Inspection on 30/05/06 for 71 London Road

This inspection was carried out on 30th May 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

71 London Road 11/10/07

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 Justine Williams Key Unannounced Inspection 30th May 2006 09.30 71 London Road DS0000023885.V294642.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 71 London Road DS0000023885.V294642.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. 71 London Road DS0000023885.V294642.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 71 London Road Address 71 London Road Southborough Tunbridge Wells Kent TN4 0NS 01892 515520 01892 515520 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 7 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7) of places 71 London Road DS0000023885.V294642.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st September 2005 Brief Description of the Service: 71 London Road is currently registered for 7 people. The house is a detached premises on three floors with an attached flat which is used for independent living and is currently not registered. There are gardens to the front and rear which residents can use. There is car parking to the front of the house. All rooms are of good size with all single bedrooms. A single staircase accesses the upper floors of the main house. There are bathrooms and toilets on the first and second floors. Residents have use of a large sitting room, and kitchen, dining room and a laundry room. The home is close to local shops and pubs with bus services easily accessible. The main town of Tunbridge Wells, where there are all the facilities of a larger town, is approximately 3 miles away. There is a main line station approximately 1½ miles away. The home is owned by Moat Housing who have a specialist housing facility at the rear of the property. The fees are currently from £491.30 to £727.95. 71 London Road DS0000023885.V294642.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was carried out on 30th May 2006 between 09.30 am and 1.30pm by regulatory inspector Justine Williams. During that time residents, staff and the manager agreed to speak with the inspector both in public and privately. This report contains assessments made from observation, conversation and records. Residents were very happy at the home and are in the process of getting to know a man who may come to live at the home in the near future, this process is being handled sensitively by staff. The current residents have lived at the home for some years. One resident may be moving on to a more independent house, this is as a direct result of the support given by the staff and manager. What the service does well: What has improved since the last inspection? The recruitment practices have been improved to better ensure the safety of residents. Any gaps in employment history are now explored, and staff are not employed to work at the home until satisfactory CRB and POVA checks are obtained. The health and safety issues identified at the last inspection with respect to standards of cleanliness and electrical testing and hazards have been addressed. Reference request from the home are now standardised to ensure consistent information is requested. 71 London Road DS0000023885.V294642.R01.S.doc Version 5.1 Page 6 The manager has started to develop the quality assurance systems at the home, stake holders, residents and relatives have been issued with questionnaires and the information has been collated. 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. 71 London Road DS0000023885.V294642.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 71 London Road DS0000023885.V294642.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,4 Quality on this outcome area is good. This judgment has been made using available evidence including a visit to the service. Residents know they will have their individual needs and aspirations assessed, and are able to test-drive the home prior to moving in. EVIDENCE: There have been no new residents moving into the home for some time, however records for the existing residents contained a comprehensive assessment. Residents are actively encouraged to visit the home on several occasions to join in with a variety of activities, and to meet the staff and other residents. During this site visit the inspector met a young man who was visiting for lunch, as a staged process of introduction to the home and the other residents. Detailed records were seen in respect to this resident’s visits, his individual needs and consultation and liaison processes with other professionals involved in his care. Residents spoken had been consulted as to their views on the prospective resident. 71 London Road DS0000023885.V294642.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality on this outcome area is good. This judgment has been made using available evidence including a visit to the service Residents care plans reflect their changing and individual needs, their right to make decisions about their lives are upheld. They are supported to take risks in order to maintain their independence. EVIDENCE: Resident’s records contained adequately detailed information for staff to be able to meet their needs. Care plans are regularly reviewed each resident has a key worker. It was evident from talking to the residents, the manager and staff that residents are actively encouraged to make decisions and choices, and any limitations imposed are documented and agreed with relevant professionals and are notably in the residents best interests in accordance with the Care Programme Approach. Both general and responsive risk assessments are carried out and recorded. Residents are able to take risks and have those risks explained to them. Staff 71 London Road DS0000023885.V294642.R01.S.doc Version 5.1 Page 10 are aware that residents have the right to take risks and are encouraged to judge whether the risk is appropriate. Where necessary other professionals are consulted. Advice will be incorporated into the risk assessment or it may be recorded that professionals are aware that the resident chooses to take the risk. 71 London Road DS0000023885.V294642.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality on this outcome area is good. This judgment has been made using available evidence including a visit to the service Residents have a good quality of life with opportunities for social, educational, and recreational experiences. EVIDENCE: One resident has recently been employed to do some sessional work, supported by staff. residents are encouraged and helped to continue their education and training, one resident has recently successfully completed a maths GCSE. Residents are supported to claim benefits where appropriate. Staff assist and encourage residents to participate in local community activities. Residents are enrolled in various centres and organisations, which provide an array of activities such as cookery, pottery, arts and crafts, computer skills etc. In addition residents are offered other activities such as cinema and theatre trips, meals and pub outings and these are discussed at the residents 71 London Road DS0000023885.V294642.R01.S.doc Version 5.1 Page 12 meetings, staff try to come up with new ideas and at the last meeting watching lambing was offered. The family and friends of residents are welcomed to the house. Any restrictions to meeting with family or friends are agreed with the multi disciplinary team and resident and are to protect the residents well being. Staff were observed to respect residents rights to privacy and did not enter their bedrooms without permission. Those residents that wish to cook their own meals and snacks, and do their own shopping, are able to do so and staff provide any assistance needed to support these activities. One resident has a personal food budget and the manager is considering offering another resident the same as she is enjoying cooking for herself. Residents are responsible for cleaning their own rooms but are helped and prompted by staff if needed. One resident is responsible for the 2 cats which live at the house. Staff cook for the residents with their help, and drinks and snacks are available at any time. There is no restriction on using the kitchen. Residents may eat wherever they wish. One resident is assisted and encouraged to eat a special diet in line with medical advice. 71 London Road DS0000023885.V294642.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality on this outcome area is good. This judgment has been made using available evidence including a visit to the service Residents’ health and personal care needs are well managed and promote physical and mental wellbeing. EVIDENCE: Staff offer the level of assistance or encouragement that the residents require, and individual preferences regarding personal care are taken into account. Residents have a designated key worker to ensure consistency of care. Records of visits and appointments with health care professionals are kept. One resident goes to London regularly alone (according to her preference) for an appointment with a specialist. Other residents receive the support they need to attend appointments. Residents are registered with a local medical centre. Medication is stored in a suitable locked cupboard. The medication policy was last reviewed in 2003, and needs to be updated. The medication policy should include comprehensive information about “homely remedies” and this was discussed with the manager. One resident is self-medicating, a risk assessment has been completed with respect to this however risk assessments should 71 London Road DS0000023885.V294642.R01.S.doc Version 5.1 Page 14 include information on storage, re ordering etc, to ensure all aspects of potential risk are covered. Staff have received appropriate medication training, to minimise risk of errors and safely administer medicines. Staff do not administer medicines without having had training. 71 London Road DS0000023885.V294642.R01.S.doc Version 5.1 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 on this outcome area is good. This judgment has been made using available evidence including a visit to the service Residents can express their views and be listened to. They are protected from the risks of abuse. EVIDENCE: The complaint procedure is posted on the notice board. Residents are aware they can make a complaint and that the complaint will be acted on. There have been no new complaints for some time. Minor complaints expressed by residents are recorded on their individual file. In order to track complaints for trends it is recommended that these also be recorded in the complaint file. This would also enable the manager include them in the quality assurance system. Staff undertake adult protection awareness training. Staff are aware of POVA (Protection of Vulnerable Adults) procedures and POVA first checks are used as part of recruitment. 71 London Road DS0000023885.V294642.R01.S.doc Version 5.1 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): 24,30 Quality on this outcome area is good. This judgment has been made using available evidence including a visit to the service Residents have a comfortable clean environment in which to live. EVIDENCE: The home is located with easy access to local shops, including a Tesco Express, pubs and small independent shops. Buses going to Tunbridge Wells and Tonbridge pass close by. The home was formerly a large domestic property and remains in character with the local area. To the front of the house is a large chalet, which can be, used for private meetings, to the rear a small lawned area with seating. Residents are responsible for cleaning their own rooms with staff support. Communal areas are cleaned by support staff. the home was clean tidy and in a good state of decorative order. Residents spoken with were happy with their rooms and had been involved in decorating their rooms to their personal tastes. The laundry is appropriately sited away from the kitchen. Residents continue to do their own washing and ironing with support. 71 London Road DS0000023885.V294642.R01.S.doc Version 5.1 Page 17 71 London Road DS0000023885.V294642.R01.S.doc Version 5.1 Page 18 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 Quality on this outcome area is good. This judgment has been made using available evidence including a visit to the service Residents have staff available who have the training and skills to work effectively with people with mental health problems. Robust recruitment procedures and practices are now being implemented. EVIDENCE: Staff communicate well with residents, and have the skills and attributes to work effectively with the residents. 50 of staff have NVQ qualifications. Recruitment files for 2 new staff members were seen, both contained 2 written references, CRB and POVA checks. The manager was aware of the need to check any gaps in employment. One of the residents has participated in the interviewing of staff. the manager asks standard questions of candidates and records their answers for equal opportunities purposes. Staff have a job description which reflects their role. To monitor training needs a training matrix is used. Some staff hold NVQ level 3. New staff have an induction procedure to follow. Staff have received training in first aid, food hygiene, NAPPI training and other more specific training to enable them to care effectively for the residents. 71 London Road DS0000023885.V294642.R01.S.doc Version 5.1 Page 19 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 on this outcome area is good. This judgment has been made using available evidence including a visit to the service Systems are in place for the effective management of the service and protection of residents. EVIDENCE: The manager was deputy at the house prior to becoming manager and managed a forensic unit in the recent past. The manager has numerous years experience with working with this client group, including in the capacity of manager. The manager is near completion of the registered manager award, and undertakes training to update her knowledge and skills. The manager is in the process of structuring a formal quality assurance system, and annual development plan. Questionnaires from residents, relatives and stakeholders have been collated and the manager proposes to include the results in the service user guide, and to use them as part of the quality assurance systems. Some auditing takes place but could be expanded upon. Further work is needed develop a proactive development plan for the house. 71 London Road DS0000023885.V294642.R01.S.doc Version 5.1 Page 20 Information received in the pre inspection questionnaire, and through discussions with the manager and observation indicates that there are good systems in place to protect the health and safety of residents and staff. These include fire safety training, risk assessments and drills, first aid training and the provision of equipment, food hygiene training etc. The pre inspection questionnaire Following the last inspection the “walk round” risk assessments are conducted regularly and are effective. Following the last inspection the kitchen is regularly and frequently checked by staff for any potential hazards such as food being inappropriately stored and unlabelled. The response to the inspection indicated that servicing and maintenance of supplies and equipment is carried out including portable appliance testing. The manager ensures that electrical equipment brought into the home is tested for safety and all electrical equipment visually inspected as part of the walk round check. 71 London Road DS0000023885.V294642.R01.S.doc Version 5.1 Page 21 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 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 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 X 3 71 London Road DS0000023885.V294642.R01.S.doc Version 5.1 Page 22 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) Timescale for action The registered person shall make 30/07/06 arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care homeIn that risk assessments with respect to self-administration of medicines be expanded upon in scope. Requirement 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 YA20 Good Practice Recommendations It is recommended that the home develop its medication practices further to include homely remedies where agreed by the relevant health care professionals. This should then be included in the medication policy. It is recommended that minor expressions of dissatisfaction made by residents be recorded in the complaint file with actions taken recorded. A formal development plan which can be used in a continuous cycle of planning, action, review should be in DS0000023885.V294642.R01.S.doc Version 5.1 Page 23 2 3 YA22 YA39 71 London Road place as recommended at the last inspection. 71 London Road DS0000023885.V294642.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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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