Inspection on 21/06/06 for Angel Home

This inspection was carried out on 21st June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Angel Home 12/06/07

Angel Home 20/10/05

Angel Home 25/05/05

Angel Home 07/01/05

Angel Home 04/11/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Angel Home Angel Home 43 Stayton Road Sutton Surrey SM1 1QY Lead Inspector Deborah Yapicioz Key Unannounced Inspection 21st June 2006 15:40 Angel Home DS0000007204.V287806.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 Angel Home DS0000007204.V287806.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. Angel Home DS0000007204.V287806.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Angel Home Address Angel Home 43 Stayton Road Sutton Surrey SM1 1QY 020 8715 6940 020 8647 2548 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) Angel Home Limited Mrs Christine Mouralidarane Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Angel Home DS0000007204.V287806.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th October 2005 Brief Description of the Service: Angel Home is a residential care home for five younger adults who have learning disabilities. The home itself is semi-detached house situated on a residential road in Sutton. The current owners have recently purchased the home next door and are in the process of converting the two houses into one residential unit. T The current accommodation compromises of a two storey building; on the first floor there is a lounge/diner, kitchen, toilet, small office, laundry room and one bedroom. There is access via the kitchen and lounge/dining room to a small garden, which is dominated by a ramp. On the second floor, there is a further four bedrooms and a bathroom. To the front of the building there is a small garden. There is restricted car parking near the home, although the home itself has parking for one vehicle at the back of the property. The home is within easy walking distance of Sutton town centre, where there are shops, post office and pubs. Sutton has good transport links as it is on many bus routes and there is also a railway station that goes into London and the coast. Angel Home DS0000007204.V287806.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was inspected under the National Minimum Standards Care Homes for Younger Adults. The inspection was unannounced and began at 3.40pm on 21st June 2006. Christine Mouralidarane is the home manager however she was not on duty at the time of the inspection. Isabella Murugupillia the deputy manager was on duty at the time of the visit and facilitated the inspection. Methods of inspection included meeting with the service users, a tour of the premises, observation of contact between staff and service users, meeting with members of staff and discussions with the deputy manager. Records examined included service user plans, care manager assessments, risk assessments, medication records, complaints, staffing records, health and safety and fire records. The home manager had completed a Pre Inspection Questionnaire. The inspector would like to thank the service user, the staff team and Mrs Murugupillia for their help in facilitating the inspection. What the service does well: What has improved since the last inspection? At the last inspection a requirement was made around the format of the homes risk assessments. The management team have reviewed the format and have devised a more detailed document with a section that shows when the risk Angel Home DS0000007204.V287806.R01.S.doc Version 5.2 Page 6 assessment was last reviewed. Although the document is now in place the management team are in the process of updating and rewriting the assessments therefore the requirement is partially met and will be reassessed at the next inspection when the management team will have had the opportunity to complete the rewriting of the assessments. The inspector was informed that the home manager and the deputy manager have attended the Person Centred Planning for facilitators course run by the London Borough of Sutton and Person Centred principles will be incorporated into the care planning process at the home. 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. Angel Home DS0000007204.V287806.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 Angel Home DS0000007204.V287806.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4,5, Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The home provides good information and introduction opportunities for prospective service users and their families to make an informed choice about moving to the home. Each of the service users is issued with an individual contract setting out the terms and conditions of the placement, which safeguards the interests of both parties. EVIDENCE: The registered provider has compiled a statement of purpose outlining the aims and objectives of the home, and the facilities and services it provides. This information is given to families and professionals considering a placement at Angel Home. The information includes a copy of the contract and the latest inspection report. The statement of purpose and service users was seen in service users bedrooms during the inspection. The home only accepts referrals following an assessment completed by a care manager. The home also completes an assessment. The home has had no new admissions since the last inspection although the service users files looked at during the inspection all contained the necessary information to comply with the standard. The deputy manager said that compatibility with others already living in the home is taken into account when considering a prospective placement. Flexible visits and overnight stays are arranged for any prospective service users to get a “feel” of the home. Angel Home DS0000007204.V287806.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users have comprehensive individual care plans with information on their needs and personal goals. Individual care plans include consultation with service users and are regularly updated by the key-worker to reflect current needs and service users wishes. EVIDENCE: At the last inspection a requirement was made around the format of the homes risk assessments. The management team have reviewed the format and have devised a more detailed document with a section that shows when the risk assessment was last reviewed. Although the document is now in place the management team are in the process of updating and rewriting the assessments therefore the requirement is partially met and will be reassessed at the next inspection when the management team will have had the opportunity to complete the rewriting of the assessments. Each of the service users has an individual tailored care plan. The care plans are on the service users file and is a record of their aims and goals as well as their achievements. The inspector was informed that the home manager and the deputy manager have attended the Person Centred Planning for facilitators course run by the London Borough of Sutton and Person Centred Planning principles will be Angel Home DS0000007204.V287806.R01.S.doc Version 5.2 Page 10 incorporated into the care planning process at the home. Care plans are internally reviewed every six months and formally reviewed 12 months. The deputy manager keeps a central record of review dates, which was available during the inspection. Regular service user meeting are held and service users are encouraged to attend. Notes are taken of each meeting and placed in communal areas. The home operates a key worker system. Angel Home DS0000007204.V287806.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users have a varied programme of social activities organised by the staff team to reflect service users individual interests. The home has an open visitors policy to ensure friendships and family links are maintained. EVIDENCE: The service users are supported to access local day centres where they attend a variety of sessions depending on their individual interests and goals. Details of the service users daily activities and commitments are kept on the service users file. It is part of the role of the staff team to encourage service users at the home to maintain and develop independent living skills. The service users are encouraged to help out with household chores and the home arranges social activities based on service users interests. One of the service users went to Blackpool on holiday last year and some day trips have been organised, however not all service users at the home have had an annual holiday. The home manager must ensure that service users are offered the opportunity to have a holiday. The service users are on the electoral register and can vote if they wish to. Angel Home DS0000007204.V287806.R01.S.doc Version 5.2 Page 12 The homes have a visitor’s policy and family members are welcome to visit. One relative who was visting the home during the inspection said that she was always made to feel welcome at the home. Service users are encouraged to have friendships outside of the home and one of the service users regularly visits his girlfriend at weekends. The menu reflects the likes and dislikes of the service users. The menus for the home are agreed on a weekly basis and a menu board was on display at the home. Menu plans were also provided as part of the pre-inspection information. Alternatives to the main meal are provided and the service users spoken to during the inspection said that they liked the meals provided. On the evening of the inspection it was one of the service users birthday and he had chosen a “take away” meal as part of his birthday celebrations. Angel Home DS0000007204.V287806.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal care is carried out in a way that residents prefer so that dignity and choice are maintained. Residents’ physical and emotional health needs are detailed in personal plans to offer consist care in this area. Residents’ medication is well managed to ensure good health. EVIDENCE: The deputy manager explained that the service users need varying degrees of assistance with their personal care. Some service users need more support, while others just need a prompt. The level of support a service user needs would be detailed and recorded at their review and this information was seen on service users files and the information provided to agency and full time staff. The staff team at the home monitor the health of each of the service users and would ensure they receive any treatment needed. A record and dental and health checks was seen on service users files. Service users have access to relevant professional support to maximise independence, including advice and guidelines for dealing with challenging behaviour from the Community Team for People with Learning Disability. Key workers at the home monitors the service users health and any health appointments are kept on service user files. Incident forms are completed following any accidents. Angel Home DS0000007204.V287806.R01.S.doc Version 5.2 Page 14 The home uses a nomad system for medication and there is a locked cupboard for controlled drugs in keeping with good practise. The staff team at the home have attended an accredited medication course. Records examined showed that all medicines administered are recorded on Medicine Administration Record Sheets, which were up to date at the time of the inspection. Angel Home DS0000007204.V287806.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is complaints policy and procedure, which facilitates good access to the complaints system for the residents, their family or their representatives. The home has the appropriate policies in place to ensure the protection of vulnerable service users. EVIDENCE: The home has a clear complaints policy, which includes the timescales and the process of the investigation. Each service user had their own copy of the complaints policy in their bedrooms, which was written in plain English, and using Makaton symbols. The home has not received any complaints in the last twelve months, nor has the Commission. Service users during discussions said that they did not have any complaints about the care that they were receiving. The home has a copy of Sutton’s Vulnerable Adults Policy and Procedures. The Staff team spoken to during the inspection were aware of the complaints procedure and the adult protection policy and were aware of the need to report any incidents. Angel Home DS0000007204.V287806.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Generally the home provides a comfortable, clean and safe environment for service users to live in however the home manager must investigate the source of the mal odour in the first floor bedroom. EVIDENCE: Angel Home is a residential care home for five younger adults who have learning disabilities. The home itself is a semi-detached house situated on a residential road in Sutton, close to the high street and local amenities. The current owners have recently purchased the home next door and are in the process of converting the two houses into one residential unit. The building works should be completed later this year and will result in the home providing care and accommodation for up to nine service users with a learning disability. Currently each of the service users in the home has a single room, which is decorated and personalised to reflect their individual taste. Service users choose the colour schemes for their bedrooms. During the inspection it was noted that there was a mal odour in one of the first floor bedrooms. The home manager must investigate the source of the mal odour and carry out the necessary steps to eliminate the source. The home has appropriate laundry facilities separate from the kitchen and the preparation of food. The washing machine is capable of washing clothes at high Angel Home DS0000007204.V287806.R01.S.doc Version 5.2 Page 17 temperatures, which helps with the control of infections. The laundry has suitable flooring. There is a locked cupboard for the Control of Substances Hazardous to Health products. The home has policies and procedures on the disposal of clinical waste. Angel Home DS0000007204.V287806.R01.S.doc Version 5.2 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 in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team at the home have a range of skills and abilities, which enable them to meet the needs of the service users living at the home. EVIDENCE: The home ensures that there are at least two members of staff on duty at night there is one waking member of staff. The staff job descriptions looked at during the inspection were comprehensive in their content and linked to achieving service users goals, as set out in their individual care plans. It is company policy that all new employees are not permitted to start work until two satisfactory references from their previous employees have been confirmed as well as the other information required in schedule two of the care standards act including a Criminal Records Check. Two of the staff files looked at during the inspection contained all the necessary information to meet this standard. The home offers training opportunities to staff at all levels within the home. Angel Home DS0000007204.V287806.R01.S.doc Version 5.2 Page 19 New members of staff complete an induction programme covering various subjects including health and safety, fire drills, and introductions to service users and other staff. The induction programmes are signed, dated and kept on staff files. The atmosphere in the home is friendly. The service users spoken to during the inspection said that they liked the staff team and would staff were observed to treat people in a kind courteous manner. Angel Home DS0000007204.V287806.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management style appears to be transparent with clear lines of accountability. In the main health and safety arrangements are in place to ensure potential risks to service users health and safety are so far as reasonably possible identified and minimised. EVIDENCE: Christine Mouralidarane is the home manager however she was not on duty at the time of the inspection. The home manager is also one of the homes joint proprietors. Ms Mouralidarane has applied to complete the National Vocational Qualification level four. Isabella Murugupillia the deputy manager was on duty at the time of the visit and facilitated the inspection. During the inspection the Ms Murugupillia produced up to date certificates for Gas and Electrical checks and a legion Ella certificate. Angel Home DS0000007204.V287806.R01.S.doc Version 5.2 Page 21 Records required for the safety and well being of service users are in place including accidents, water temperatures, complaints, incidents, food records, fire records, staff and service users case files, medication records and so forth. All staff must attend mandatory health and safety training including moving and handling. The home has a health and safety policy in place. Environmental risk assessments are in place. A first aid box and a fire blanket are situated in the home. There are fire extinguishers throughout the house. Coloured chopping boards and knives were seen in the kitchen. There was a clear line of accountability within the home and the deputy manager demonstrated a good knowledge of the service users and the staff team. The home has regular staff meetings and the team receive supervisions. The staff team are also asked to complete competency questionnaires as part of their supervisions. The staff members spoken to during the inspection felt supported by the management team and were clear who they would speak to if they had a problem. Angel Home DS0000007204.V287806.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 2 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 2 X LIFESTYLES Standard No Score 11 x 12 3 13 3 14 X 15 2 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 3 X Angel Home DS0000007204.V287806.R01.S.doc Version 5.2 Page 23 Yes 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 YA9 Regulation 15(2)(b) Requirement Timescale for action 31/08/06 2 YA30 16. -(2) (k) 3 YA37 15. (2)(c)(d) The home must review all documentation relating to risk assessments to ensure that it covers all aspects of the service users lives, and that they are updated annually. Partially completed The home manager must 31/08/06 investigate the source of the mal odour in the room next to the sleep in room and take the necessary steps to eliminate the odour. The home manager must ensure 31/08/06 that an application for a variation is submitted to accommodate the service user who is over sixty-five years old. 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 YA14 Good Practice Recommendations The home manger must ensure that all service users have DS0000007204.V287806.R01.S.doc Version 5.2 Page 24 Angel Home an annual holiday. A record of the holiday should be kept on their file. Angel Home DS0000007204.V287806.R01.S.doc Version 5.2 Page 25 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 © 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 Angel Home DS0000007204.V287806.R01.S.doc Version 5.2 Page 26 - 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!