Inspection on 21/02/06 for Brambledown Road (44)

This inspection was carried out on 21st February 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Brambledown Road (44) 30/07/08

Brambledown Road (44) 23/05/07

Brambledown Road (44) 22/05/06

Brambledown Road (44) 30/11/05

Brambledown Road (44) 01/11/04

Brambledown Road (44) 09/07/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

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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 Brambledown Road (44) 44 Brambledown Road Wallington Surrey SM6 0TF Lead Inspector Deborah Yapicioz Unannounced Inspection 21st February 2006 11:30 Brambledown Road (44) DS0000007165.V285215.R01.S.doc Version 5.1 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 Brambledown Road (44) DS0000007165.V285215.R01.S.doc Version 5.1 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. Brambledown Road (44) DS0000007165.V285215.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Brambledown Road (44) Address 44 Brambledown Road Wallington Surrey SM6 0TF 020 8647 1325 020 8647 1325 brambledown@independencehomes.co.uk 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) Independence Homes Limited Karen Ann Walker Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Brambledown Road (44) DS0000007165.V285215.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th November 2005 Brief Description of the Service: 44 Brambledown Road is a residential care home that is registered with the Commission for Social Care Inspection to provide a service for up to seven adults with learning disabilities between the ages of 18 and 65. The home specialises in providing a service to people who also have epilepsy. The property itself is a spacious detached building situated in a quiet residential area of Wallington. The premises consist of seven single rooms that have all been provided with wash hand basins. Bedrooms are situated on the ground and first floor. There is a communal lounge, a dining room, a laundry and a kitchen. The kitchen and separate laundry are used for supported independent living skills training and for preparing meals, drinks and snacks. The home also has a conservatory at the rear of the building. The garden contains a patio area, a brick barbeque, an area of lawn, a vegetable patch, a path, mature trees and bushes, a shed and a side access gate. There is some off street parking at the front of the building. Brambledown Road (44) DS0000007165.V285215.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes second inspection for the year 2005/6 and was unannounced. The inspection took place on the morning of 21st February 2006. The home was inspected under the National Minimum Standards Care Homes for Younger Adults. A previous inspection took place on the 30/11/05 2005 when most of the standards that the Commission for Social Care Inspection considers as key standards were inspected. Methods of inspection included a partial tour of the premises, meeting with the service users and the manager Claire Walker. Records examined included staff and service user records, risk assessments, medication records, complaints, staffing records, and health and safety and fire records. The inspector would like to thank the service users, the staff team and Ms Walker for their help in facilitating the inspection. What the service does well: What has improved since the last inspection? What they could do better: 44 Brambledown Road does not currently have a registered manager although the home has a temporary management structure in place. Claire Walker is Brambledown Road (44) DS0000007165.V285215.R01.S.doc Version 5.1 Page 6 covering the management role at the home with support from other managers in the organisation. Ms Walker will be going on maternity leave later this year and she informed the inspector that the organisation would be recruiting a permanent manager. The registered provider must ensure that a suitable qualified and competent individual submits an application to register as the homes manager. 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. Brambledown Road (44) DS0000007165.V285215.R01.S.doc Version 5.1 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 Brambledown Road (44) DS0000007165.V285215.R01.S.doc Version 5.1 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 The home provides information and introduction opportunities for prospective service users and their families to make an informed choice about moving to the home. EVIDENCE: The registered provider has compiled a statement of purpose outlining the aims and objectives of the home, and the facilities and services it provides. The home is part of the “Independence Homes” group and the acting manager informed the inspector that the company is in the process of devising a corporate service users guide for all the homes in the area, which will also include information relevant to individual homes. She is confident that the guide will be available later this year. The company has a procedure for taking on new service users, which includes undertaking a comprehensive, needs assessment. Copies of these assessments for the homes most recent admission were available on request and covered every aspect of their personal, social and health care needs. Risk assessments are also included Compatibility with others already living in the home is taken into account. Any prospective service user would have a gradual introduction to the home with a series of short visits and overnight stays. The time frame would be flexible depending on the service user. Brambledown Road (44) DS0000007165.V285215.R01.S.doc Version 5.1 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): 6,9 The service users have comprehensive individual care plans with detailed information on their needs and personal goals. Individual care plans include consultation with service users and are regularly updated by the key-worker to reflect current needs and ensure service users wishes are represented. The home operates a risk management strategy thus enabling the service users to participate in activities in the home and in the community with appropriate support. EVIDENCE: The service users all have individual plans that are a record of their aims and goals as well as their achievements. The plans follow on from the initial assessments completed at the time of their referral to the home. Information is available in respect of service users’ preferred likes and dislikes, and includes guidelines on dealing with any aggressive or challenging behaviours. The home has a key work system. The key worker has recorded monthly sessions with the individual service users. A monthly report detailing seizures and any areas of concern are sent to the company’s head office for action/monitoring. The individual plans are reviewed every six months unless there is an issue with the service user or the placement and meetings need to take place more often. The home operates a risk management system and Brambledown Road (44) DS0000007165.V285215.R01.S.doc Version 5.1 Page 10 individual assessments are on service users files. Copies of individual risk assessments are kept under review and new risk assessments are completed when a new activity or area of risk is identified. Brambledown Road (44) DS0000007165.V285215.R01.S.doc Version 5.1 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): 13,16 The service users have a varied programme of social activities organised by the staff team to reflect service users individual interests. The daily routines and house rules promote residents’ rights and encourage independence. EVIDENCE: The home manager informed the inspector that the service users are encouraged to pursue their own interests and hobbies, and have a choice about the entertainment brought into the home. The social events include cinema, bowling, trampolining, cycling, dance and aerobics. A record of all social activities is kept. Two of the service users enjoy playing football and are in the Chelsea team for disabled footballers. Some service users have their own televisions and music systems in their bedrooms as they wish. The manager stated that the service users often attend social events in other homes and have friendships with people other that the residents of the home. The home manager informed the inspector service users meetings take place, usually on a monthly basis. The company also holds service users forums and representatives from the home attend. Brambledown Road (44) DS0000007165.V285215.R01.S.doc Version 5.1 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): 18,20 Personal care is carried out in a way that residents prefer so that dignity and choice are maintained. Residents’ physical and emotional health needs are detailed in personal plans to offer consist care in this area. EVIDENCE: The service users need varying degrees of assistance with their personal care. The level of support a service user needs would be detailed in their initial assessment and updated at review meetings and their preferred routines are set out in their individual Plan. The staff team at the home monitor the health of each of the service users and would ensure they receive any treatment needed. Regular health checks and potential complications and problems are identified and dealt with at an early stage. The staff team keep a record of any medical appointments attended on the service users files. Any seizures are recorded and each service user has access to a neurologist. The home provides consistency and continuity through designated key workers Incident forms are completed following any accidents. Each of the service users files looked at during the inspection contained a form detaining the specific wishes of the service users in the event of their death or a serious illness. The home has a policy and procedure in place for the receipt, recording, storage, handling, administration and disposal of medication. There were still some gaps in medication records at the time of the inspection Brambledown Road (44) DS0000007165.V285215.R01.S.doc Version 5.1 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): 22,23 There is complaints policy and procedure, which facilitates good access to the complaints system for the residents, their family or their representatives. The home has the appropriate policies in place to ensure the protection of vulnerable service users. EVIDENCE: The complaints procedure was clear and contained all of the elements required to meet standard 22 including a minimum response time of less than 28 days. There have been no complaints since the last inspection. The home has a copy of the local authority Adult Protection Policy on site. The staff team have attended training on adult protection issues. The home manager is booked to attend local the authority training on their adult protection policy in March2006. Brambledown Road (44) DS0000007165.V285215.R01.S.doc Version 5.1 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 The general décor of the home is good providing a comfortable, clean and safe environment for service users to live in. EVIDENCE: The home is situated in a residential road in Wallington, close to local shops and transport links. The home was comfortable, bright, well ventilated and free from offensive odours on the day of the inspection. The home has a conservatory to the rear of the house, which is also used as an office/meeting area. There was suitable domestic lighting in the home although it was noted that the ceiling light fitting in the vacant room at the top of the stairs was not connected properly. The home’s premises are in keeping with the local community and are suitable for their purpose. Service users spoken to during the inspection said they liked their bedrooms. The rooms are also fitted with listening devices to help staff monitor service users seizures, particularly at night. Consent forms are kept on the service users files. Brambledown Road (44) DS0000007165.V285215.R01.S.doc Version 5.1 Page 15 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): 32,34 The staff team at the home have a range of skills and abilities, which enables them to meet the needs of, the service users living at the home. EVIDENCE: The home manager arranges for at least three members of the staff team to be on duty at any time during the day. There are two members of sleep in staff at night one waking and one sleep in person who is on call. On the morning of the inspection there were three members of staff as well as the home manager on duty. All new members of staff receive a structured induction as part of their probationary period of employment. The record of this is signed and dated on completion. The induction covers epilepsy training, service users care needs, emergency procedures, safe working practices, adult protection, moving and handling etc. The home has a rolling programme of staff training in place such as National Vocational Qualifications. The home manager informed the inspector that all staff at the home are in the process of completing the Learning Disability Awards Framework. Two staff have completed National Vocational Qualification training, four staff have started National Vocational Qualification training. Training records are kept on the staff members file. The home has regular staff meetings; records of the issues discussed are on file at the home. The staff team at the home receive supervision from the home manager. Brambledown Road (44) DS0000007165.V285215.R01.S.doc Version 5.1 Page 16 The atmosphere in the home is friendly and welcoming and the service users spoken to were complimentary about the staff team. Brambledown Road (44) DS0000007165.V285215.R01.S.doc Version 5.1 Page 17 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): 37,42 The home appears to be well managed. Health and safety arrangements are adequate to ensure potential risks to service users health and safety are as far as reasonably possible identified and minimised. EVIDENCE: 44 Brambledown Road does not currently have a registered manager although the home has a temporary management structure in place. Claire Walker is covering the management role at the home with support from other managers in the organisation. Ms Walker will be going on maternity leave later this year and she informed the inspector that the organisation will be recruiting a permanent manager. The registered provider must ensure that a suitable qualified and competent individual submits an application to register as the homes manager. Both staff and service users are encouraged to participate in the day-to-day operation of the home and to give their opinion about the way the service is delivered. This happens in a variety of ways including key worker support meetings, which take place on a monthly basis between service users and their key workers the sessions are recorded and kept on service users files. The Brambledown Road (44) DS0000007165.V285215.R01.S.doc Version 5.1 Page 18 staff team have regular supervisions and annual appraisals. Service users meetings and staff meetings also take place. Records required for the safety and well being of service users are in place including accidents, water temperatures, risk assessments, complaints, incidents, food records, staff and service users case files, medication records and so forth. Staff meetings are held regularly which are recorded. Fire drills take place regularly. A representative of the proprietor is carrying out monthly regulation 26 visits, and a report of each visit is produced and a copy is sent to the Commission for Social Care Inspection. Brambledown Road (44) DS0000007165.V285215.R01.S.doc Version 5.1 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 Standard No Score 1 2 2 3 3 X 4 X 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 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 2 X 2 X X X X 3 X Brambledown Road (44) DS0000007165.V285215.R01.S.doc Version 5.1 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 YA20 Regulation 17(1)(a) Sch 3 3(1) 9(1) (2) Requirement The registered person must ensure medication administration records are correctly filled in at all times The registered person must ensure a suitably qualified and competent individual submits an application to register as the homes manager, subject to a fit person interview with the Commission. The home manager must ensure the light fitting in the vacant room at the top of the stairs is fixed. Timescale for action 21/02/06 2 YA37 31/07/06 3 YA24 23(2(p) 21/02/06 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 YA1 Good Practice Recommendations The home manager must ensure the service users guide in put into a format, which is suitable for the service users at the home. DS0000007165.V285215.R01.S.doc Version 5.1 Page 21 Brambledown Road (44) 2. YA21 The home manager must ensure the information on the service users files detailing their wishes around death and dying is clear. Brambledown Road (44) DS0000007165.V285215.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Brambledown Road (44) DS0000007165.V285215.R01.S.doc Version 5.1 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!