CARE HOME ADULTS 18-65
Addington House Addington House 62 Addington Road Sanderstead South Croydon Surrey CR2 8RB Lead Inspector
James O`Hara Unannounced Inspection 14th November 2005 10:10 Addington House DS0000039907.V258483.R01.S.doc Version 5.0 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 Addington House DS0000039907.V258483.R01.S.doc Version 5.0 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. Addington House DS0000039907.V258483.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Addington House Address 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) Addington House 62 Addington Road Sanderstead South Croydon Surrey CR2 8RB 020 8651 9132 020 8651 9132 Beaconcaregroup@AOL.COM Addington House Limited Shaun Fegan Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Addington House DS0000039907.V258483.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 11th April 2005 Brief Description of the Service: Addington House opened in March 2003. The home is situated on the main road in a suburban part of Sanderstead; the home is registered for the provision of support to six service users with learning disabilities. At present the home has six service users all of whom are diagnosed Autistic Spectrum. The home offers six bedrooms; four with en suite facilities, a comfortable lounge and a large garden. The home is within easy reach of Croydon by bus and a short walk to Sanderstead. Addington House DS0000039907.V258483.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the second inspection at the home this year. Methods of inspection included a tour of the premises a formal interview with one service user and discussion with the registered manager. Records examined included service user care plans, staffing records, training records, health and safety and fire records. Previous requirements and recommendations were discussed with the registered manager. What the service does well: What has improved since the last inspection? What they could do better:
There was one requirement and four recommendation set at the last inspection. The requirement was that the home ensures that all new service users have a care management needs assessments carried out prior to moving into the home. No new service user has moved to the home however the registered manager explained that he is aware of this procedure. As a result of this inspection three requirements and four recommendations have been set. The overall impression when visiting the home is that it is well organised and service users are offered opportunities to take part in appropriate activities both in and out of the home. Two new members of staff have started work at the home since that last inspection. Both started work at the home after completing only a POVA First check. The home should not start staff to work in the home until a Criminal Records Bureau Check is obtained.
Addington House DS0000039907.V258483.R01.S.doc Version 5.0 Page 6 The home should carry out weekly fire equipment checks and the practice of wedging open service users bedroom doors must be eliminated. Service users contracts should be signed and agreed by the service user or a representative of the service user and the registered manager so that they are aware of their own and the homes responsibilities. Service users should be involved in completing their own Person Centred Plans so that they can express their wishes and plan for the future. The inspector would like to thank the service users, the registered manager and staff for their support on the day of the inspection. 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. Addington House DS0000039907.V258483.R01.S.doc Version 5.0 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 Addington House DS0000039907.V258483.R01.S.doc Version 5.0 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 and 5. Standards 2 and 3 were assessed as met at the last inspection. All service users have contracts however these should be signed and agreed by service users and the registered manager so that they are aware of their own and the homes responsibilities. EVIDENCE: No new service user has moved to the home since the last inspection, the registered manager explained that he is aware that all new service users must have a care management needs assessments carried out prior to moving into the home. Two service users contracts were examined these included terms and conditions, fees and charges, the homes responsibilities and the service users responsibilities. However these had not been fully completed. The service user contracts need to include current charges and be agreed and signed by the service user and the registered manager. Addington House DS0000039907.V258483.R01.S.doc Version 5.0 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. Service user care plans are comprehensive and include detailed information on the service users needs and personal goals. However service users should be involved in completing their own Person Centred Plans so that they can express their wishes and plan for the future. EVIDENCE: Service user individual care plans are very comprehensive and headings include a pen portrait of the service user, weekly activities, health needs and communication skills to mention a few. There is evidence of monthly reports on the service user. The registered manager explained that these reports are sent to the service users care manager along with any incident reports. The service user care plans are completed by the home and the service users care manager. There is little to suggest the level of service user involvement. It has been recommended in previous inspections that each service user have a Person Centred Plan completed every six months. Addington House DS0000039907.V258483.R01.S.doc Version 5.0 Page 10 The registered manager stated that he and all other members of staff are due to attend training on Person Centred Planning. It is recommended that all members of staff complete training on Person Centred Planning and that all service users have a Person Centred Plan completed every six months. Addington House DS0000039907.V258483.R01.S.doc Version 5.0 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): 14. Standards 12, 13, 15, 16 and 17 were assessed as met at the last inspection. Appropriate arrangements are made so that service users have opportunities to engage in regular leisure activities both inside and outside of the home. EVIDENCE: One service user was interviewed in the privacy of his bedroom. The service user said, “I am very well looked after and I receive one to one support and staff always makes sure that I can attend activities that I like to do”. He also said “it’s the little things that I appreciate like staff knocking on my door just to see if I am well and offering me drinks and snacks in the evening”. He said, “This place is a thousand times better than my previous place where I lived”. He explained that he had plenty of activities inside and outside the home he had a play station and computer games, music player, DVD player and lots of DVDs in his room. It was noted that other service users had computers, music players and play stations in their bedrooms. Addington House DS0000039907.V258483.R01.S.doc Version 5.0 Page 12 Addington House DS0000039907.V258483.R01.S.doc Version 5.0 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 and 20. The arrangements for health care needs of the service users is good, all service users are registered with a local General Practitioner, the home has the support of the local pharmacist for advice on medication and all staff has attended training on Autism and Aspergers. EVIDENCE: At the last inspection it was identified by the organisations Clinical Psychologist that staff should attend training on Autism and Aspergers. This training was attended by all members of staff on the 12/05/05. Addington House DS0000039907.V258483.R01.S.doc Version 5.0 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 the following standard(s): 23. Standard 22 was assessed as met at the last inspection. Generally the arrangements for complaints and protection from abuse are well managed and ensure that service users feel listened to and safe. EVIDENCE: The registered manager showed evidence that the majority of staff had attended training on protection of vulnerable adults on the 02/02/05. It is recommended that all other members of staff attend training on the protection of vulnerable adults. Addington House DS0000039907.V258483.R01.S.doc Version 5.0 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 the following standard(s): 24 and 30. The home is suitable to the needs of the service users and is in good decorative order throughout. The overall impression when visiting this home is that it is homely, comfortable clean and hygienic. EVIDENCE: During a tour of the premises it was noted that a drawer in the kitchen was broken, a bathroom door was badly dented and the wardrobe door in one of the service users bedrooms was missing. The registered manager stated that he had contacted his organisation about these and these are due to be repaired by a handyman. It is recommended that the drawer in the kitchen, the bathroom door and the wardrobe door is repaired or replaced. Addington House DS0000039907.V258483.R01.S.doc Version 5.0 Page 16 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 and 34. Standards 35 and 36 were assessed as met at the last inspection. Arrangements have been made to ensure that the majority of staff will complete an NVQ level 2 qualification in the coming year. The home should obtain all the information required in Schedule 2 National Minimum Standards for all members of staff prior to commencing employment in the home thus ensuring that service users are safeguarded so far as reasonably practicable from risk of harm or abuse. EVIDENCE: The registered manager provided evidence that three members of staff are completing NVQ level 2 in Care and one member of staff is completing NVQ level 3 in Care. The registered manager stated that four other members of staff are due to start NVQ level 2 courses in December this year. The deputy manager is completing the RMA and NVQ level 4 along with the registered manager. Training records for 2005 indicate that staff has attended training on autism, epilepsy, adult protection, fire safety, food hygiene, non violent crisis intervention, first aid, health and safety and moving and handling. Addington House DS0000039907.V258483.R01.S.doc Version 5.0 Page 17 Two new members of staff have started work at the home since that last inspection. The registered manager stated that both members of staff had started work at the home after completing only a POVA First check. Employers must always ensure that new staff has all documentation as stated in Schedule 2 of the National Minimum Standards before starting work with vulnerable people. POVA First is only to be used were the lack of staff places the service users health and welfare at critical risk. A number of conditions need to be in place if staff are to start work with POVA clearance only. • • • The employer must write to the Commission requesting and have agreement that staff start work at the home with POVA clearance only. The home must explain the critical risk to the service user/s. The employer must provide evidence that all other documentation as stated in Schedule 2 of the National Minimum Standards has been obtained for the new staff. The employer must ensure that new staff do not work alone with service users. The employer must ensure that the new staff has an identified senior member of staff to supervise them on each shift. The employer must ensure that the new staff completes induction training during this period. • • • The registered manager must inform the Commission when the Criminal Records Bureau Check for the two members of staff is available in the home and arrange a date for these to be examined. Addington House DS0000039907.V258483.R01.S.doc Version 5.0 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 and 42. Standard 39 was assessed as met at the last inspection. In general the home appears to be well run and well managed. The management approach of the home creates an open, positive and inclusive atmosphere. The health and safety of the service users could be compromised if the home does not carry out appropriate fire equipment checks and staff continues the practice of wedging open service users bedroom doors. EVIDENCE: The registered manager and the deputy manager are both completing the Registered Managers Award and NVQ level 4. The registered manager stated that he is not happy with the company that he is currently completing the qualification with and provided evidence that he and the deputy manager plan to move to another company. Addington House DS0000039907.V258483.R01.S.doc Version 5.0 Page 19 Evidence was seen for Portable Appliance Testing Certificate 05/07/05, Landlords Gas Safety Certificate 20/04/05, Legionella testing 10/10/05 and an officer from London Fire & Emergency Planning Authority visited the home on 27/10/05. There was evidence that the home carries out monthly fire drills however the fire alarm system is checked only on a monthly basis. The registered manager must ensure that the fire alarm system is checked on a weekly basis. It was observed that one of the service users bedroom doors was wedged open; service users could be at risk in the event of a fire. If it is assessed that service users wish or there is a need to keep their bedroom doors open then their doors should be fitted with an automatic release mechanism that is connected to the fire alarms system. The registered manager must ensure that the practice of wedging bedroom doors open is eliminated. Addington House DS0000039907.V258483.R01.S.doc Version 5.0 Page 20 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 3 Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X X X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X 2 X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Addington House Score 3 X 3 X Standard No 37 38 39 40 41 42 43 Score 3 X X X X 2 X DS0000039907.V258483.R01.S.doc Version 5.0 Page 21 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 YA3434. Regulation 19 (1) b. Requirement The home should obtain all the information required in Schedule 2 National Minimum Standards for all members of staff prior to commencing employment in the home. The registered manager must inform the Commission when the Criminal Records Bureau Check for the two members of staff is available in the home and arrange a date for these to be examined. The registered manager must ensure that the practice of wedging bedroom doors open is eliminated. The registered manager must ensure that the fire alarm system is checked on a weekly basis. Timescale for action 14/11/05 2. YA42. 23 (4) a. 14/11/05 3. YA42. 23 (4) c. 14/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations
DS0000039907.V258483.R01.S.doc Version 5.0 Page 22 Addington House 1. 2. Standard YA5 YA6 3. 4. YA23 YA24 The service user contracts need to include current charges and be agreed and signed by the service user and the registered provider. It is recommended that all members of staff complete training on Person Centred Planning and that all service users have a Person Centred Plan completed every six months. It is recommended that all members of staff attend training on the protection of vulnerable adults. It is recommended that the drawer in the kitchen, the bathroom door and the wardrobe door is repaired or replaced. Addington House DS0000039907.V258483.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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