Inspection on 30/11/05 for Brambledown Road (44)

This inspection was carried out on 30th November 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 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) 22/05/06

Brambledown Road (44) 21/02/06

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 Unannounced Inspection 29th November 2005 11:45 Brambledown Road (44) DS0000007165.V268328.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 Brambledown Road (44) DS0000007165.V268328.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. Brambledown Road (44) DS0000007165.V268328.R01.S.doc Version 5.0 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.V268328.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st November 2004 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.V268328.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place on 30th November 2005. The care home was inspected under the National Minimum Standards Care Homes for Younger Adults. The home manager Karen Walker has been seconded to another post within the organisation. The home is currently being managed by Claire Walker supported by Jackie Lawrence the director of Operations for Independence Homes Ltd. The inspection was spent meeting with Ms Walker, looking at records, talking to service users and a tour of the premises. Information supplied on the pre-inspection questionnaire was also used in writing this report. Records examined included service user plans; care manager needs assessments and risk assessments, medication records, complaints, staff files, health and safety and fire records. What the service does well: What has improved since the last inspection? What they could do better: Although the home manager has attended the in-house training course on adult abuse it would be beneficial to the home for her to attend the training run by the local authority . There are still some gaps in the medication records for the home, which was also noted at the previous inspection. The acting manager must take steps to ensure that medication records are correctly filled in at all times. Brambledown Road (44) DS0000007165.V268328.R01.S.doc Version 5.0 Page 6 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.V268328.R01.S.doc Version 5.0 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.V268328.R01.S.doc Version 5.0 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): 1,2,3,4, 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. This information is given to families and professionals considering a placement at 44 Brambledown Road. The home is in the process of putting the service users into a format suitable for the service users at the home. Any new service users to the home will only be considered once compatibility with the current service users is established. Service users are only admitted to the home once a full assessment of their needs; compiled by their care manager or other relevant person has been received. It was noted that the home carries out 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. The new service user will have a gradual introduction to the home before being offered a trial period. New service users have a review within six months of moving into the home. Families are involved in the assessment process. Brambledown Road (44) DS0000007165.V268328.R01.S.doc Version 5.0 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 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: Brambledown Road (44) DS0000007165.V268328.R01.S.doc Version 5.0 Page 10 Each of the service users has an individual tailored care plan. The care plans are on the service users file and is a record of their aims and goals as well as their achievements. The home operates a risk management system and individual assessments are on service users files. Copies of individual risk assessments are kept on the service users file and cover a variety of situations including learning new skills and bathing. There are also risk assessments relating to the environment and staff under the health and safety at work act. Risk assessments are reviewed regularly. A family member or care manager is the named Appointee for all the homes service users. In keeping with recommended good practice no persons working at the care home act as the Appointee/agent for service users currently residing at the home. Three of the service users have independent advocates The home also has a comprehensive missing person’s policy, which gives staff clear guidance if a service user was to go missing. Brambledown Road (44) DS0000007165.V268328.R01.S.doc Version 5.0 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): 11,12,15,17 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 daily routines and house rules promote residents’ rights and encourage independence as far as possible. Dietary needs are catered for with meals that are nutritionally well balanced, nicely presented, and clearly based on the service users food and drink preferences, providing them with daily variation and healthy eating options. EVIDENCE: The home is supporting service users to access appropriate activities through local colleges. The colleges include Carshalton and North East Surrey College of Technology. Courses participated include drama, mosaics, art and “out in the community”. Two of the service users are currently doing voluntary work at a local urban farm. The home has its own transport and the service users regularly go bowling, to the cinema, and out on day trips. The service users have all been on holiday to Corfu this year. Service users also have access to social activities through the local men cap clubs. The home is keen to maintain the service users family links. Visitors are welcomed and the service users families are invited to their reviews. There is an open visitors policy. Friends are also welcome to visit Brambledown Road (44) DS0000007165.V268328.R01.S.doc Version 5.0 Page 12 The house rules and daily routines are as flexible as possible, bearing in mind the weekday commitments of the service users. At the weekends there is more flexibility with breakfast and bedtimes. The service users are actively encouraged to plan and cook the meals they wish to eat. They are also offered an alternative if they don’t like the main choice. The service users also go shopping for the food with staff members. Any health needs would be taken into consideration when planning meals. The staff team at the home keep a record of all the food eaten by the service users Brambledown Road (44) DS0000007165.V268328.R01.S.doc Version 5.0 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): 18,19,20,21 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. Service users have been consulted on their personal, religious and cultural preferences in relation to illness, death and dying, thus ensuring their individual wishes are respected, although some information is contradictory. EVIDENCE: The home has a policy on the receipt, recording, storage, handling, administration and disposal of medication. It is the homes policy that all medicines administered are recorded on Medicine Administration Record Sheets. During the inspection it was noted that there were still some gaps in the medication records. The home must ensure all medication records are filled in correctly in future. 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. Brambledown Road (44) DS0000007165.V268328.R01.S.doc Version 5.0 Page 14 Personal care is provided in private, and timings of this are also flexible. The home provides consistency and continuity through designated key workers All service users are registered with a local General Practitioner. They are able to access community health facilities such as dentists, opticians and chiropodists as required. Any seizures are recorded and each service users has access to a neurologist. Service users are supported to attend outpatient appointments and other medical appointments as required. Since the last inspection the home has consulted the service users on their wishes concerning death and dying so that the suitable arrangements can be made which comply with the service users religious beliefs and their cultural heritage. A record of their particular wishes is kept on their file however some of the details are contradictory. One of the service users has two of the forms on their files, one stating he wished to be buried, the other one saying he wished to be cremated. The homes acting manager has agreed to look into this issue. Brambledown Road (44) DS0000007165.V268328.R01.S.doc Version 5.0 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 The home’s complaints policy and procedure, facilitates good access to the complaints system for the residents, their family or their representatives. The home has 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. The home has a copy of the local authority Adult Protection Policy on site, although the acting manager has not yet completed the London Borough of Sutton training. The home manager should apply for a place on this course. The staff team at the home have had training regarding Adult Protection Issues provided by “Independence Homes”. Brambledown Road (44) DS0000007165.V268328.R01.S.doc Version 5.0 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): 24,25,30 The home is homely, bright and clean thus providing the service users with safe, comfortable surroundings that meet their needs. 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. 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 All of the service users in the home has a single room, which is decorated and personalised to reflect their individual taste. The home was comfortable, bright, well ventilated and free from offensive odours on the day of the inspection. There is a pleasant garden at the rear of the home which the service users spend time in during the summer months. The home has appropriate laundry facilities separate from the kitchen and the preparation of food. The washing machine is capable of washing clothes at high temperatures, which helps with the control of infections. There is also a tumble dryer. The laundry has suitable flooring. There is a locked cupboard for the Control of Substances Hazardous to Health products. The home has policies and procedures on the disposal of clinical waste. Brambledown Road (44) DS0000007165.V268328.R01.S.doc Version 5.0 Page 17 Brambledown Road (44) DS0000007165.V268328.R01.S.doc Version 5.0 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): 32,34,35 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. The staff team have all had Criminal Records Check, as a safeguard to offer protection to the homes service users EVIDENCE: The home arranges for at least three members of staff to be on duty at all times throughout the day when all the service users are at home. This does not include the home manager. At night the home has one waking and one sleep-in member of staff on shift. The home offers training opportunities to staff at all levels within the home. New members of staff complete an induction programme covering various subjects including health and safety, fire drills, epilepsy and medication. The information detailed on the pre-indicate that the staff team at the home have been able to access various training courses including food and hygiene, non violent crisis intervention, National Vocational Qualifications, first aid, manual handling and midazolam. Brambledown Road (44) DS0000007165.V268328.R01.S.doc Version 5.0 Page 19 Once a staff member completes their induction, training needs are identified in supervision and appraisals. The staff team are issued with attendance certificates for participating in courses and a record is kept on their file. Staff files at the home include, Criminal Records Checks, supervision records and job descriptions. The inspector noted that staff job descriptions were comprehensive in their content and linked to achieving service users goals, as set out in their individual care plans. Brambledown Road (44) DS0000007165.V268328.R01.S.doc Version 5.0 Page 20 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 The management style is open with clear lines of accountability, which is aimed at ensuring the well being of the service users. 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: The home manager Karen Walker has been seconded to another post within the organisation. The home is currently being managed by Claire Walker supported by Jackie Lawrence the director of Operations for Independence Homes Ltd. Ms Walker has worked for the company since November 2004 when she was employed as a support worker; she was promoted to team leader in May 2005 and has been the acting manager at Bramble down since October 2005. Ms Walker has submitted an application to be the registered manager with the Commission for Social Care Inspection. 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, staff and service users case files, medication records and so forth Brambledown Road (44) DS0000007165.V268328.R01.S.doc Version 5.0 Page 21 Staff meetings are held regularly which are recorded. Independence Homes Ltd have recently introduced “Kronos” a system for recording, monitoring and managing staff rota at the home. A representative of the registered provider visits the home regularly and copies of the visit report are sent to the Commission for Social Care Inspection Croydon office. Brambledown Road (44) DS0000007165.V268328.R01.S.doc Version 5.0 Page 22 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 2 3 3 3 X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 X X X X 3 LIFESTYLES Standard No Score 11 3 12 3 13 X 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Brambledown Road (44) Score 3 3 2 2 Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 X DS0000007165.V268328.R01.S.doc Version 5.0 Page 23 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) 13. -6 Requirement Timescale for action 30/11/05 2 YA23 The registered person must ensure medication administration records are correctly filled in at all times The acting manager must attend 31/03/06 the London Borough of Sutton training ion the adult protection policy 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 2 Refer to Standard YA1 YA21 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. 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.V268328.R01.S.doc Version 5.0 Page 24 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.V268328.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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