Inspection on 24/07/06 for Bowley Close, 5

This inspection was carried out on 24th July 2006.

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 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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bowley Close, 5 06/10/05

Bowley Close, 5 21/06/05

Bowley Close, 5 18/01/05

Bowley Close, 5 19/08/04

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 Bowley Close, 5 Farquhar Road London SE19 1SS Lead Inspector Ms Alison Pritchard Unannounced Inspection 24th July 2006 1.30pm DS0000007064.V299344.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 DS0000007064.V299344.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. DS0000007064.V299344.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bowley Close, 5 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) 0208 670 8662 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) of places DS0000007064.V299344.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 4 people with learning disability , one of whom may be over 65 years of age 6th October 2005 Date of last inspection Brief Description of the Service: The aims and objectives of the home are to provide support and accommodation to four adults with learning and physical disabilities who may have little or no verbal communication skills. It is a purpose built bungalow located in a cul de sac close to the centre of Crystal Palace. It opened in 1989. There are several other care homes grouped together in the close, all of which are managed by Choice Support. The home aims to provide a comfortable, homely atmosphere in a safe and clean environment. The home is close to local facilities such as shops, cafes, pubs, a park and a sports centre. Public transport routes are also close by. The close is situated off the side of a steep hill, making pedestrian travel for wheelchair users and people with limited mobility difficult. At the time of the inspection there were no vacancies in the home. Information on the scale of charges and how information about the home is given to potential residents was requested but not received by the CSCI. DS0000007064.V299344.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 an afternoon and early evening in late July 2006. The inspection methods included observation of care practice, chatting with one resident, discussion with staff and the Registered Manager of the home, inspection of service user and staff 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 two relatives and a health care professional. 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, staff and the Manager of the home 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: Some repairs to the building remain outstanding. There are some vacancies on the staff team which need to be recruited to, to ensure consistency of care for the residents. DS0000007064.V299344.R01.S.doc Version 5.2 Page 6 Although the management arrangements have been suitable there has not been a manager who has been registered under the Care Standards Act for a long time. 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. DS0000007064.V299344.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 DS0000007064.V299344.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 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: Each resident has an individually written service user guide which describes the service they will receive. The document uses photographs, plain English and symbols. There have been no new admissions to the home for a significant period. 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. DS0000007064.V299344.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. EVIDENCE: The home is introducing person centred planning as a model for the care planning for residents. The care plans are individualised and accessible to residents through the use of plain English, photographs and symbols. There are clear and useful guidelines to describe how staff should best support residents with activities and care practices. The key worker and the manager of the home meet regularly with the resident to discuss their goals and how they might be achieved. Risk assessments are in place to cover a range of activities and behaviours. They are regularly reviewed and appropriate for the residents’ needs. 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. DS0000007064.V299344.R01.S.doc Version 5.2 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): 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 n appropriate range of activities both in the home and in the local community. The meals provided are healthy and reflect residents’ preferences and needs. EVIDENCE: The residents follow a range of activities which reflect their needs and interests and allow them to have access to community resources. These activities include line dancing, shopping, attending social clubs, day centres, and a café project. Two of the residents attend a day centre which is appropriate to their cultural needs. Care plans include careful assessment of the residents’ cultural needs and a range of activities are devised to meet them. The home has worked hard to successfully introduce one of the residents to a range of activities in the community, this has significantly improved the quality of his life. There are four drivers on the staff team so this assists residents to access community facilities. Within the home activities include art-work, television, DS0000007064.V299344.R01.S.doc Version 5.2 Page 11 dancing and cookery. Arrangements were being made for holidays for residents. Relatives who visit the home confirmed that they are welcomed and able to see their relatives privately. The routines of the home are flexible and are focussed on the residents’ needs. Staff showed respect to residents, calmness and good humour 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. Residents have easy access around the home and the garden. The menu records showed that residents are provided with a range of meals which are nutritious, reflect their preferences and their cultural needs. DS0000007064.V299344.R01.S.doc Version 5.2 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, 20, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents benefit from the careful attention which is paid to the physical, medical and emotional needs. EVIDENCE: The care planning system involves involvement of the residents in determining how their care will be provided. An advocate is involved with the residents and is a regular visitor to the home. She is invited to contribute to issues of importance to the residents. One of the residents was unwell at the time of the inspection. Appropriate medical assistance had been sought and the manager was diligent in ensuring that the resident was given the necessary support from medical services. One of the residents has been supported by staff to deal with a bereavement. The home has good relationships with health care professional involved with the residents and this is of benefit to them. Members of the multi-disciplinary team which focuses on the needs of people with learning disabilities are involved with the home and offer specialist support and advice. When residents need a medical procedure for which they are unable to give informed consent DS0000007064.V299344.R01.S.doc Version 5.2 Page 13 the home arranges best interests meetings so that people involved with their care can contribute their views to the decision. 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 supplying pharmacy carried out a check of the medication arrangements in February 2006 and the Primary Care Trust did a check in November 2004. There are few medication errors in the home and overall the records and stocks showed that medication is managed well. The manager has written guidelines for reference so staff know how to deal with residents’ medication appropriately. DS0000007064.V299344.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The residents benefit from appropriate arrangements for dealing with complaints and the protection of residents. EVIDENCE: The complaints procedure of the managing organisation meets the standards required. There have been no recent complaints about the home and the care provided. 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. The staff team training in the operation of the procedure arranged. 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. Six monthly audits of the home’s finances are conducted. DS0000007064.V299344.R01.S.doc Version 5.2 Page 15 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, 26, 27, 28, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. There are a number of matters relating to the building which have needed improvement for some time. EVIDENCE: The home is located in a purpose built bungalow which is accessible to all of the residents. The building was cleaned to a satisfactory standard. The communal space consists of a living room / dining room which is adequate in size for the numbers and needs of residents. The room is decorated well in a homely manner with photographs, plants and pictures. The kitchen is in need of refurbishment. Each of the bedrooms is single and key workers assist residents to make their personal space homely and appropriate to their needs. One of the bedrooms is less personalised and the reasons for this were clear. Consideration should be given to how the room may be personalised without presenting risks to the resident. Some of the previous requirements relating to improvements required to the building were not met and remain in place – see below. DS0000007064.V299344.R01.S.doc Version 5.2 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): 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 staff on duty in sufficient numbers to meet residents’ needs. However as there are three vacancies on the staff team this is only achieved through the use of bank staff and permanent workers working additional hours. EVIDENCE: On the day of the inspection the manager of the home was working between 9.30am and 5.30pm. There were three care staff on duty during the morning until the mid-afternoon and two staff on duty in the evening. One member of staff is awake and on duty overnight. Arrangements were being made for an additional member of staff to work during the evening in response to one resident being unwell and needing additional attention. At the time of the inspection there were three vacancies on the staff team – one for a deputy manager and two for care staff. These vacancies are covered by bank staff and members of the permanent team working additional hours. The use of temporary staff can be unsettling for the residents. It is required that the plans for recruitment to the vacant posts are sent to the CSCI. DS0000007064.V299344.R01.S.doc Version 5.2 Page 17 The recruitment records were not inspected on this occasion but at that time were in good order. The manager said that it is hoped that one of the residents will be able to become involved in staff recruitment. Five members of care staff have achieved NVQ 2 or above and two others are due to begin the training in September 2006. There is a training and development plan for the home. It covers a good range of topics relevant to the residents’ needs. Staff confirmed that they regularly receive supervision from the manager of the home. Staff meetings are held at regular intervals and provide a forum for discussion of residents’ needs and organisational developments. DS0000007064.V299344.R01.S.doc Version 5.2 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, 38, 39, 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Although the management arrangements are suitable the home has not had a registered manager for a long time. There are good arrangements to monitor the quality of care in the home. EVIDENCE: Although the manager has been in post for two years there have been delays in the submission of an application for registration under the Care Standards Act. During the inspection the manager received a document which completed the application and this was submitted to the CSCI. However since the inspection the inspector has been informed that the manager is transferring to another post within Choice Support. The service manager has provided information that the two management posts in the home are being recruited to, and there will be appropriate arrangements for the handing over of information to ensure consistency for the residents. DS0000007064.V299344.R01.S.doc Version 5.2 Page 19 The indications of the inspection were that management arrangements were good and that staff are supported in their work. The service manager is involved with the home and provides support. Although the service manager was unavailable on the day of the inspection the manager had been in contact with another service manager to liaise with him about the arrangements for dealing with the ill health of one of the residents. 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. Spot checks are carried out by senior managers on a quarterly basis. The service manager is also a regular visitor. All of these systems contribute to the quality monitoring systems. Regular health and safety checks are conducted in the home. During a tour of the home some paint was found to be stored in an electrical cupboard. This could present a risk and a staff member moved it to amore appropriate place. Two matters relating to food storage need to be improved. Fresh food frozen after purchase had not been labelled with the date of freezing. An open tin of evaporated milk was stored in the refrigerator. The manager of the home was informed about these matters during the inspection and she agreed to address them with staff. There is a business plan for Choice Support and a copy of this is available along with information about how the ten identified goals in the plan relate to this house. DS0000007064.V299344.R01.S.doc Version 5.2 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 Standard No Score 1 3 2 3 3 X 4 3 5 X 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 2 25 3 26 2 27 2 28 2 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 2 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 3 3 3 X 3 3 3 X X 2 3 DS0000007064.V299344.R01.S.doc Version 5.2 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 YA26 Regulation 16(2)c Timescale for action The Registered Person must 01/10/06 ensure that more suitable curtain fixings are supplied in one service user’s bedroom, and that consideration is given to finding appropriate decoration to make the room more homely. Progress has been made towards meeting this requirement. The target date has been extended to allow further time for the requirement to be met. compliance. 2. YA27 23(2)b,c,d The Registered Person must address the following repairs: • Replace seat in the shower room. • Repair the adjustable work surface in the kitchen • The condition of the linoleum is to be assessed and arrangements made for it to be cleaned, repaired or replaced as appropriate. Progress has been made towards meeting this requirement but the DS0000007064.V299344.R01.S.doc Version 5.2 Page 22 Requirement 01/10/06 above matters remain outstanding. The target date has been extended to allow further time for the requirement to be met. 3. YA28 23(2)b,c,d The Registered Person must give 01/10/06 review the suitability of the kitchen, its fittings and storage, to ensure that it meets the needs of the service users. The outcome of this review, with timescales for any action to be taken, is to be submitted to the CSCI in writing. The Housing Association has assessed the suitability of the kitchen but CSCI has not been informed of the outcome. This remains outstanding and a new date for compliance is set. 4. YA33 18(1)a&b The Registered Person must 01/10/06 ensure that action is taken to recruit staff to cover vacancies. Progress has been made towards meeting this requirement but the above matter remains outstanding. The target date has been extended to allow further time for the requirement to be met. 5. YA26 23(2)(b) The Registered Person must 01/01/07 ensure that the linoleum around the basin area in one bedroom is replaced. The Registered Person must 01/09/06 ensure that food hygiene standard are improved by: • Fresh food which is frozen after purchase is labelled with the date of freezing. • Ensuring that food is not stored in the refrigerator in open cans. DS0000007064.V299344.R01.S.doc Version 5.2 Page 23 6. YA42 16(2)(g) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000007064.V299344.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 DS0000007064.V299344.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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