Inspection on 06/10/05 for Bowley Close, 5

This inspection was carried out on 6th October 2005.

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

The inspector found 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 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bowley Close, 5 24/07/06

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 Lynn Hampton Unannounced Inspection 6th October 2005 08.20 Bowley Close, 5 DS0000007064.V256377.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bowley Close, 5 DS0000007064.V256377.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bowley Close, 5 DS0000007064.V256377.R01.S.doc Version 5.0 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 *** Post Vacant *** Care Home 4 Category(ies) of Learning disability (0), Learning disability over registration, with number 65 years of age (0) of places Bowley Close, 5 DS0000007064.V256377.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 4 people with learning disability , one of whom may be over 65 years of age 21st June 2005 Date of last inspection Brief Description of the Service: 5 Bowley Close is a purpose built bungalow located in a quiet cul-de-sac close to the centre of Crystal Palace. There are several other care homes grouped together in the close, which opened in 1989. All are managed by a voluntary organisation, Choice Support. The home is near local facilities, including shops, cafes, pubs, a park and a sports centre. There are excellent local transport links, and the Close benefits from free on street parking for visitors. However, the locality is very hilly, which can make pedestrian travel difficult for older people and/or people with mobility problems. The home aims to provide a comfortable, homely atmosphere in a safe and clean environment. Each service user has their own bedroom, and shares communal facilities. The stated aims of the service are to provide support and accommodation to four adults with learning and physical disabilities, who may have little or no verbal communication skills. At the time of this inspection, there were three male and one female service users. Bowley Close, 5 DS0000007064.V256377.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place in the early part of a Thursday morning, 6th October 2005. During the visit the inspector met two care staff, the home’s manager and a Service Manager from Choice Support who visited briefly. A range of documents were examined and a tour of the building took place. The inspector met and spent time with all four residents, most of whom were getting up and having breakfast. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Bowley Close, 5 DS0000007064.V256377.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bowley Close, 5 DS0000007064.V256377.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): N/A These standards were not assessed at this inspection. The finding of the previous inspection was that the standards were met. EVIDENCE: Bowley Close, 5 DS0000007064.V256377.R01.S.doc Version 5.0 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 8 Service users have individual plans that reflect their needs and personal goals. However, documentation at the home would benefit from clarification and simplification. EVIDENCE: It was noted in the report of the last inspection (June 2005), that the home maintains several different case files on each service user, in addition to planning sheets, diaries, activity planners and other recording documentation. While these records show that users are consulted about, and involved in developing their individual plans, it was confusing to have so many different files, and sometimes difficult to locate specific information. Some documents did not always tally with each other, and some were not fully completed or dated. A Requirement was made for documentation to be signed and dated, and a Recommendation made that the paperwork systems be reviewed. Progress in this was discussed with the manager. Improvements have been made to the system, and it was found that case files had been tidied and put in date order. However, there continued to be discrepancies between records of activities, and some gaps in recording. Bowley Close, 5 DS0000007064.V256377.R01.S.doc Version 5.0 Page 9 Choice Support has implemented a standard system of recording throughout all of their care homes, and individual homes will not be able to make major changes individually. Therefore, the Previous Recommendation is discontinued, and a new Requirement made that Choice Support review the systems in place to ensure that they support the care planning process, and promote quality of service delivery appropriate to each individual home. Bowley Close, 5 DS0000007064.V256377.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 Service users have individual programmes of activities in place, that reflect their interests, are culturally appropriate, and which support them to maintain relationships with family and within the community. EVIDENCE: Staff were able to describe how they support service users to engage in appropriate activities and keep in touch with family. One service user is visited by her sister (who lives in Canada) once a year. The manager is actively looking for more culturally appropriate services in the community that service users can link up with. Care planning and review records showed that service users are consulted as much as possible, and that participation in planned activity is recorded and monitored. During this inspection, a phone call was received from the Day Centre attended by two residents, giving very short notice of cancellation. It was reported that this happens quite often. Identifying other resources and options would be helpful to the service users, to give them choices should they be unable to attend this Day Centre. Bowley Close, 5 DS0000007064.V256377.R01.S.doc Version 5.0 Page 11 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, 20 Service users receive personal care in the way that they prefer and require. Medication procedures are in the process of being changed, and the manager must ensure that this does not compromise service user care. EVIDENCE: Staff were seen to talk to service users with respect, and permanent staff were aware of their routines and how to communicate with them. One member of staff was covering a shift on Bank. She was able to give same-gender personal care to the female resident, and it was reported that same gender care was promoted wherever possible for male and female residents. The permanent member of staff and manager spoke about what efforts were being made to communicate with a resident who was from Cyprus. This included learning words of Greek, and also trying to identify culturally appropriate services. Staff were also seen to use Makaton (sign language) where appropriate. The Bank staff was usually based at another Choice Support home, and was unsure about the timetable of activities for a service user (see also comments in Staffing). Bowley Close, 5 DS0000007064.V256377.R01.S.doc Version 5.0 Page 12 Administration of medication was not observed during this inspection, but the Service Manager arrived at the home to follow up on an incident that had occurred. The home is changing over its medication system to one where the medication comes in a pre-packed dispenser. It was reported that the last tablets of a box of medication were administered by a member of staff, without there being further supplies in the home. This meant that it was not realised until the next medication time that there was no supply in the home to be able to administer the resident their medication. The GP was contacted for advice, and supplies obtained at the earliest opportunity. The Service Manager visited the home to discuss with the manager and ensure that all appropriate action had been taken. The manager was sure that the situation would not recur, as the new monitored dosage system would soon be fully in place, and described to the inspector the action that had been taken to redress the situation, and ensure that no further lapse occurred. Medication administration and recording will be more closely inspected at the next inspection visit. Bowley Close, 5 DS0000007064.V256377.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Systems are in place to protect service users from abuse. EVIDENCE: Choice Support has an Adult Procedure in place and notifies the Commission and social services of any incidents, although none have occurred relating to 5 Bowley Close. The report of the previous inspection noted that one complaint had been appropriately responded to, and no further complaints have been received since that time. All service users have access to Advocacy services. Bowley Close, 5 DS0000007064.V256377.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 29, 30 Service users live in a comfortable, safe and clean environment, and their bedrooms suit their lifestyle. The lounge is having new fittings, but could be made more homely. Repairs have been undertaken, but there are still other repairs and replacements needed throughout the home. EVIDENCE: The inspector was shown around the home by a service user and a member of staff, with individual service users showing their bedrooms. Each bedroom is decorated to reflect the interests and tastes of the service user, and most were full of photographs or equipment relating to their hobbies. One room had a small lounge area partitioned off from the bed, which was particularly homely and looked very comfortable. The inspector was told that one resident had asked to redecorate his room with blue paint (his favourite colour). This was being very well planned, so that he would be able to take part as much as possible in the redecoration, but without having to move out of the room. Residents are able to choose a bed to suit their preferences, including double beds. One person disliked sleeping on a standard bed, and so had a futon that was nearer the floor. Bowley Close, 5 DS0000007064.V256377.R01.S.doc Version 5.0 Page 15 One service user has his room more sparsely decorated due to his needs. There was no mirror at the time of this inspection, but the workmen who were on site at the time were going to fit one. He had an album of photographs available, but no pictures or photo frames on the wall. The curtains in his room were secured by Velcro, to prevent them from being damaged or from causing harm when pulled from the window. However, the Velcro wasn’t sturdy enough, and the curtains tended to come away easily when touched (See Requirements). The window in this user’s room was also not working properly - it would not stay open and the room smelt musty due to the poor ventilation. The manager reported that this was going to be repaired by the workmen on site that day. There was adequate communal space in the home – a laundry room; a bathroom/toilet; a shower/toilet, and a further separate toilet in the hallway. However, these were all showing signs of wear and tear. The linoleum in these rooms was beginning to lift at corners and edges, which may trap germs or become a hazard. This should be assessed and arrangements made for linoleum to be cleaned, repaired or replaced as appropriate. The seat in the shower room was worn and parts were rusty. This should be replaced. A dripping tap in the bath needs to be repaired. Cupboards in the laundry room and kitchen were also showing signs of wear. This is particularly an issue in the kitchen, as staff are trying to enable residents to be more involved in food preparation and other domestic tasks. Several cupboards showed signs of having been repaired several times, and one drawer front was broken. This should be repaired and consideration given to upgrading fittings in the home to meet the needs of the service users. Storage is limited in the kitchen due to space being taken with adjustable work surfaces (needed to assist users in wheelchairs who work in the kitchen). This should be reviewed as part of consideration of a refit. The adjustable work surface was reported to be not working at the time of the inspection, and needs to be repaired. A Requirement from the last inspection, regarding the kitchen sink was being addressed by workmen on site during the inspection. The home has a large communal lounge, with a television and music centre. This is sparsely decorated, with two 2-seater sofas that would not comfortably accommodate all service users. The manager reported that the carpets, curtains and sofas in the lounge were being replaced and new fittings were on order. This will be beneficial for users, but consideration should also be given to making the room more homely. Appropriate decoration, or ornaments that could be securely attached to the walls (if necessary) would make the area more domestic in style. The garden was neat and tidy, although the manager reported that she had requested for an area to be cleared to allow them to grow herbs and vegetables, as one service user had enjoyed doing this at a Day Centre. This is to be commended. Bowley Close, 5 DS0000007064.V256377.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 35 Service users are supported by an effective permanent staff team. However, continuing problems in covering vacancies can undermine consistency or quality of care in the home, or lead to staff working excessive hours to cover gaps in the rota. EVIDENCE: The report of the last inspection, in June 2005, highlighted that long-standing staff vacancies had been filled, and a Requirement about this had been met. However, the staff rota was examined during this inspection and it was found that there was one vacancy that was being covered mainly by members of the permanent staff team. The manager was rostered to work three extra 5-hour shifts, which meant that she was working a total of 50 hours a week. Although the manager was rostered to have two complete rest days, these were not consecutive. This could lead to fatigue. The manager reported that one permanent member of the day staff had moved to work nights, and another had reduced their hours. She outlined difficulties experienced in getting regular Bank cover, as the Bank Co-ordinator is off on long-term sick. This can mean that different Bank staff work occasional shifts and don’t build up knowledge of the residents to promote continuity of care. Bowley Close, 5 DS0000007064.V256377.R01.S.doc Version 5.0 Page 17 For example, staff at the home had been taught by Occupational Therapists to work with one service user in doing movement exercises, which temporary staff would not be able to do. It was also reported that there were problems in getting staff who could drive, which was often necessary as residents rely on this to be able to attend activities. These matters must be addressed as a matter of urgency by the organisation. The home has a Waking Night staff, to meet the needs of the service users. One person chooses to get up at 5 a.m., and the Waking Night staff is available to support him with personal care and breakfast. For clarity, the hours of the Waking Night staff should be shown on the rota using the 24-hour clock, or highlighted separately to distinguish it from the day staff hours. The rota showed that changes had been made using correction fluid (Tippex). This must not be used, and corrections are to be made in ink in future. Bowley Close, 5 DS0000007064.V256377.R01.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, 39 The service users benefit from a well run home, which is user-led. The application for registration of the manager is outstanding. EVIDENCE: The manager at the home has been in post for some time, but is not yet registered by the Commission. Although an application had been submitted, this had gone astray. The manager contacted the Commission following the inspection and confirmed that a new application form had been received, and was to be submitted without delay. A Requirement made in the report of the last inspection visit, regarding this matter, remains in force. The Service Manager visits the home regularly to monitor the quality of the service, and was at the home to ensure that an incident had been responded to appropriately (see Personal and Health Care Support, above). This system of supervision is good practice. Bowley Close, 5 DS0000007064.V256377.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X 2 X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 2 X 2 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 2 X 2 x CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Bowley Close, 5 Score 3 X 2 X Standard No 37 38 39 40 41 42 43 Score 2 X 3 X X X X DS0000007064.V256377.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes 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)(2) Requirement Timescale for action 01/05/06 2 YA26 3 YA27 The Registered Person must, in consultation with care managers, review record-keeping and documentation used for care planning in Choice Support homes. The outcome of the review, with timescales for any action to be implemented, to be notified to CSCI in writing. 16(2)c The Registered Person must 01/05/06 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. 23(2)b,c,d The Registered Person must 01/02/06 address the following repairs: • Replace seat in the shower room. • Repair dripping tap in bathroom • Repair broken drawer front and 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. DS0000007064.V256377.R01.S.doc Version 5.0 Bowley Close, 5 Page 21 4 YA28 5 YA28 6 YA33 7 YA33 8 YA35 9 YA37 23(2)b,c,d The Registered Person must give 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. 16(2)c The Registered Person must give consideration to making the lounge more homely, with appropriate decoration, or ornaments that could be securely attached to the walls (if necessary). 18(1)a&b The Registered Person must ensure that action is taken to recruit staff to cover vacancies, and to ensure that regular Bank cover is readily available to provide temporary cover where necessary. 17(2) The Registered Person must Schedule ensure that the duty roster 4 clearly indicates which staff are doing Night Wake shifts, and that correction fluid is not used. 18(1)a The Registered Person must review whether further action can be taken to ensure that there are staff on duty who can and will undertake driving of service users, where this promotes and enhances users care. The outcome of this review, with timescales for any action to be taken, is to be submitted to the CSCI in writing. 8 The Registered Person must ensure that the application for manager registration is facilitated as speedily as possible. The previous timescale of 30th September 2005 is unmet. 01/05/06 01/05/06 01/12/06 01/12/06 01/02/06 01/02/06 Bowley Close, 5 DS0000007064.V256377.R01.S.doc Version 5.0 Page 22 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 Bowley Close, 5 DS0000007064.V256377.R01.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. Extracts may not be used or reproduced without the express permission of CSCI Bowley Close, 5 DS0000007064.V256377.R01.S.doc Version 5.0 Page 24 - 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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