Inspection on 21/06/05 for Bowley Close, 6

This inspection was carried out on 21st June 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Bowley Close, 6 26/10/05

Bowley Close, 6 14/01/05

Bowley Close, 6 22/07/04

Bowley Close, 6 22/03/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 6 Bowley Close 6 Bowley Close Farquhar Road London SE19 1SS Lead Inspector Rossella Volpi Unannounced 21st June 2005 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 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 Stationary 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. 6 Bowley Close G52 G02 7065 6 Bowley 234728 210605 Stage 2 uiv.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 6 Bowley close Address 6 Bowley Close, Farquhar Road, SE19 1SS Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Category(ies) of registration, with number of places 0208 670 8432 Choice Support Care Home 4 6 Bowley Close G52 G02 7065 6 Bowley 234728 210605 Stage 2 uiv.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14/1/2005 Brief Description of the Service: 6 Bowley Close is a care home for a maximum of four adults with learning and physical disabilities, who might also have other support needs, including limited verbal communication. The home is intended to be for long term placements and in recent years all the residents have been men. The overall aim is that of providing care and support to enable service users to continue to make informed choices about the service they want and their life, thus enabling fulfilling experiences. The home aims to achieve this by ensuring a thorough assessment of needs and aspirations and a service delivered by experienced staff, in collaboration with external agencies. The provider is an organisation named: ‘Choice Support’. The day-to-day running of the home is delegated to a care manager. The home is one of a group of homes, adjacent to each other, all run by Choice Support. The premises are a purpose built bungalow located in a cul-de-sac, a short distance from Crystal Palace Parade. They are situated at the bottom of a steep hill and this would present problems for people with mobility difficulties. The area has local amenities, a large park and public transport. 6 Bowley Close G52 G02 7065 6 Bowley 234728 210605 Stage 2 uiv.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and consisted of two visits conducted on 21 June 2005, during the afternoon and evening. The first visit was brief and involved mainly observation of lunch being served. The second visit (from about 5 to 8 pm) included discussion with staff (the manager and the two care workers present) and inspection of records. It was not possible to communicate with the residents directly on this occasion and therefore this report cannot incorporate their views. Emphasis was given, however, during the inspection to general observation of what was happening and of the interaction between staff and residents. Not all core standards were inspected on this occasion, but priority was given to following up those areas where requirements or recommendations had been made at the previous visit. This included medications, complaints, premises and food hygiene. It is intended that, during the course of the inspection year (April 2005 to March 2006) all core standards would be inspected. What the service does well: Residents’ needs, aspirations and how to achieve them were assessed and regularly reviewed, thus enabling the home to offer appropriate care and support to the residents. Although the residents’ views could not be ascertained, from direct observation of residents being supported with meals and other activities, it was evident that they were treated with respect, that staff were attentive and that the interaction between staff and residents was relaxed. The manager said that he was proud of the staff team and considered that they had the right mix of skills and experience. Staff said that they felt well supported by the manager and each other, informed and stimulated. Residents were supported to access local facilities, maintain family links and take part in leisure activities, such as shopping, visiting local pubs and restaurants, attending church, hydrotherapy sessions, walks in the park, car drives etc. Staff used different methods of communication, usually under the guidance of a speech therapist, to both ascertain preferences and to remind residents of what had been planned for the day. The menu showed that a range of food was provided, based on staff’s knowledge of residents’ likes and dislikes and their dietary needs. Staff were clear of their responsibilities in supporting complaints, or initiating them on behalf of the residents. They discussed how they kept vigilant to prevent or detect any signs of possible abuse. This was backed by training. The home was well maintained, clean and personalised. 6 Bowley Close G52 G02 7065 6 Bowley 234728 210605 Stage 2 uiv.doc Version 1.30 Page 6 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. 6 Bowley Close G52 G02 7065 6 Bowley 234728 210605 Stage 2 uiv.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection 6 Bowley Close G52 G02 7065 6 Bowley 234728 210605 Stage 2 uiv.doc Version 1.30 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 standard(s) 2 The home understood the importance of (and was committed to) a full assessment of residents’ needs and aspirations. This would therefore enable appropriate care and support, to meet residents’ individual needs. EVIDENCE: All the current residents had been at the home for several years and therefore there were no recent assessments of prospective residents. It was discussed with the manager and staff how they ensured that they could meet the aims of the service and the needs of individual residents. The discussion gave evidence that the home continued to consider individual needs assessment as fundamental to ensure that the home could deliver the service expected. The manager was clear that the assessment would involve all significant people, including the prospective resident, their family or advocate (if appropriate) and social care or health professionals external to the home. These principles would also apply should a major review of needs of existing residents become necessary. 6 Bowley Close G52 G02 7065 6 Bowley 234728 210605 Stage 2 uiv.doc Version 1.30 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 standard(s) 6 There were individual care plans in place. Needs, aspirations and how to achieve them were recorded and regularly reviewed, thus enabling the home to offer appropriate care and support to the residents. EVIDENCE: Each resident’s file had a care plan, regularly reviewed. Two of the plans were looked at in more detail and were discussed with the manager and one carer. They demonstrated involvement of the resident, or their family or advocate in the reviews. However, it was not possible to ascertain this directly from the residents or their representatives on this occasion. The key-worker system underpinned the setting of goals and their review. 6 Bowley Close G52 G02 7065 6 Bowley 234728 210605 Stage 2 uiv.doc Version 1.30 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 standard(s) 13, 14, 15, 17 Residents were encouraged and supported to access local facilities, take part in appropriate leisure activities, both inside and outside the home and maintain family links and relationships. This enabled residents to pursue fulfilling activities, mix with the general community and maintain the personal links important to them. Attention was given to the provision of meals, so that residents could enjoy a healthy diet, but one that reflected individual preferences. EVIDENCE: 6 Bowley Close G52 G02 7065 6 Bowley 234728 210605 Stage 2 uiv.doc Version 1.30 Page 11 The residents continued to take part in activities in the local community. These included shopping, visiting pubs and restaurants in the local area, attending church, hydrotherapy sessions, walks in the park, car drives etc. (This was evident from discussion of the care plans with staff, from the activity charts and from what was happening on the day of inspection). The care planning process was used to identify appropriate activities. Staff were using prompts and different methods of communication, usually under the guidance of a speech therapist, to both ascertain preferences and to remind residents of what had been planned for the day. Two residents had a range of sensory materials to use. Only two of the residents had regular family contact and in one of these cases, the contact was only by exchange of cards. The manager assured that an advocate visited regularly and spent time in the home observing how residents were supported, communicating directly with them and speaking to staff. The menu for the home showed that a range of food was provided, based on staff’s knowledge of residents’ likes and dislikes. Health needs were taken into account. Records of whether residents enjoyed particular meals were maintained, so that this information could be used in menu planning. The food hygiene recommendations previously made had been complied with. 6 Bowley Close G52 G02 7065 6 Bowley 234728 210605 Stage 2 uiv.doc Version 1.30 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 standard(s) 18,19,20 Health care needs were assessed and recognised and staff showed awareness and commitment to deliver personal care and support in a way that respected individual choice and the dignity of each individual. EVIDENCE: From direct observation of residents being supported with meals and other activities, it was evident that they were treated with respect, that staff were attentive and that the interaction between staff and residents was relaxed. Staff conveyed a clear sense of commitment to the delivery of a flexible service, with routines to reflect residents’ lifestyles and where personal care would be delivered with sensitivity and respect. (This was apparent both when discussing the service provided generally and individual care plans). The care plans and discussion with staff demonstrated continuing appropriate liaison with health care professionals, including the GP, optician, chiropodist, occupational and speech and language therapists. None of the residents were able to manage their own medication. The medication was stored safely and the manager said that all staff had received the necessary training. There were guidelines in place for the administration of some medications, also agreed by the GP. The medication administration record was accurate. The details of a resident’s allergy had been added to his records, as required in the previous inspection report. 6 Bowley Close G52 G02 7065 6 Bowley 234728 210605 Stage 2 uiv.doc Version 1.30 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 standard(s) 22,23 Residents’ views and feelings where sought where possible and acted upon, although in many cases this could mainly be done by observing behaviour. The provider had set procedures, clear to staff, for responding to issues raised, so that residents could be protected from abuse, neglect and self-harm. EVIDENCE: There were complaints’, adult protection and whistle blowing procedures. (These were not inspected on this occasion, but the manager said that there had been no significant changes in the past year). It was understood that the adult protection procedure adopted was that of the placing authority. It was discussed with the manager that he should satisfy himself that such procedure gives clear instruction to staff on how to act in case of suspicion or allegation of abuse. This would be followed up when the procedures are next inspected. All staff interviewed were clear of their roles and responsibilities in supporting complaints, or initiating them on behalf of the residents. They discussed how to keep vigilant to prevent or detect any signs of possible abuse. (The comments below, under the section on staffing and relating to stability, are also relevant). The manager said that all staff periodically undertook adult protection training. A previous requirement, regarding the information to be included in the record of complaints, was discussed with the manager. From the discussion, it was clear that what was required would be followed in case of any new complaint. There had not been any since the requirement. Why and how complaints, if any, should be logged, was discussed with the manager in some detail. The manager said that he would be reviewing the complaints’ record log format, to ensure that it could effectively support the recording and review of issues raised and the informing of the home’s quality assurance system. 6 Bowley Close G52 G02 7065 6 Bowley 234728 210605 Stage 2 uiv.doc Version 1.30 Page 14 The low incidence of complaints was discussed with the manager. He and the other staff all spoke of the close monitoring of behaviour they do to ascertain residents’ feelings and of the different means of communication with the residents. Additionally the provider had arranged for an advocate, from an independent organisation, to visit regularly and spend time with the residents. This was particularly important as the majority of the residents had limited or no family contact. The complaint’s investigation, which was being conducted at the time of the last inspection, had been completed. The records showed that a full response had been given to the complainant. 6 Bowley Close G52 G02 7065 6 Bowley 234728 210605 Stage 2 uiv.doc Version 1.30 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 standard(s) 24,25, 26, 27, 28, 30 The home offered single, comfortable bedrooms and shared facilities, which were well maintained, clean and personalised. Attempts had been made to embellish the environment so as to create a homely feel for the residents. EVIDENCE: Bowley close was a bungalow, purpose built to meet the needs of the residents. It was understood that the provider was reconsidering whether the location of the home, in a row of bungalows all with a similar purpose, was wholly consistent with the principle of community inclusion. The premises were spacious and met the national minimum standards regarding private, communal space and sanitary accommodation. Bedrooms were personalised and fully furnished. There was a small garden, which was accessible from the living room. There were items of sensory equipment available in the living room for residents’ use. There was a policy for the control of infection. Previous requirements, regarding a broken light fitting and inappropriate storage of paint, had been complied with. 6 Bowley Close G52 G02 7065 6 Bowley 234728 210605 Stage 2 uiv.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 35, 36 Residents benefited from a staff team who was clear about their roles and responsibilities and who received regular and ongoing support and training. Therefore, overall, the provider was equipping staff to appropriately support the residents’ group, but training and induction records needed to be precise or fuller. EVIDENCE: All staff interviewed confirmed that they had received a job description and all were clear about their responsibilities. The induction process was discussed in some detail with the more recent member of staff and with the manager. There was evidence of a thorough process, from the discussion, but there was no written record kept. This should be kept to ensure that the induction has covered all areas necessary to maintain safer working practices for staff and residents. It was discussed in some detail, with the manager, the utmost importance of a stable staff team. Particularly so in a home where so much depends on staff effectively monitoring and appropriately interpreting the messages from residents. Although this was a small home with, therefore, a small team of core staff, three members of staff had started in the last 12 months. The manager spoke of how he was intending to enable retention of staff. This included support, professional supervision, training and other ways to ensure job satisfaction as well as performance. 6 Bowley Close G52 G02 7065 6 Bowley 234728 210605 Stage 2 uiv.doc Version 1.30 Page 17 Staff said that they were well supported and found the supervision sessions both helpful and stimulating. The manager stated that the home was on target to meet the requirement that 50 of the staff team would hold a national vocational qualification (NVQ 2 or 3) in care by the end of 2005. The manager discussed the range of the additional training staff had been attending, which was appropriate to the needs of the residents and consistent with what staff said. The record of the mandatory training was inspected. There were some gaps, although in most cases, (but not all), it was then found that the person had in fact attended the training when due, although the records had not been updated. It was discussed with the manager that he may want to redesign the format of such record. This would be to make it easier to record when each staff is supposed to attend each course, if they attended or not and when next due to attend. 6 Bowley Close G52 G02 7065 6 Bowley 234728 210605 Stage 2 uiv.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The provider had complied with the previous requirements regarding health and safety, to promote the welfare of the residents. Lighting in the office, for staff, needed to be improved. EVIDENCE: The manager showed a current certificate of gas safety. The broken light fitting had been repaired. The perch stool in the kitchen had been repaired. The food hygiene concerns raised at the previous inspection had been resolved. It was noted that the office lighting was poor for people working at the desk and needed to be improved. 6 Bowley Close G52 G02 7065 6 Bowley 234728 210605 Stage 2 uiv.doc Version 1.30 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 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 x x 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score 3 x x x 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 6 Bowley Close Score 3 2 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x G52 G02 7065 6 Bowley 234728 210605 Stage 2 uiv.doc Version 1.30 Page 20 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. 2. Standard Regulation Requirement Timescale for action 1October 2005 35 13 (4), (5),(6); 18 (c) 3. 35 18 (c ) 4. 42 23 (a) The registered provider must: - Review the records of the mandatory training for staff. - Ensure that all staff are up to date with such traning. - Ensure that the records accurately reflect the training undertaken, the date when it was completed and when it is next due. The registered provider must ensure that a record of staff induction is kept, showing what the induction training included and when the different components were completed. The registered provider must ensure that there is suitable lighting in the office, appropriate for all tasks staff are expected to perform. 1 Octover 2005 20 July 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. 6 Bowley Close G52 G02 7065 6 Bowley 234728 210605 Stage 2 uiv.doc Version 1.30 Page 21 No. 1. 2. Refer to Standard 22 35 Good Practice Recommendations That the manager redesigns the complaints log to make it easier to record the necessary information. That the manager redesigns the record of mandatory traning to make it easier to record the necessary information. 6 Bowley Close G52 G02 7065 6 Bowley 234728 210605 Stage 2 uiv.doc Version 1.30 Page 22 Commission for Social Care Inspection 46 Loman Street Southwark London 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 6 Bowley Close G52 G02 7065 6 Bowley 234728 210605 Stage 2 uiv.doc Version 1.30 Page 23 - 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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