. Service users are encouraged to visit the home prior to admission and can even spend an afternoon there, come for tea, stay for a meal and in some cases stay overnight if that is appropriate. The manager stated that in such a small home it is important that all service users interact well and so these visits are important for all service users. Townend H58-H09 S13814 Townend V226031 120705 Stage 4.doc Version 1.30 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 standard(s) 6 The home uses person centred plans, which meet the needs of the service users. EVIDENCE: The home uses person centred planning and these are all kept in service users individual files. The files are comprehensive and contain not only the person centred plans but the risk assessments also. The home has a key-worker system and the plans are compiled by each keyworker for their service user. The manager stated that no plans are written by the staff unless they have had training. The individual files also contain the care managers assessment and these are reviewed every year and sooner if required. G.P. letters, referral forms for other health care professionals and any accident forms are also kept on file making it an easy to read and understand document. Townend H58-H09 S13814 Townend V226031 120705 Stage 4.doc Version 1.30 Page 10 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 standard(s) 12 & 13 The home supports service users to access educational and social activities and have access to the local community. EVIDENCE: The home had recently reviewed access to the day centres for some service users and this was documented. The manager stated that some activities or times were not appropriate. One service user was doing too many art sessions but the home felt would benefit from communication so the activities were swopped. Another service user that had attended the day centre in the morning had been unwell and was always better in the afternoon so this was also changed. Each key worker identifies preferences when they are writing the personal plans and at reviews. Some service users enjoy swimming but for one service user where this is not appropriate the manager takes her to the hydrotherapy pool that they have in their group on a one to one basis. The service users can access local facilities as the home is close to the town and this includes the local church, hairdressers, dentist and sometimes to the pub for a meal. When the inspector arrived one service user was asking to go to town for a coffee and doughnut and a carer took him. Townend H58-H09 S13814 Townend V226031 120705 Stage 4.doc Version 1.30 Page 11 There is an elderly day centre near by and two service users access this facility. The home has a mini bus, which is new and arrived three weeks ago, and also a car and some staff can drive these vehicles. The aromatherapist, opticians, and chiropodist all visit the home on a regular basis. Townend H58-H09 S13814 Townend V226031 120705 Stage 4.doc Version 1.30 Page 12 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 standard(s) 19 & 20 Service users health needs are met and they are protected by the homes medication policies and training. EVIDENCE: All service users are registered with a local G.P. He used to call at the home on a weekly basis but this facility was not required so the manager calls when he is needed. The manager stated that he still occasionally calls in when he is passing to see that everything is all right. Service users can also visit the surgery. They all have yearly medicals and the home has printed information from the Internet about any medical conditions that the service users may have as an aid to the staff. They work as part of a multi-disciplinary with evidence in the individual notes and comment cards that the dietician and speech and language therapist visits. The manager is working with the speech and language therapist to develop the table mat idea as mentioned in the summary. The G.P. also makes referrals to the hospital as required and evidence for this is in the individual files and the inspector saw this. The local pharmacy supplies the medication in blister packs and these are dispensed by the staff, as no service user is able to self medicate. The manager stated that no member of staff is allowed to do the medicines until they have had training and there are records of the training in the home. Townend H58-H09 S13814 Townend V226031 120705 Stage 4.doc Version 1.30 Page 13 There is a medicine administration chart that is valid for three months and these are written up by q carer and counter signed by the manager. There is also a G.P. prescribing and reviewing chart and the doctor was due the following week to review the medicines. All charts contain a photograph of the service user and care plans for when to use specific drugs like behaviour modifying medication. There is a protocol for homely remedies and the manager has to sign these. Townend H58-H09 S13814 Townend V226031 120705 Stage 4.doc Version 1.30 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 standard(s) 22 The home has an adequate complaints policy, which contains stages of and time scales for the process. EVIDENCE: The homes complaints policy is displayed in the hall at reception and there is also a copy in each service user guide. The manager has used some symbols in the guide to help to service users understand each section. The procedure is well laid out with the timescales and contains CSCI address, inspector and telephone number. The manager also told the inspector that here is also a complaints log, which all staff are aware of and can complete, and the manager checks this on a regular basis. There have bee no recent complaints. Townend H58-H09 S13814 Townend V226031 120705 Stage 4.doc Version 1.30 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 standard(s) 24,25,27 & 28 The communal areas of the home are of a good standard but attention is required on some bedrooms and downstairs bathroom. EVIDENCE: The communal areas of the home are bright and cheerful and the wood flooring in the dining room has been a success the manager stated. However as the inspector toured the building some problems were noticed and will be requirements at the end of this report. Three service users bedrooms have been decorated this last year but it was noticed that there needs to be further decorating in the bedrooms as one room had been stripped of wall paper. The manager stated that they were due to be decorated in the next two to three months but this particular room needs to be done within the next week. The bedrooms that had been decorated the manager stated that one service user participated in the process of stripping wallpaper and helping generally with the decorators. The home has three bathrooms but only one downstairs and this has to service five service users. This bathroom has a parker bath but no shower and with the increasing needs of the service users this was not adequate and will be a requirement. Townend H58-H09 S13814 Townend V226031 120705 Stage 4.doc Version 1.30 Page 16 Townend H58-H09 S13814 Townend V226031 120705 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Staff are well trained and have access to training days and therefore have a positive attitude towards the service users. EVIDENCE: The manager has her RMN qualification and also has the NVQ level 4 in care. Her two deputies are also RMN trained and one is studying for her NVQ level 4.and she also has her assessors qualification. Three members of staff have NVQ level 2 and two staff is doing the course at the moment. The manager showed the inspector training ng records for the home and all staff receives the statutory training and staff can also request specific training to do their job. The inspector spoke with the manager about night staff and found the home has one waking member of staff but the other sleeps. The inspector felt given the layout of the building and the increasing needs of the service users both staff need to be awake to support the needs of the service users. One service user can get out of bed frequently although this bed now has an alarm but should they fall then the home is left inadequately covered. This will be a requirement at the end of the report. Townend H58-H09 S13814 Townend V226031 120705 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 The systems for consultation are good with some evidence of consultation and ideas acted upon. EVIDENCE: The manager stated that most service users are unable to verbally communicate. The inspector did witness good interaction between staff and service users to anticipate their needs. There is a key worker system in place and the staff therefore knows their service users well and can understand what they are trying to communicate. The manager does hold regular meetings with the service users to pass on information and to share ideas, these meetings are minuted. The manager also sends quality assurance questionnaires to relatives, visiting professionals and any other visitor to the home so their performance can be monitored. The feed back from these questionnaires were positive as was the comment cards received by the inspector prior to the inspection. Townend H58-H09 S13814 Townend V226031 120705 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 2 x 2 3 x x Standard No 11 12 13 14 15 16 17 x 3 3 x x x x Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Townend Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x x x H58-H09 S13814 Townend V226031 120705 Stage 4.doc Version 1.30 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 26 Regulation 23(2)(d) Requirement The registered provider should ensure all bedrooms are decorated to a good standard and suitable for the needs of the service users. The registered provider should ensure there are adequate bathroom/shower facilities to match the changing needs of the service users. The registered provider should ensure adequate numbers of staff at night to take into consideration the layout of the building and changing needs of the service users. Timescale for action 12/8/05 2. 27.2 23(2)(j) 12/10/05 3. 33.2&33.11 18(1)(a) 12/8/05 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 Good Practice Recommendations Townend H58-H09 S13814 Townend V226031 120705 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 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 Townend H58-H09 S13814 Townend V226031 120705 Stage 4.doc Version 1.30 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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