Inspection on 03/11/05 for Athol House, London Cheshire Home

This inspection was carried out on 3rd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Athol House, London Cheshire Home 09/11/07

Athol House, London Cheshire Home 09/01/07

Athol House, London Cheshire Home 26/04/05

Athol House, London Cheshire Home 18/01/05

Athol House, London Cheshire Home 02/08/04

Athol House, London Cheshire Home 17/03/04

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1-3 Frederick Gardens

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

CARE HOME ADULTS 18-65 Athol House, London Cheshire Home Athol House 138 College Road London SE19 1XE Lead Inspector Mark Stroud Unannounced Inspection 3rd November 2005 11:10 Athol House, London Cheshire Home DS0000007004.V254478.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 Athol House, London Cheshire Home DS0000007004.V254478.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. Athol House, London Cheshire Home DS0000007004.V254478.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Athol House, London Cheshire Home Address Athol House 138 College Road London SE19 1XE 020 8670 9279 020 8761 7830 sandy.seymour@ic-uk.org 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) Athol House, London Cheshire Home Care Home 21 Category(ies) of Physical disability (0), Physical disability over 65 registration, with number years of age (0) of places Athol House, London Cheshire Home DS0000007004.V254478.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th April 2005 Brief Description of the Service: Due to the size and environmental limitations of the building the organisation has decided to re-provide the service. The timescale for reprovision is unclear, the organisation currently prioritising the re-provision of other London based services. Athol House is a care home providing personal care and accommodation for 21 people with a physical disability. The building is leased; the service set up and managed by The Leonard Cheshire Foundation, a voluntary organisation. The home is located on the outskirts of Dulwich and Crystal Palace. Accessible bus routes, train services, and shops are close by. The home has its own vehicles now used by volunteers and staff. The home consists of a two-storey building, bedrooms provided over both floors. All the bedrooms are single. There is a passenger lift between floors. The home has a garden to the rear, accessible to service users using a wheelchair. Athol House, London Cheshire Home DS0000007004.V254478.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. I am a Regulatory Inspector, and stayed at the home for a day, to see if service users get the right help. I spoke to service users, staff, and the new manager. What the service does well: What has improved since the last inspection? 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. Athol House, London Cheshire Home DS0000007004.V254478.R01.S.doc Version 5.0 Page 6 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 Athol House, London Cheshire Home DS0000007004.V254478.R01.S.doc Version 5.0 Page 7 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): EVIDENCE: None of these Standards were assessed at this inspection. Athol House, London Cheshire Home DS0000007004.V254478.R01.S.doc Version 5.0 Page 8 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&9 Service users know that their most urgent needs are planned for but the home need to work harder to work in partnership with them, and work towards agreed goals. EVIDENCE: The home maintains good plans to meet the health needs of service users. Service users receive respite as well as longer term placements, and the home are able to make good plans to meet needs, including cultural and dietary preferences and needs, making sure they research the needs of service users where they are unsure. The home records the social networks of service users they know who the important people are in their lives, and make sure they support these relationships. The professionals involved outside the home are written down, and their assessments are used to provide the right care to service users, as well as making sure service users are able to see them regularly. Preferences for the gender of carers are recorded so that service users dignity is respected, where this is an issue. Plans still do not identify in enough detail the need for service users to develop their independence, but the home are starting to look at goals with service users in weekly meetings with their key workers, where agreement is written down. This needs to be used now to update agreements in plans. Plans still lack detail regarding the Athol House, London Cheshire Home DS0000007004.V254478.R01.S.doc Version 5.0 Page 9 communication needs of service users, and this is not being addressed in key work sessions. One Service Users Plan says ‘can express needs’ where there were likely to be support needs as well. Plans assess the risks to service users from pressure sores, eating and drinking, and make sure these needs are met. The risk assessments that staff write down need to start from what service users are doing to keep themselves safe, and make sure staff support them to stay safe. Athol House, London Cheshire Home DS0000007004.V254478.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Service users are getting more opportunities to participate in their community, and enjoy activities they enjoy, and are now able to make more choices about the way they live. EVIDENCE: Service users say they are pleased they can follow their interests, including pottery and gardening. This is provided through attendance at day services. Service users say they want to go to more clubs where they can meet people and make more friends. A lot of service users are not attending day services. Two activities co-ordinators are due to start working at the home 14/11/05. Some service users have registered with dial-a-ride, but they still rely on volunteers mostly who drive the homes van, so they can go out into the community. Only three staff are qualified and happy to drive the homes van. Recently the manager has supported some service users to go to other day services to try out computer equipment that is more accessible to them. Plans are being made for service users to attend more regularly now. The homes computer equipment has now been moved upstairs where it is more accessible. Service users are having regular meetings, writing down minutes and what is going to be changed at the home, and these are displayed for Athol House, London Cheshire Home DS0000007004.V254478.R01.S.doc Version 5.0 Page 11 everyone to see. The first things they are changing is how the home looks and is organised, so they have more control over their environment, and get experience of making more important decisions. More work is needed raise the confidence of service users who have not been used to having access to opportunities away from the home especially, and begin to plan with them to meet their developing aspirations. Opportunities for employment and work type settings must be a choice. Service users feel they have good contact with relatives when they live locally, and are able to visit the home. Athol House, London Cheshire Home DS0000007004.V254478.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 & 19 Service users know their health needs will be met. EVIDENCE: Although service users are supported by health professionals to choose the right equipment for their individual use, communal furniture like the dining table, used several times a day by service users, has not been assessed by an occupational therapist or other health professional to make sure it meets their needs. When staff are concerned about a service users health they are good at sharing information, and making sure they are doing everything they need to. The dates when service users see health professionals for things like foot care, diabetes, physiotherapy, are written down, so service users know someone is making sure they are seen regularly. The home use complimentary medicine including reflexology, where this is agreed with the GP. Service users enjoy this, and find it useful. Athol House, London Cheshire Home DS0000007004.V254478.R01.S.doc Version 5.0 Page 13 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 Service users know they will be kept safe and listened to. EVIDENCE: The home have responded quickly and effectively to concerns about abuse to a service user since the last inspection, involving other agencies and taking action to protect the service user and increase their independence. New staff are asked to think and learn about keeping service users safe from harm, when they start working at the home. The concerns described in the last report were sorted out, the service users wishes and needs respected. The home deals with informal and formal complaints well, taking decisive action when they need to. Service users have a leaflet they can look at explaining what complaints are, and how to make one, called ‘Having your say’. Athol House, London Cheshire Home DS0000007004.V254478.R01.S.doc Version 5.0 Page 14 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, 27 & 30 Service users like the home they live in, but need more changes to be made so that it is accessible to them. The home is clean. EVIDENCE: One service user said they like the size of the home because they have their own private space and know that there is a community of people including supportive staff working alongside them and available to respond to their needs quickly. Some redecoration of the home has been finished, and the new manager has arranged for ‘corporate volunteers’ to come in to paint the first floor bathroom, and other rooms and communal areas that need to be decorated. Service users asked for new curtains or blinds in the lounge, and this was passed on to the new manager. On the ground floor around the staff office walls are being damaged from wheelchair impact, particularly on corners. One service user said they bang their head on the corner of the walls at the entrance to their bedroom, and want them to be re-profiled phone manager. The new manager has made plans to make the building more accessible, ordering a new ramp to the rear entrance so that service users go into the office more easily and independently. London Borough of Southwark Athol House, London Cheshire Home DS0000007004.V254478.R01.S.doc Version 5.0 Page 15 environmental health recently left an award reflecting god standards of hygiene in the kitchen area. Bathroom areas have been cleaned and redecorated, awaiting further redecoration, bin lids in place. Athol House, London Cheshire Home DS0000007004.V254478.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): 34 & 35 Service users know that staff working at the home have the skills to meet their needs. EVIDENCE: Since the last inspection the organisation found some gaps in the checks they need to make into the background of staff working at the home. They have now finished making sure there are no gaps. New staff receive an induction so they can meet service users needs, and keep them safe. All permanent staff at the home has completed NVQ level 2, and some staff are progressing to NVQ Level 3. Staff understand what their responsibilities are, including what they need to do as key workers, where they work more closely with individual service users. New staff recruited who are due to start work at the home soon are having their backgrounds checked thoroughly. Athol House, London Cheshire Home DS0000007004.V254478.R01.S.doc Version 5.0 Page 17 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 Service users are happy with the new manager but still not sure what is going to happen to their home in the future. EVIDENCE: The new manager has applied to the Commission for Social Care Inspection (CSCI) to be registered as the homes manager and is due to be interviewed by a Regulation Inspector in December 05. There is a lot of support for the new manager from service users and staff, praising their openness. The organisation has developed their own Standards, which the home has assessed themselves against. Part of the action plan includes clarification of plans for the reprovision of the service, but there are no timescales or specific targets for this work to date. A meeting regarding the future of the home was held after the last inspection, but staff and service users are still unclear about the future of the home. There is some anxiety and anger about this. Overall the plan is comprehensive, and focused on the needs of service users, particularly their involvement through the use of more accessible documentation. There was a fire drill two months ago, and the alarm is tested weekly, fire equipment Athol House, London Cheshire Home DS0000007004.V254478.R01.S.doc Version 5.0 Page 18 checked annually. Liquids like bleach and other cleaners, that could be harmful to service users who don’t understand what they are, were not found left out. Athol House, London Cheshire Home DS0000007004.V254478.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 x x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X 3 x x 3 LIFESTYLES Standard No Score 11 x 12 3 13 2 14 3 15 3 16 x 17 Standard No 31 32 33 34 35 36 Score x x x 2 3 x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Athol House, London Cheshire Home Score 2 3 x x Standard No 37 38 39 40 41 42 43 Score 3 x 2 x x 3 x DS0000007004.V254478.R01.S.doc Version 5.0 Page 20 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 YA6 Regulation 15 Requirement The Registered Person must ensure that agreements in key work sessions are used to update Service User Plans, and that these include goals to meet the communication needs of service users, including their confidence and ability to use the skills they already have. The Registered Person must ensure that further arrangements are made for individual service users to access transport flexibly when they need it, to enable them to engage in local, social and community activities, further extending their choice. The Registered Person must ensure that these arrangements are assessed by an occupational therapist or other suitably qualified professional, to consider better access and support to service users (timescale of 30.04.05 and 31.07.05 not met). The Registered Person must ensure that a clear plan of action including service user DS0000007004.V254478.R01.S.doc Timescale for action 28/02/06 2 YA13 16 28/02/06 3 YA18 23(2)(n) 28/02/06 4 YA24YA39 12(1)(a) 23 28/02/06 Athol House, London Cheshire Home Version 5.0 Page 21 consultation is drawn up, so that the home accommodates a maximum of twenty people with no more than ten people sharing a staff group, a dining area and other common facilities by 1st April 2007.(timescale of 31.05.05 not met) 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 YA9 Good Practice Recommendations The Registered Person should ensure that risk assessments start from the things service users do to keep themselves safe and say exactly what staff need to do to support them. The Registered Person should ensure that walls and especially corners are protected from impact with wheelchairs and that the service users entrance to their bedroom is assessed with them and an occupational therapist or other relevant professional, and modifications made to prevent them banging their head on the wall. 2 YA24 Athol House, London Cheshire Home DS0000007004.V254478.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH 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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