Inspection on 22/05/06 for Brambledown Road (44)

This inspection was carried out on 22nd May 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 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) 21/02/06

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

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 Brambledown Road (44) 44 Brambledown Road Wallington Surrey SM6 0TF Lead Inspector Deborah Yapicioz Key Unannounced Inspection 22nd May 2006 13:00 Brambledown Road (44) DS0000007165.V287807.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 Brambledown Road (44) DS0000007165.V287807.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. Brambledown Road (44) DS0000007165.V287807.R01.S.doc Version 5.2 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.V287807.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st February 2006 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.V287807.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes first inspection for the year 2006/2007 and was an unannounced visit, which took place on the afternoon of 22nd May 2006. The home was inspected under the National Minimum Standards Care Homes for Younger Adults. Claire Walker the acting home manager was not on duty at the time of the inspection so Clare Ireland and Laura Scott facilitated it. Methods of inspection included a tour of the premises, observation of contact between staff and service users, talking with service users and staff. Records examined included service user plans, care manager assessments, risk assessments, medication records, complaints, health and safety and fire records. As the home manager was not on duty, it was not possible to view staff files. The files will be reviewed at the next inspection. The inspector would like to thank the service users, the staff team, Ms Scott and Ms Ireland for their help in facilitating the inspection. Several comment cards were sent to the Commission for Social Care Inspection local office and the inspector would like to thank everyone who took the time to complete them. What the service does well: What has improved since the last inspection? The tour of the premises demonstrated that the service users have been encouraged to personalise their rooms with the help of their key worker. Each room reflected the interests and individuality of their occupants. The home has had the top landing and hallway including the woodwork decorated has been painted a pale lilac, which makes the area appear much lighter. The service users told the inspector that they had chosen the colour and really liked it. Brambledown Road (44) DS0000007165.V287807.R01.S.doc Version 5.2 Page 6 The recording on the homes Medicine Administration Record Sheets 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. Brambledown Road (44) DS0000007165.V287807.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 Brambledown Road (44) DS0000007165.V287807.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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides information and introduction opportunities for prospective service users and their families to make a choice about moving to the home, although a service users guide is not yet generally available. EVIDENCE: The home is part of the “Independence Homes” group and the inspector was informed that the company has nearly completed the process of devising a corporate service users guide for all the homes in the area. This will also include information relevant to individual homes. The home has statement of purpose in place. The organisation has a pre-assessment format. The referral process for new service users includes having a full assessment of service users needs to ensure that the service users needs can be met by the home. This would also include any cultural or religious issues. The service users files looked at during the inspection all contained clinical and medical assessments completed before the service users moved into the home. The introductory assessments include details on the service users background, education, allergies, medical history and details of how the home will meet their needs. 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.V287807.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): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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 service users wishes. The home operates a risk management strategy thus enabling the service users to participate in activities with appropriate support. EVIDENCE: Brambledown Road (44) DS0000007165.V287807.R01.S.doc Version 5.2 Page 10 The services users’ files looked at during the inspection were comprehensive and contained history likes and dislikes, goals, medical information, reviews, risk assessments, and an assessment of care needs. The care plans also included 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 individual assessments where seen 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.V287807.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users at the home are offered the opportunity to engage in age appropriate activities with an emphasis on using community based facilities. 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. The home has an open visitors policy to ensure friendships and family links are maintained. EVIDENCE: There is an open visitors policy and the home just ask that visitors phone to ensure their family member is going to be in before they visit. Visitors can be seen in any of the homes communal areas as well as the service users bedrooms. The house rules and daily routines are as flexible as possible, bearing in mind the weekday commitments of the service users. The service users are on the electoral register and can vote if they wish to. Brambledown Road (44) DS0000007165.V287807.R01.S.doc Version 5.2 Page 12 The home is supporting service users to access appropriate activities through local colleges. The colleges include Carshalton and North East Surrey College of Technology. Details of the service users daily activities and commitments are kept on the service users file. The home has its own transport. The local parks, cafes, pubs, theatres, libraries, bowling alley, and shops are accessed. In house activities are also provided and one of the service users told the inspector that she really enjoys doing jigsaw puzzles. Service users also attend clubs. The service users have the opportunity to attend religious services if they wish. The service users all have an annual holiday on the day of the inspection two of the service users were on holiday in Spain. Brambledown Road (44) DS0000007165.V287807.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. Residents’ medication is well managed to ensure good health. EVIDENCE: The service users need varying degrees of assistance with their personal care. Some service users just needs a prompt while others need more support. The level of personal support a service user needs would be detailed at their review and recorded in their personal file. Personal care is provided in private, and timings of this are flexible. The home provides consistency and continuity through designated key workers All service users are registered with a local General Practitioner. The staff team receive training on medication and epilepsy as part of their induction Key workers at the home monitors the service users health and any health appointments are kept on service user files. Seizure activity is monitored and reported to the homes director of care. Each of the service users has an emergency pack of medication. The contents of the emergency packs are checked weekly and check lists are completed. The home has a policy and procedure in place for the receipt, recording, storage, handling, administration and disposal of medication. Medication checks are also in place. The inspector was informed that the home is currently Brambledown Road (44) DS0000007165.V287807.R01.S.doc Version 5.2 Page 14 introducing a new medication system to the home. All medication records were complete at the time of the inspection. Brambledown Road (44) DS0000007165.V287807.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. Comment cards were sent to the relative and friends of service users at the home. Several family members commented that they were not aware of the homes complaints procedure. After discussion with the staff on duty it was decided that the complaints procedure should be reissued to the service users families. 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. Brambledown Road (44) DS0000007165.V287807.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,26,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The general décor of the home is good providing a comfortable, clean and safe environment for service users to live in. Service user’s bedrooms provide privacy and reflect individual interests and preferences. EVIDENCE: The home is situated on a quiet residential road in Wallington. The home’s premises are in keeping with the local community and appear suitable for their purpose. The home has had the top landing and hallway including the woodwork decorated, which has improved the appearance of that area. The service users told the inspector that they had chosen the colour. There is a communal lounge, dining and kitchen on the ground floor. There is also a conservatory at the rear of the house part of which is used as an office each of the service users in the home has a single room. All of the rooms have been personalised and decorated to reflect their individual taste. Bedrooms viewed provided sufficient and suitable furniture. The rooms are 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.V287807.R01.S.doc Version 5.2 Page 17 The premises were generally bright, airy and clean on the day of the unannounced inspection. There was suitable domestic lighting and ventilation. There is also a large garden at the rear of the home which the service users spend time in during the summer months. All areas of the premises viewed were clean and free from offensive odours. There are appropriate laundry facilities. Systems are in place for controlling the spread of infection. This includes staff training in this area. Brambledown Road (44) DS0000007165.V287807.R01.S.doc Version 5.2 Page 18 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): 31,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team at the home have a range of skills and abilities, which enable them to meet the needs of the service users living at the home. EVIDENCE: On the morning of the inspection there were three members of staff on duty. As the home manager was not on duty, it was not possible to view staff files. The files will be reviewed at the next inspection. 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 including LADAF, fire safety, adult protection and Non Violent Crisis Intervention. Staff members spoken to during the inspection commented positively on the homes induction process and felt that the training courses offered had helped them build on their skills. The home has regular staff meetings; records of the issues discussed are on file at the home. Brambledown Road (44) DS0000007165.V287807.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The management style appears to be transparent with clear lines of accountability, however a permanent home manager must be recruited and register with the Commission for Social Care Inspection. In the main health and safety arrangements are adequate to ensure potential risks to service users health and safety are so far as reasonably possible identified and minimised. EVIDENCE: 44 Brambledown Road does not 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 in the near future and the home is in the process of recruiting a manager for the home. The registered provider must ensure that a suitable qualified and competent individual submits an application to register as the homes manager. Many of the records required for the safety and well being of service users are in place including accidents, PAT testing, water temperatures, risk assessments, complaints, incidents, food records, service users case files, Brambledown Road (44) DS0000007165.V287807.R01.S.doc Version 5.2 Page 20 medication records and so forth. Fire drills at the home are up to date and staff meetings take place regularly although service users meeting have not been held as frequently as recommended and should be increased in frequency. The staff team at the home completes monthly health and safety inspection reports. The service users and staff made positive comments about the home and the management team. A representative of the registered provider visits the home regularly and copies of the visit reports are sent to the Commission for Social Care Inspection Croydon Office. The visit reports are detailed documents, which cover staff, service users and health and safety issues. Brambledown Road (44) DS0000007165.V287807.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 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 3 25 X 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 X 33 X 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 2 X X 3 X Brambledown Road (44) DS0000007165.V287807.R01.S.doc Version 5.2 Page 22 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard YA39 YA37 Regulation 12. (5)(a)(b) 9(1) (2) Requirement The home manager must ensure the service users meetings take place on a more regular basis 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. Timescale for action 31/08/06 31/07/06 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. It is recommend that a copy of the complaints procedure is reissued to family members. 2. YA22 Brambledown Road (44) DS0000007165.V287807.R01.S.doc Version 5.2 Page 23 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.V287807.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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