Inspection on 15/08/06 for Bowley Close, 4

This inspection was carried out on 15th August 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bowley Close, 4 20/02/06

Bowley Close, 4 16/08/05

Bowley Close, 4 09/12/04

Bowley Close, 4 13/07/04

Bowley Close, 4 22/03/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Townley Road, 2-3

Chatsworth Care - Tudor Lodge

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

CARE HOME ADULTS 18-65 Bowley Close, 4 Farquhar Road London SE19 1SS Lead Inspector Ms Alison Pritchard Unannounced Inspection 15 August 2006 11:00 th DS0000007076.V295354.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 DS0000007076.V295354.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. DS0000007076.V295354.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bowley Close, 4 Address Farquhar Road London SE19 1SS 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 8670 2360 4bowley@choicesupport.org.uk www.choicesupport.org.uk Choice Support See standard 37 Care Home 4 Category(ies) of Learning disability (0), Learning disability over registration, with number 65 years of age (0), Mental disorder, excluding of places learning disability or dementia (0), Mental Disorder, excluding learning disability or dementia - over 65 years of age (0) DS0000007076.V295354.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 4 (four) people with learning disability and mental disorder, 1 (one) of whom may be over 65 years of age. 20th February 2006 Date of last inspection Brief Description of the Service: 4, Bowley Close is a home for four people with learning disabilities who may also have mental health problems and present behaviour which is challenging. The home is located in a cul-de-sac close to the centre of Crystal Palace. It is purpose built and it and the other homes in the close are managed by Choice Support. Each service user has a single bedroom. There are shops, sports facilities, pubs and restaurants nearby. Public transport routes are close by allowing easy access to other parts of London. The road from Bowley Close to Crystal Palace is steep and could be difficult for anyone with a mobility problem. In August 2006 there were three residents living at the home. The Manager has stated that relevant information about the home is made available in the service brochure and that is supplied to Social Services departments who may wish to refer potential residents to the home. CSCI inspection reports available to anyone who requests a copy, including social workers of current residents. The current residents pay fees each week of £32.95. Funding authorities pay the remaining costs of the placements. DS0000007076.V295354.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 a late morning and afternoon in mid- August 2006. The inspection methods included observation of care practice, a chat with a resident, discussion with staff and the Assistant Manager of the home, inspection of service user files, as well as a range of records and policy documents. Residents’ relatives and involved professionals were sent survey forms so that they could contribute to the inspection process. Responses were received from relatives. These responses have been taken into account in this report and the Inspector is grateful for the contributions. The CSCI also has access to information about the home gathered through notifications from the home. All of this information has been taken into account in compiling this report. The inspection was well facilitated by the residents and staff who were helpful and courteous throughout the process. What the service does well: What has improved since the last inspection? What they could do better: Care needs to be taken to ensure that medication procedures are safe by signing the administration recorded as soon as the medicine has been administered. The home needs to be sure that when staff meetings are held residents are not upset by the use of temporary staff who are unfamiliar with their needs. Records of complaints need to be held in the home and available for DS0000007076.V295354.R01.S.doc Version 5.2 Page 6 inspection. The current registration certificate must be displayed in a prominent place in the home. 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. DS0000007076.V295354.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 DS0000007076.V295354.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 the service. The policies and procedures for admission ensure that both the home and the potential resident have enough information to decide whether it would be an appropriate place for the person to live. EVIDENCE: The Registered Manager has stated that he would ensure that the service brochure is supplied to Social Services Departments who may wish to refer potential residents to the service. In addition the previous CSCI reports about the home would be made available to social workers. There have been no new admissions to the home for some time and none are planned. . The policy of the managing organisation is for assessments to be sought prior to admission and for introductory visits to be arranged. After admission the policy is for placements to be subject to a twelve week trial period. Each of the residents has a statement of terms and conditions on file which describes the service they will receive. DS0000007076.V295354.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, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Care planning contributes to good quality care for residents which reflects the residents’ needs and wishes and to which people of importance to the resident are invited to contribute. A risk management system contributes to safe care practices. EVIDENCE: All of the residents have care plans in place, reviews had taken place shortly before the inspection. There are a range of guidelines assist staff in taking a consistent approach to behaviour management, skills development and communication. Photographs are used effectively to ensure that the documents accessible to resident. Care is taken to listen to residents and to use communication methods which are appropriate to their needs, understanding and abilities. Relatives confirmed that they are consulted about their relatives care and kept informed about important matters affect them. An advocate is also involved with the residents DS0000007076.V295354.R01.S.doc Version 5.2 Page 10 and visits the home. She is invited to contribute to issues of importance to the residents. Risk assessments are used as part of the risk management strategy to ensure that residents are not unnecessarily restricted in their activities. 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. DS0000007076.V295354.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): 11, 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 the service. Residents are supported to take part in an appropriate range of activities both in the home and in the local community. The meals provided are nutritious and take good account of residents’ cultural needs. EVIDENCE: Care plan goals for residents included skill development and activities which reflect their interests. On the day of the inspector’s visit to the service one resident went for a walk in the local area, another went to a day centre and the third was at home and was encouraged by staff to take part in activities including music and dancing. Two of the three residents attend day centres. All of the residents go out in the local community although the involvement of one person is rather more limited than the others. This resident has a well developed activity programme at home. The activities include household tasks such as cookery and laundry and leisure such as art, crafts and music. There is a photographic communication DS0000007076.V295354.R01.S.doc Version 5.2 Page 12 system used by this resident so that choices may be made within the range of activities available. The home has a well equipped sensory room on the first floor and this is enjoyed by residents. Arrangements were being made for a resident to go on a day trip to Paris with staff. Visitors are able to visit the home at reasonable times without prior arrangement. Relatives confirmed that they are welcomed to the home. The only private space available is residents’ bedrooms, otherwise communal space is used by visitors. Residents do not have keys to their rooms as it is judged that none would be able to use keys effectively. The residents have free access around the communal area of the home. The routines of the home are flexible and are focussed on the residents’ needs. Staff showed respect to residents in their interaction with them. Observation confirmed that residents are able to choose to spend time alone if they wish and staff will respect their privacy. Staff ensure that residents are supported to behave in a manner appropriate to the situation. The menu record and food stocks showed that the range of food provided is varied and nutritious. The menu includes fresh fruit and vegetables as well as culturally appropriate meals. DS0000007076.V295354.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, 21 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents benefit from the attention which is paid to their physical, medical and emotional needs and the involvement of a range of professionals in determining the best way to support them. Care notes should be signed by staff. One error was seen in relation to record keeping about the administration of medication. Otherwise medication was well managed. Work is underway to review to policy relating to the ageing of residents and how the home will respond to increased needs. EVIDENCE: There are a range of professionals involved with residents in accordance with their particular needs. They contribute to the care planning process which determines how the residents’ care will be provided to take account of their needs. For example a review of a resident’s care plan was arranged for a few days after the inspection visit. As well as family members and staff from the home, professionals from a range of health care disciplines were invited. These included a challenging behaviour specialist, speech and language therapist, psychiatric specialists and social work staff. DS0000007076.V295354.R01.S.doc Version 5.2 Page 14 Daily notes are kept on each residents’ progress and activities. The notes are full and detailed but staff must be sure to sign all of the entries. One of the residents does not respond well to being cared for by unfamiliar people. This was the case during a recent staff meeting when temporary staff were responsible for his care and he became distressed as a result. The Registered Person must consider how to resolve this situation so that it does not recur. None of the residents are able to self medicate so this aspect of residents’ care is looked after by the home. The medication is stored safely. The medication administration records were generally in good order but one item of medication given the previous evening had not been signed for. This error was corrected during the inspection after the deputy manager followed up the matter. At the last inspection it was required that there is a policy and procedures to cover illness, death and dying. At this visit the inspector was informed that the policy regarding ‘what to do in the event of a death’ is to be reviewed to include the matters specified in the standard. DS0000007076.V295354.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The residents benefit from appropriate arrangements for dealing with complaints and protection from abuse. Records of complaints must be maintained in the home. EVIDENCE: The complaints procedure of the managing organisation meets the standards required. There have been two recent complaints about the home and the inspector was assured that the managing organisation had taken action in relation to them. Nevertheless these were not recorded in the complaints record held at the home. It is recommended that relatives of residents are supplied with copies of the complaints procedure as it is sometime since these were distributed. There have been no matters requiring investigation under the adult protection procedures. In November 2005 the staff team received training in the operation of the procedure. A new member of staff confirmed that his induction to the home included details of the vulnerable adults and whistle-blowing policies and procedures. There are safe procedures for dealing with residents’ finances. The procedures ensure that there is clarity about who is responsible for valuables held on behalf of residents. DS0000007076.V295354.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, 25, 27, 28, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Overall the home is clean, homely and suitable for the needs of the residents, however the first floor bathroom should be redecorated. EVIDENCE: The home is purpose built and suitable for its purpose. It is comfortable and homely and generally in a good state of repair. Residents each have their own bedroom which can be personalised as they and their family wish. There is also ample communal space including a sensory room. There are sufficient bathrooms and toilet but the first floor bathroom needs to be redecorated. The home was clean throughout. DS0000007076.V295354.R01.S.doc Version 5.2 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): 31, 32, 33, 35, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. There are sufficient numbers of trained staff to meet residents’ needs. EVIDENCE: In addition to the team manager and deputy manager there are eight full time care staff, two of whom work solely at night time. This allows for ‘one to one’ staffing to be provided at all times of the waking day, and the rota is arranged to ensure that both male and female staff are on duty so that residents’ personal care needs can be attended to. At night time, one member of staff is awake in the home. Additional support is available at night- time through the on-call system. The recruitment records were not inspected on this occasion but were seen by the inspector in August 2005. At that time the records were in good order. Staff are given copies of the GSCC Code of Conduct and the Choice Support Code of Conduct is compliant with that document. During the inspection a member of staff who had transferred from another home managed by Choice Support was being introduced to the service. He was additional to the minimum numbers of staff and given the opportunity to read files and get to know the residents of the home. He had been given a full DS0000007076.V295354.R01.S.doc Version 5.2 Page 18 induction to the home by the manager according to the induction format of Choice Support. Four members of care staff have achieved NVQ 2 or above. Over the last year staff have received training in a range of issues relevant to the residents’ needs including: • dealing with challenging behaviour; • person centred care planning; • healthy eating; • diffusion techniques; • communication and • report writing. Senior staff responsible for supervision have received training in supervision techniques and all staff receive supervision at approximately six weekly intervals. Team meetings are held at similar intervals and are another forum for support. DS0000007076.V295354.R01.S.doc Version 5.2 Page 19 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, 38, 39, 40, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. There are good management systems in the home, monitoring of the quality of care and health and safety systems are well managed. The current registration certificate must be displayed in a prominent place in the home. EVIDENCE: The manager of the home has been in post since January 2006. An application to the CSCI for registration under the Care Standards Act 2000 has been submitted. The indications of the inspection are that management arrangements are good and that staff are supported in their work. Managers visit each month on behalf of the registered provider, they visit on an unannounced basis and include discussion with staff in the visit. The reports of the visits are sent to the CSCI. The service manager is also a regular visitor. All of these systems contribute to the quality monitoring systems. DS0000007076.V295354.R01.S.doc Version 5.2 Page 20 The registration certificate displayed in the hallway is out of date as it shows the name of the previously registered manager. It must be replaced by the current certificate for the home which was displayed in the office. Health and safety records were up to date and in good order. The fire safety risk assessment was done in February 2005 and includes provision for regular checks of the system and fire drills, all of which are carried out. Health and safety checks are carried out each week and are documented. DS0000007076.V295354.R01.S.doc Version 5.2 Page 21 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 2 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 2 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 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 2 2 3 X 3 2 X 3 X DS0000007076.V295354.R01.S.doc Version 5.2 Page 22 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 YA21 Timescale for action 12(1)(a)(b) The Registered Person must 01/01/07 4(a)(b) ensure there is a policy and procedures to cover illness, death and dying. The inspector was informed that the policy regarding ‘what to do in the event of a death’ is to be reviewed to include the matters specified in the standard. The date for compliance has been amended to reflect this. 2. YA18 18(1)(b) The Registered Person must 15/09/06 ensure that the use of temporary staff does not have an adverse effect on residents. The Registered Person must 15/09/06 ensure that staff sign to confirm the administration of medication at the time it is administered. The Registered Person must 15/09/06 ensure that the complaints record held at the home includes details of complaints made, any investigation and action taken to resolve the matter. Regulation Requirement 3. YA20 13(2) 4. YA22 17(1)(a) sch4 para 11 DS0000007076.V295354.R01.S.doc Version 5.2 Page 23 5. YA40 CSA s28(1) The Registered Person must 15/09/06 ensure that the current registration certificate is displayed in a prominent place in the home. 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 YA27 Good Practice Recommendations It is recommended that the Registered Person should consider how the first floor bathroom could be made more homely and welcoming. A resident has been assisted to add some art work to the room, however the room is in need of redecoration and as a result this recommendation is withdrawn and replaced by recommendation 2 below. 2. 3. 4. YA27 YA18 YA22 The Registered Person should include the redecoration of the first floor bathroom in the redecoration schedule for the current year. The Registered Person should ensure that the daily notes of residents’ progress and activities are signed by staff making the entry. The Registered Person should ensure that relatives of residents are supplied with copies of the complaints procedure as it is some time since these were distributed DS0000007076.V295354.R01.S.doc Version 5.2 Page 24 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. Extracts may not be used or reproduced without the express permission of CSCI DS0000007076.V295354.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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