Inspection on 09/08/07 for Beatrice Road, 36

This inspection was carried out on 9th August 2007.

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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Beatrice Road, 36 09/11/06

Beatrice Road, 36 08/02/06

Beatrice Road, 36 09/08/05

Beatrice Road, 36 08/02/05

Beatrice Road, 36 29/09/04

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 Beatrice Road, 36 London SE1 5BT Lead Inspector Ms Alison Pritchard Unannounced Inspection 9 August 2007 11:45a th Beatrice Road, 36 DS0000007107.V343181.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 Beatrice Road, 36 DS0000007107.V343181.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. Beatrice Road, 36 DS0000007107.V343181.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beatrice Road, 36 Address London SE1 5BT 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) 020 7252 0302 020 7252 0302 jo.morgan@choicesupport.org.uk www.choicesupport.org.uk Choice Support Keshorsingh Beegun Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Beatrice Road, 36 DS0000007107.V343181.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9 November 2006 Brief Description of the Service: The home provides accommodation and care for 3 men with multiple and profound disabilities. It is one of a number of homes operated by Choice Support Southwark, which provides staffing and daily operational support services. The building is owned and maintained by Habinteg Housing Association. The property is similar in design to others in the street and is indistinguishable as a care home. As the home is a bungalow it is accessible throughout and there are a number of adaptations for people with disabilities. The home is located in a residential street in South East London, close to a shopping area with banks, cafes, pubs and public transport routes. The building has 3 single bedrooms, a lounge, dining area, kitchen, WC /laundry room, bath, shower room and a garden at the back of the house. There is an additional room that is used as an office. At the time of this inspection, all of the residents were male, this has been the case for several years. The Registered Manager informed the inspector in November 2006 that potential residents are given information about the home and the services available through the Statement of Purpose. Copies of CSCI inspection reports are made available to service users’ relatives, advocates and social workers. Information on the costs of placements has been requested for inclusion in the final report. Beatrice Road, 36 DS0000007107.V343181.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and carried out over two afternoons in mid August. The inspection methods included observation of care practice; discussion with the manager and staff members; inspection of residents’ files and a range of records and policy documents. Involved professionals and were sent survey forms so that they could contribute to the inspection process. Feedback was received from a relative. The inspector is grateful for the views shared. The CSCI also has access to information gathered through notifications from the home. A document called an Annual Quality Assurance Assessment was completed by the Registered Manager of the home in advance of the inspection and returned it to the inspector. All of this information has been taken into account in compiling this report. What the service does well: What has improved since the last inspection? What they could do better: The reorganisation of files and the start of an archiving exercise meant that certain key documents in residents’ care could not be located. These included the residents’ care planning goals, minutes of placement reviews, of key Beatrice Road, 36 DS0000007107.V343181.R01.S.doc Version 5.2 Page 6 worker meetings and care guidelines. These must always be available for staff reference and for 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. The summary of this inspection report can be made available in other formats on request. Beatrice Road, 36 DS0000007107.V343181.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 Beatrice Road, 36 DS0000007107.V343181.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. 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 admission policy and practice takes into account the need to gather information about the potential service user’s needs. The information to be provided for anyone thinking of coming to live at the home is currently being reviewed. EVIDENCE: The inspector was informed that the service user guide and the ‘statement of purpose’ are under review. It is required that copies of the reviewed documents be sent to the CSCI when the process is complete. The last admission to the home took place in 2006, the home currently has no vacancies. Choice Support encourages people who are thinking of moving to the home to visit and meet the other residents so that they can all decide whether the move would be a good thing. The admission procedure is for the home to have a copy of social work assessments before someone moves to the home so that they are clear about the person’s needs. When someone moves to the home there is a twelve week trial period so that the resident and the home can then review how the placement is going and make any changes necessary. An agreement which detailed a resident’s rights and responsibilities was seen on his file. Beatrice Road, 36 DS0000007107.V343181.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Certain key documents relating to care planning were not available. This hampers staff ability to provide care in keeping with residents’ identified goals and wishes. There are good arrangements to make sure that residents’ views are included in the running of the organisation. EVIDENCE: The inspector was informed that the filing and management of document system was changing. This may have contributed to a lack of clarity over the location of care planning goals, key work meetings and care guidelines. The Annual Quality Assurance Assessment included the information that key workers hold six to eight weekly meetings with the residents, and that all staff have received training in person centred planning. Nevertheless on one file there was no evidence of reviews of the person’s placement at the home since 2005, neither could recent care planning goals and key worker notes be found. Advocates and family members are involved with the residents and, as appropriate, are asked to contribute their views to important decisions about the residents’ lives. Beatrice Road, 36 DS0000007107.V343181.R01.S.doc Version 5.2 Page 10 The managing organisation has links with a service called ‘Customer Watch’ which is a forum through which people with learning disabilities can express their views on the services provided through Choice Support (Southwark). This ensures that the opinions of service users generally are included in the overall planning of the organisation. Risk assessments addressing a number of activities which involved risk were viewed. They had all been reviewed within the last year. Residents’ personal information is stored with due regard for confidentiality. Choice Support is registered under the Data Protection Act and there is a confidentiality policy to ensure that staff handle residents’ personal information with care. Beatrice Road, 36 DS0000007107.V343181.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents take part in a range of activities which meet their needs and reflect their interests. The staff team is keen to increase the range of activities in which they take part. The meals provided are good and take account of residents’ particular needs. EVIDENCE: Activities that the residents follow in the community include using local facilities such as cafés, pubs, the library and shops. They also go to a specialist facility which provides sensory activities. Holidays have been arranged for residents. At home there are a number of resources available for each of the residents to follow activities, including a range of sensory equipment and computer games. They also have a range of videos and musical equipment to use. One of the residents has massage therapy. Specialists are to be asked advice about how to increase the range of activities in which residents take part. Beatrice Road, 36 DS0000007107.V343181.R01.S.doc Version 5.2 Page 12 Residents are helped to keep in touch with people of importance to them, by receiving visits and being accompanied by staff to attend family occasions when appropriate. The residents are given a healthy diet prepared in accordance with their needs. The evening meal being prepared on the first visit consisted of shepherd’s pie with fresh fruit salad. Staff showed awareness of the need to present meals well, to allow residents to taste the different elements of a meal and to take account of their nutritional needs. The Registered Manager stated on the AQAA that discussions with one resident’s family have begun with a view to ensuring that the menu reflects adequately his cultural background. Stocks of food showed that fresh fruit and vegetables are a regular feature of the menu. Beatrice Road, 36 DS0000007107.V343181.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. 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. As staff do not have access to care guidelines this could hamper their ability to provide consistent care in keeping with residents’ high support needs. Medication is well managed and there is good liaison with health care professionals. EVIDENCE: When one of the resident’s files were examined it was not possible to identify current care guidelines. Guidelines were seen on a file regarding the way in which an aspect of personal care was to be provided. The guidelines were not dated but indications were that they were rather old and unused. As noted above the filing system was being changed and this may have contributed to the lack of clarity. The residents require a high level of care so it was a matter of concern that current guidelines were not in place. This compromises the ability of staff to provide consistent care in keeping with residents’ wishes and needs. The staff team is mixed in terms of gender, so the three male residents can be provided with same gender care for at least a proportion of the time. There was information that showed that residents see health care professionals and appropriate referrals have been made for advice and guidance. Some of the professionals with whom the residents have contact include the GP, audiology, dental, physiotherapy, occupational therapy and speech and Beatrice Road, 36 DS0000007107.V343181.R01.S.doc Version 5.2 Page 14 language therapy services. One of the residents needs regular assistance from community nursing services and this is provided properly. Staff have received training in particular procedures relating to one resident’s needs. In circumstances when the resident is unable to give consent for medical treatment appropriate steps are taken, including holding meetings to determine the best action to take in the best interests of the resident. Family members and advocates are involved as is appropriate. The medication is safely stored. A monitored dosage system is used. The records of medication administration are completed fully and the Registered Manager checks the records and balances regularly. Homely remedies were approved by the GP in 2007. Staff have received training in the safe administration of medication, including that which requires specialist knowledge. The medication file contained a lot of documents which were dated and staff would be able to access information more easily if some of the inessential information was removed. Beatrice Road, 36 DS0000007107.V343181.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. 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The complaints and vulnerable adults procedures contribute to the protection of residents. EVIDENCE: There have been no complaints made in the last year. The complaints procedure of Choice Support meets the required standards and includes details of the timescales within which issues will be investigated. The Annual Report issued by Choice Support includes information that the organisation has conducted a thorough review of their policies, procedures and training to ensure that they are aimed at the protection of people who use their range of services. Choice Support introduced a new ‘safeguarding adults policy and procedure’ in March 2007. The judgement of the CSCI is that this is a thorough document which is clearly written and links all the aspects of safeguarding. The policy also introduces a new initiative of an internal protection committee. Staff have received training in adult protection issues. It is judged that this demonstrates that Choice Support is actively working to improve processes and practice. Staff confirmed that they have received training in adult protection issues and it is included in the induction training which new staff receive when they join the organisation. Overall the procedures for dealing with residents’ finances which are managed on their behalf by the home are safe. More detailed itemising of items of expenditure in financial records would allow more effective checking to take Beatrice Road, 36 DS0000007107.V343181.R01.S.doc Version 5.2 Page 16 place. Each item of receipted expenditure should be itemised in the financial record so that cross-referencing can take place. Information on a resident’s file showed that action had been taken to protect his financial interests. Beatrice Road, 36 DS0000007107.V343181.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The building is homely and suitable for the needs of the residents. EVIDENCE: The home is a bungalow, accessible to all of the residents. Each resident has their own bedroom which is suitable for their needs. The communal areas are a living room, a dining room and a kitchen. There is a bathroom with adaptations and a separate WC which adjoins a laundry. To the rear of the home is a garden which is attractive and accessible by residents. At the time of the inspection visit gardeners were visiting the home and tidying and tending the area. Some redecoration has been done since the inspector’s last visit to the home and this has improved conditions. The home has liaised with specialists to ensure that the residents are supplied with the equipment they need to meet their needs and assist them to maintain their independence. The home was clean and there were no offensive odours. Beatrice Road, 36 DS0000007107.V343181.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are enough well trained and supported staff to meet the residents’ needs. EVIDENCE: In addition to the team manager there are eight permanent and full time care staff, including two who work solely at night time. A new Deputy Manager has recently joined the staff team and this has increased the management input previously available to the home. A limited number of members of the Choice staff bank work at the home to cover vacancies caused by sickness and staff holidays. This allows care to be provided by people who are familiar to the residents. During the day time there are always three members of staff on duty. At night time, a member of staff is awake in the home. Additional support is available at night- time through the on-call system. Staff were observed to be relaxed and warm to residents. Of the eight care staff four have achieved NVQ or above, one is undertaking NVQ 3. This exceeds the minimum standard that at least 50 of the team, has or is working towards, NVQ 2 or above. Beatrice Road, 36 DS0000007107.V343181.R01.S.doc Version 5.2 Page 19 There is a training and development plan for the home and individual training needs are assessed through supervision and appraisal. Additional training is provided by Choice Support in a range of topics appropriate for the needs of the residents. When the staff recruitment records were last checked at the managing organisation’s head office they were in good order. As the records are kept centrally the home should ensure that a checklist confirming that appropriate checks and references have been taken up is kept in the home and available for inspection. The Registered Manager stated in the Annual Quality Assurance Assessment that he would like to improve the level of service user involvement in the recruitment process. He also recognises that the staff team does not reflect the cultural background of the residents and this was identified as an area to improve over the next year. There is a ‘debriefing’ service which staff may call if they are involved in dealing with difficult incidents. Staff receive regular supervision and attend staff meetings, systems which support them to do their jobs well. A member of the care team described the staff team as supportive and helpful. Beatrice Road, 36 DS0000007107.V343181.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42, 43. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Quality assurance and other management systems contribute to the safety of residents. EVIDENCE: The Manager of the home has been registered as Manager of this home under the Care Standards Act since February 2005. He has achieved the Registered Managers Award and NVQ level 4. The Manager is also responsible for the management of another Choice Support home in a neighbouring street. A new Deputy Manager has recently joined the staff team and this has increased the management input previously available to the home. Managers from other services make visits to the home and complete reports of their visits. Although the visits should be made monthly reports were available for four months of the previous seven. A senior manager from Choice Support arrived at the home as the inspector was leaving on the first day of inspection, so this provided evidence of the involvement of senior staff in the home. Beatrice Road, 36 DS0000007107.V343181.R01.S.doc Version 5.2 Page 21 The Directors, Managers and Trustees of Choice Support meet regularly with representatives of service users who sit on a ‘service user forum’. They are involved with reviews of policies and procedures and two people with learning disabilities are part of the organisation’s Quality Assurance sub-committee. Health and safety checks are carried out. The fire alarms are tested weekly, with the last service of the system having taken place in April 2007. Fire drills have been conducted quarterly. Gas appliances were found to be safe in July 2007 and electrical appliances in April 2007. The managing organisation, Choice Support, has a business plan from which objectives for the home have been drawn. These are centred on the further involvement of the residents in the running of the organisation, for example through Customer Watch and through taking part in staff recruitment. Beatrice Road, 36 DS0000007107.V343181.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 2 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 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 X 3 X 3 X X 3 3 Beatrice Road, 36 DS0000007107.V343181.R01.S.doc Version 5.2 Page 23 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 YA1 Regulation 4(2) 5(2) Requirement The Registered Provider must send to the CSCI copies of the reviewed service user guide and the statement of purpose when the process is complete. The Registered Provider must ensure that care planning goals and care guidelines are available, included in the care practice of the home and reviewed regularly. Timescale for action 01/12/07 2. YA6 YA18 15 01/12/07 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 YA23 Good Practice Recommendations It is recommended that each item of receipted expenditure is itemised in the financial record so that cross-referencing can take place. Beatrice Road, 36 DS0000007107.V343181.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Beatrice Road, 36 DS0000007107.V343181.R01.S.doc Version 5.2 Page 25 - 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. 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