Inspection on 11/10/07 for 71 London Road

This inspection was carried out on 11th October 2007.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

71 London Road 30/05/06

71 London Road 21/09/05

71 London Road 13/04/05

71 London Road 13/10/04

71 London Road 14/04/04

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

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

CARE HOME ADULTS 18-65 71 London Road 71 London Road Southborough Tunbridge Wells Kent TN4 0NS Lead Inspector Mark Hemmings Key Unannounced Inspection 11th October 2007 08:45 71 London Road DS0000023885.V352540.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 71 London Road DS0000023885.V352540.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. 71 London Road DS0000023885.V352540.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 71 London Road Address 71 London Road Southborough Tunbridge Wells Kent TN4 0NS 01892 515520 F/P 01892 515520 mhr71london@btconnect.com 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) Mental Health Residential Limited (MHR) Mrs Mary Veronica Crouch Care Home 9 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (0) of places 71 London Road DS0000023885.V352540.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Mental disorder, excluding disability or dementia (MD) maximum number of places 9. The maximum number of service users to be accommodated is 9. 2. Date of last inspection 30 May 2006 Brief Description of the Service: 71 London Road (the Service), is registered to provide accommodation and personal care for nine people who have difficulties with managing aspects of their mental health. The property is a detached house. All of the people in residence have their own bedroom. Two of them share a self contained flat that is linked to the main accommodation. All of the bedrooms in the main accommodation, have a private wash hand basin. The property is located about half way between Tonbridge and Tunbridge Wells. It is within normal walking distance of shops and other community-based facilities. The Registered Provider is a charitable organisation. It rents the premises from a housing association. The Registered Provider gives a variety of information to prospective people who might want to live in the Service. There is a Service Users’ Guide. This is a brochure that outlines the principal features of the facilities and services available in the Service. There is a document called the Statement of Purpose. This gives a more detailed account than does the Guide. Also, the Registered Provider ensures that a copy of the most recent Inspection Report from the Commission, is available for reference. The current weekly fee for residence in 71 London Road runs from £515.20 to £755.71. 71 London Road DS0000023885.V352540.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Report is based upon a number of sources of evidence. These include a review of the correspondence in relation to the Service received by the Commission since the last inspection. Another source of evidence involves any written information received from the people who use the Service users, from their relatives and from social workers (care managers). Also, the Inspector completed an unannounced site visit to the Service. This took about six hours to complete. During this time, the Inspector spoke with four of the people in residence. Some of these discussions were in private. The Inspector spoke with the Registered Manager, the Deputy Manager and with two of the support workers. The Inspector examined various parts of the accommodation and he reviewed a selection of the key records and documents. What the service does well: What has improved since the last inspection? As appropriate, various of the people in residence have been helped to access a range of social and vocational opportunities. 71 London Road DS0000023885.V352540.R01.S.doc Version 5.2 Page 6 A new self-contained flat has been established. This has been done to better enable two of the people in residence to extend their independence. Various training resources have been provided for support workers, or they have been arranged for the near future. 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. The summary of this inspection report can be made available in other formats on request. 71 London Road DS0000023885.V352540.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 71 London Road DS0000023885.V352540.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. Prospective people who might want to move in, have their needs assessed and their wishes acknowledged. EVIDENCE: The Registered Manager in consultation with the person concerned, completes an assessment of the prospective person’s needs for assistance. This is done before a decision is made about whether or not the Service is a suitable place for the person’s residence. As part of this process, the person concerned can explain their preferences and wishes about their everyday lives. People say that this arrangement works well in that they consider things to have been in place for them from the point they moved into the Service. 71 London Road DS0000023885.V352540.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. The health and personal care which people receive, is based upon their individual needs. People are actively involved in making decisions about things that affect them. Sensible provision is made to promote an independent lifestyle. EVIDENCE: The people who use the Service say that the support workers offer them all the assistance they need. Also, they consider that this is provided in a reliable and consistent manner. There is a written plan of support for each service user. These are important documents. This is because they form one of the means by which the people who use the Service can be informed about and can agree 71 London Road DS0000023885.V352540.R01.S.doc Version 5.2 Page 10 to the assistance they will receive. Furthermore, the plans constitute a source of reference information for support workers. People are assisted to make decisions about their own lives. This means that they can be as independent as they want to be. When extra help is required, this is delivered in an appropriate manner. For example, people are assisted to manage aspects of the personal spending monies. Sensible arrangements are in place to help the people in residence to lead normal lives, without entertaining unreasonable risks to their wellbeing. This is not done in an intrusive manner and the result is not overly cautious. The Registered Manager is going to strengthen one application of the arrangement in order to double-check that all is in order. This development will be completed by 1 December 2007. 71 London Road DS0000023885.V352540.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 12, 13, 14, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the Service. The people who use the Service can choose to become involved in a range of social and vocational activities. They are helped to keep in touch with members of their families. Good quality meals are served. EVIDENCE: The people who use the Service are free to choose what to do each day. The pace of daily life is relaxed. There are no unnecessary rules or routines to disrupt the experience of a normal domestic setting. 71 London Road DS0000023885.V352540.R01.S.doc Version 5.2 Page 12 The people who use the Service consider themselves to be suitably occupied. An appropriate balance has been struck between people being engaged in activities and having time to themselves. The people who use the Service are assisted to keep in touch with family and friends. People can receive visitors at any reasonable hour. They can meet with their visitors in the privacy of their bedroom if they wish to do so. The Registered Manager in consultation with the people in residence, consults with relatives so that they know how things are going. The people who use the Service say that they receive good quality meals and they always have enough to eat. The menu indicates that a normally varied diet is provided. People are actively engaged in deciding what dishes to prepare and they help to cook them. 71 London Road DS0000023885.V352540.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. People are supported in accordance with their wishes. They are assisted to promote their physical health. Suitable arrangements are in place to manage medication. EVIDENCE: The people who use the Service say that the support workers are kind and considerate. They are relaxed in the company of the support workers. There is a family atmosphere. The people who use the Service are assisted to maintain their physical health. Support workers keep a tactful eye open, so that medical attention is sought promptly should the need arise. Special provision is in place for one of the people in residence who has a particular medical condition. Since the last 71 London Road DS0000023885.V352540.R01.S.doc Version 5.2 Page 14 inspection visit, family practitioners, the local community psychiatric nursing service and various other hospital-based medical services have been involved in supporting the care provided in the Service. Suitable arrangements are in place to enable medication to be stored securely and to be administered in accordance with the doctors’ instructions. Some of the people manage their own medication. They do this with various amounts of assistance from the support workers. The Registered Manager is going to strengthen an aspect of this arrangement. This will be done to ensure that each of the people concerned is indeed receiving the individual assistance they need. There is a Required Development in relation to this matter at the end of the Report. 71 London Road DS0000023885.V352540.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. There is an effective system for dealing with complaints. The wellbeing of the people who use the Service is safeguarded. EVIDENCE: The Registered Provider is aware of the need to ensure that complaints about the Service are investigated thoroughly and resolved promptly. Since the last inspection, neither the Registered Provider nor the Commission has received any formal complaints relating to the Service. The support workers have a sound understanding of what constitutes good care practice. As part of this, they are aware of the need to be alert to instances in which the well being of people who use the Service might become jeopardised. The people who use the Service say that they feel themselves able to approach members of staff if there is something on their mind. They say that they feel safe living in 71 London Road. 71 London Road DS0000023885.V352540.R01.S.doc Version 5.2 Page 16 71 London Road DS0000023885.V352540.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the Service. The people who use the Service are provided with a generally homely setting that promotes their independence. EVIDENCE: The Service provides a suitably domestic setting in which the people in residence can make their home. They say that they are comfortable living there. Some parts of the exterior paintwork are peeling away and this makes the property look a little run down. One of the central heating boilers is not working. The Registered Provider has made some interim arrangements, but plainly this matter now needs to be sorted out. There is a Required Development about this at the end of this Report. 71 London Road DS0000023885.V352540.R01.S.doc Version 5.2 Page 18 The kitchen is clean and well organised. Good food hygiene practices are in use. The local Department of Environmental Health has awarded the Service an excellent score in relation to this matter. One of the two ovens is not in use because it has a defective seal. The Registered Provider is attempting to find a replacement part. The Registered Provider has completed an organised assessment of the adequacy of the fire safety provisions in the Service. This assessment has not indicated the need for any additional measures to be introduced. Suitable facilities are in place to assist the people in residence to do their laundry. The Registered Provider is going to clarify whether or not the necessary steps have been taken to ensure that used water does not leak back into the Service’s main pipe-work. This development will be completed by 1 December 2007. 71 London Road DS0000023885.V352540.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 33, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. There are enough members of staff on duty. Security checks are completed in relation to new employees. Support workers know what they are doing. EVIDENCE: There are always support workers present whenever any of the people who use the Service are at home. The people who use the Service say that support workers are always around and willing to help whenever they need them. Support workers think that the Service is adequately staffed. The Registered Provider completes a number of security checks for new members of staff. This is done to ensure that they are suitable people to have unsupervised access to the people who use the Service. 71 London Road DS0000023885.V352540.R01.S.doc Version 5.2 Page 20 All new support workers receive introductory training. This is designed to ensure that they have the basic knowledge and skills they need in order to be able to work without direct supervision. This is important because the quality of care delivered in the Service, depends largely upon the adequacy of the competencies support workers have to hand. In addition to the introductory training, existing support workers undertake a number of training courses. These are designed to further develop their skills. The Registered Manager is going to add to this arrangement by completing an organised review of the competencies each of the support workers has to hand. This is a very good idea because it helps to make sure that everyone can contribute effectively to the delivery of the support needed by the people in residence. This development will be completed by 1 April 2008. 71 London Road DS0000023885.V352540.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. The Service is well managed. There is a quality assurance system. Various measures are in place to safeguard health and safety. EVIDENCE: The Registered Manager has both of the training Awards that are required by the Regulations. She has a good knowledge of how the Service works in practice. 71 London Road DS0000023885.V352540.R01.S.doc Version 5.2 Page 22 The people who use the Service are invited to comment informally about how things are going. In addition to this, there is a more organised system that enables them and their relatives to make suggestions about how the Service might be improved further. The results of the exercise are summarised in a Quality Report. As a development to the system, future Quality Reports are going to be shared with the service users. This is so that they know what is going to be done to implement any suggested improvements. The Registered Provider is not ensuring that one of its representatives visits the Service at least once a month. This should be done to check out first-hand how things are going. There is a Required Development in relation to this matter at the end of the Report. The Service is fitted with a modern fire detection and fire management system. The operation of this system is checked regularly. There are regular fire drills. The Registered Manager is going to add to these drills. This will be done by regularly double-checking that each of the support workers does indeed know how to operate reliably the Service’s fire safety procedure. This development will be completed by 1 December 2007. There have not been any significant untoward events in the Service since the last inspection. The Registered Provider checks the building and the accommodation to ensure that potential environmental hazards to health and safety are addressed. 71 London Road DS0000023885.V352540.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 X 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 2 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 4 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 2 X 3 X 2 X X 3 X 71 London Road DS0000023885.V352540.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 Provider should ensure that a suitably organised risk assessment and management plan is developed for each person who manages their own medication. (This Required Development is outstanding from the last inspection and it should have been completed by 30/07/06). The Registered Provider should ensure that a suitable heating service and hot water supply is reinstated to the flat. The Registered Provider should ensure that it completes the required programme of monthly inspection visits to the Service. Timescale for action 01/12/07 2. YA24 23 01/12/07 3. YA39 26 01/11/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. 71 London Road DS0000023885.V352540.R01.S.doc Version 5.2 Page 25 No. Refer to Standard Good Practice Recommendations 71 London Road DS0000023885.V352540.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 71 London Road DS0000023885.V352540.R01.S.doc Version 5.2 Page 27 - 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!