Inspection on 01/03/06 for Banyard Road, 40

This inspection was carried out on 1st March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Banyard Road, 40 31/07/07

Banyard Road, 40 07/06/06

Banyard Road, 40 26/09/05

Banyard Road, 40 08/02/05

Banyard Road, 40 31/08/04

Banyard Road, 40 03/03/04

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 Banyard Road, 40 40 Banyard Road Bermondsey London SE16 2YA Lead Inspector Ms Barbara Ryan Unannounced Inspection 09:30 01st March 2006 Banyard Road, 40 DS0000007108.V272100.R02.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 Banyard Road, 40 DS0000007108.V272100.R02.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. Banyard Road, 40 DS0000007108.V272100.R02.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Banyard Road, 40 Address 40 Banyard Road Bermondsey London SE16 2YA 0207 231 4774 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) Choice Support Hermina Van Kempen Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Banyard Road, 40 DS0000007108.V272100.R02.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26. September 2005 Brief Description of the Service: The home is registered to provide care for three people who have learning disabilities. The home is managed by a ‘not for profit’ organisation called Choice Support (Southwark) which manages a significant number of care homes for people with learning disabilities in the borough of Southwark and elsewhere. The home is in a cul-de-sac in Bermondsey, close to Southwark Park where parking is available during daylight hours. It is indistinguishable as a care home. Other local facilities include a shopping centre, market, pubs, cafés and churches. The home is close to public transport routes. Banyard Road, 40 DS0000007108.V272100.R02.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and carried out on 1st March 2006 between 9.30 and 3pm. At present there are two residents and both were at home for part of the inspection. The method of inspection included discussions with one member of permanent staff, observation of care practise in the home, informal conversation and interaction with residents, a tour of the building and examination of records. There was a subsequent phone conversation with the acting manager, clarification via email about staffing issues and further risk assessment sent by fax on 03.03.2006. What the service does well: What has improved since the last inspection? What they could do better: The home has not had a registered manager since January 2004 and this has been an ongoing requirement made in the two last inspection reports. This situation is due to the managing organisation putting together a proposal that the future management of two smaller homes in their organisation might be managed by one person. The acting manager of the home must apply for registration whilst decisions around the long-term issues of the management of the home are further explored. Banyard Road, 40 DS0000007108.V272100.R02.S.doc Version 5.0 Page 6 Information about residents’ needs, goals and achievements should be available on file in the sections marked for them. They should be regularly reviewed and progress reported. Information in the residents’ files should give a clear record of changing needs, goals set, progress and achievements, as well as how the residents have been involved in this process. Risk assessments should be kept in their allotted place, and all risks identified. Then home should keep the cupboard where hazardous substances are kept locked and the key kept in a safe place and not in the cupboard. 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. Banyard Road, 40 DS0000007108.V272100.R02.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 Banyard Road, 40 DS0000007108.V272100.R02.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): 2,5 The home has a policy on fully assessing prospective resident and all residents are given a written contract. EVIDENCE: The managing organisation has a policy of fully assessing all prospective residents. There have been no new admissions since the last inspection. At present there are only two residents and both have contracts with terms and conditions on their file. Banyard Road, 40 DS0000007108.V272100.R02.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, 7, 9 Care plans did not show clearly how residents’ changing needs have been updated. More needs to be recorded about residents’ goals and achievements, and this should show how residents’ choices are incorporated into them. Risk assessments should be kept in resident’s files in the appropriate section and all risks identified should have a risk assessment done for it EVIDENCE: Residents have care plans on their files; the files were tidy. However, it is difficult to see how care plans were regularly updated to reflect changing needs. The permanent staff member on duty felt that, with the exception of some issues around behaviour, residents’ needs have remained stable. The recording of goals and progress were not recorded on a regular basis; key worker meetings were not recorded and placed on one resident’s file on a regular basis. One resident’s care reviews had not been recorded on file as held since 20.7.2005. Up to date team meeting minutes where staff discuss and evaluated plans and goals for residents could not be located and staff were not able to say where they were. Progress of goals at a care review held in June 2005 had not been recorded on file. Banyard Road, 40 DS0000007108.V272100.R02.S.doc Version 5.0 Page 10 Issues around residents and their choices are quite complex; care plans need to show how residents are involved in setting goals and making choices. Staff were observed to work with kindness and patience around issues of choice and were sensitive in their approach to difficult issues, and worked with residents to support them to make choices and decisions Not all risk assessments are kept in the residents’ files under the appropriate section. The manager said that they kept some risk assessments else for easy assess by staff. If the home feels they need to kept a copy somewhere else then this should be duplicated and be the same as the one kept on the residents file. A risk had been identified for one resident around choking and needing support whilst eating; although this was documented on the file and staff where aware of this, a risk assessment had not been done and placed on file. The risk assessments that were on the file, however, were comprehensive and gave clear details for staff and how to work with the situation that they dealt with. Residents have a services users guide with photos and symbols to support them to understand the guide. These had not been fully completed and some of the photographs were too dark. In other parts of the guide, residents had colour photos of themselves which were much clearer and easy to identify with. One resident’s person centred planning file was looked at the other one could not be found. This file had been started but not completed; it would be of benefit to have this completed, and for all residents if they do not already have one. Banyard Road, 40 DS0000007108.V272100.R02.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): 11,12,13,14,15,17 Residents are able to access community and specialist day centre activities. These took account of cultural needs and include educational opportunities as well as social activities. Residents were able to access a healthy diet, but food should be presented more appropriately to residents EVIDENCE: There was an activities programme for residents which includes supporting residents to access community facilities, as well as more specialised activities such as art and cookery classes. There were, in this programme, times for residents to participate in the running of the home. One resident was going shopping for the food with carers on the morning of the inspection. Staff had worked hard to identify activities that would be enjoyable, culturally appropriate and possible to undertake. Staff have supported residents around issues of privacy and dignity in an appropriate manner. Residents are supported to maintain visits and contact with their family, and are able to access all parts of the building. Banyard Road, 40 DS0000007108.V272100.R02.S.doc Version 5.0 Page 12 The home had a range fresh fruit and vegetables in stock as well as a wide variety of other food. There is a weekly menu, but residents are supported to choose what they wish if they do not want what is on the menu for that day. Resident’s cultural needs were reflected in the menu and activities programme. The meal observed on the day of inspection was served at 2.30, which is quite late for a lunch time, and was not presented in an appropriate manner; this was an issue raised in a previous report that had been addressed but needs to be addressed again. Banyard Road, 40 DS0000007108.V272100.R02.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): 18,19,20,21 Residents are supported with their personal needs and their dignity and privacy maintained. Residents with behavioural issues were supported in an appropriate manner by staff. Specialist professional support may be appropriate around increasing difficulties in managing behaviour and to support residents’ emotional needs. Medication was appropriately managed. All residents had information file around funeral arrangements. EVIDENCE: An all female staff group supports residents and ensure residents are appropriately supported to maintain their personal hygiene and grooming. Residents were able choose and change their clothes as they wished and able to do this several times a day if they choose. There are complex behavioural issues for staff to deal with and all staff spoken to were aware and supportive in their understanding and actions to deal with such issues. Specialist professional support has, in the past, been involved around some of these issues and advice has been acted on and maintained over a period of time. Further specialist support may need to be sorted as these issues have increased recently and are impacting on residents’ abilities to access leisure and social activities and may reflect issues around emotional or other physical needed Banyard Road, 40 DS0000007108.V272100.R02.S.doc Version 5.0 Page 14 No resident is on a self-medication programme and this is appropriate; medication was safely stored and signed for. Medication to manage behaviour issues to be given as required under GP guidelines was available, but none was recorded as given. When asked about this, staff felt that this was because they did not feel that there was any observable benefits to the resident or that behavioural issues reduced. Homely medication was documented and signed by the GP. Residents have information on file regarding funeral agreement. Banyard Road, 40 DS0000007108.V272100.R02.S.doc Version 5.0 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 Information on complaints should be more readily available at the home and the complaints book locatable by staff. The home needs to continue to work to finalise issues around appointeeship for those residents that needed them. EVIDENCE: The managing organisation has a complaints policy. The complaints book at the home could not be located. Staff said they were aware of the home’s policy and that complaints were dealt with by their head office. Residents are escorted to the bank to access their money. Appointeeship was raised as a goal with regard to one resident, in June 05; this is an ongoing issue that has not as yet been finalised. At present residents are supported to sign, but it is not clear if all resident’s have the capacity with regard to understanding this process. Banyard Road, 40 DS0000007108.V272100.R02.S.doc Version 5.0 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): 24,26,27,30 The home provides a pleasant and homely environment that suits residents’ needs; residents’ bedrooms are personalised and meet their individual needs. The home is clean and hygienic. There are some small repairs in the upstairs bathroom to be completed. EVIDENCE: The home is situated on two floors with a large communal sitting room and kitchen/dining area. These and the hall were all decorated to a good standard and were pleasant and homely. There are patio doors leading from the dining area to a ramp leading down to an attractive garden with a paved area and raised flowerbeds. The garden was fully wheelchair accessible. There is a lift to the upper floors. Resident’s bedrooms were individual to their needs, large and pleasantly furnished. There is a walk in shower on the ground floor that at present is not used; residents use the bathroom on the first floor. This was pleasant, clean and hygienic; some tiles had come off of the wall over the hand basin and the flooring in front of the WC was beginning to wear and was raising slightly. These must be repaired. The home was clean and hygienic; it provides a comfortable environment for residents. Banyard Road, 40 DS0000007108.V272100.R02.S.doc Version 5.0 Page 17 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, 34,36 Residents are supported by a competent and qualified staff team. All supervision sessions are recorded and take place on a regular basis. The managing organisation has an adequate recruitment policy. EVIDENCE: On the day on inspection there was one worker on duty for the early morning shift, with 2 bank workers arriving at 10am. There is a sleeping-in worker at night and an on-call system. The staff on duty were observed to be relaxed, friendly and patient in their approach to residents, and knowledgeable of their needs and how to meet them. Staff are managing some challenging issues around behaviour and both residents and staff might benefit for having other specialist professionals involved to give further assessment and advice in working with these issues. Staff reported they received supervision approx every 6 weeks, although this was not recorded on the rotas on display. Staff spoken to said they were happy with the supervision and felt that it supported them; they were given a copy of the supervision notes. They reported that they felt confident in the running and management of the home. A check of Choice Support’s recruitment records showed that its’ procedures are safe, thorough and comply with the legal requirements. Banyard Road, 40 DS0000007108.V272100.R02.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): 37,42 The home has not had a registered manager since January 2004 and it is essential that the acting manager register. Health and safely procedures have improved since the last inspection. The hazardous substances cupboard needs to be locked and the key kept somewhere safe. EVIDENCE: The home has not had a registered manager since January 2004; the present person is acting up and the deputy manager is also acting up. This situation is due to the managing organisation putting together a proposal that future management of two smaller homes in their organisation might be managed by one manager. The acting manager of the home must apply for registration whilst decisions around the long-term plans for the management of the home are further explored. The home are checking a fire point once a week and completing a fire drill once a month; the emergency lighting is also being checked regularly. The Banyard Road, 40 DS0000007108.V272100.R02.S.doc Version 5.0 Page 19 hazardous substances cupboard is lockable but had the key left in it. The cupboard should be kept locked and the key somewhere inaccessible to residents. Fridge and freezer temperature are taken 3 times a day and were up to date and signed. Banyard Road, 40 DS0000007108.V272100.R02.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 2 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X 3 2 X X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 X 3 CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Banyard Road, 40 Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 2 X X X X 2 X DS0000007108.V272100.R02.S.doc Version 5.0 Page 21 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 YA6 Regulation 15(1) Requirement The registered person must ensure that resident’s files and care plan contain up to date information about their changing needs and goal. The registered person must ensure that risk assessments are completed on all areas of risk, kept one place on the file The registered person must ensure that all meals are presented in an appropriate, appetizing and timely manner. The registered manager must ensure that the complaints book is available and that staff are able to record a complaint from residents, family or other interested persons. The Registered person must ensure that missing tiles and worn floor covering in the upstairs bathroom are replaced and/or repaired. These repairs have been reported and are awaiting funding to be undertaken 6 YA37 8 The Registered Person must 01/06/06 submit an application for the DS0000007108.V272100.R02.S.doc Version 5.0 Page 22 Timescale for action 01/06/06 2 YA9 13(4)(b) 01/06/06 3 YA17 16(2) (i) 01/06/06 4 YA22 9(1) 01/06/06 5 YA27 23(2)(d) 01/06/06 Banyard Road, 40 registration under the Care Standards Act 2000 of a manager of the home. This requirement was made in the report of the Inspection of August 2004 and has been repeated at subsequent inspections. Consideration will be given to legal action if compliance is not achieved. The previous timescale of 01/05/05 is not met. Revised timescale of 01/04/06 not expired. The registered person must ensure that a hazardous substance cupboard is kept locked and the key stored safely at all times. 6 YA42 23(2)(l) 01/04/06 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 YA16 Good Practice Recommendations That a referral is made to a challenging behaviour specialist to support staff around this issue. Banyard Road, 40 DS0000007108.V272100.R02.S.doc Version 5.0 Page 23 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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