Inspection on 16/12/05 for Camilla Road, 56

This inspection was carried out on 16th December 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 no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Camilla Road, 56 08/12/06

Camilla Road, 56 20/07/05

Camilla Road, 56 08/02/05

Camilla Road, 56 18/06/04

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 Camilla Road, 56 56 Camilla Road London SE16 3NL Lead Inspector Ms Lynn Hampton Unannounced Inspection 16th December 2005 2.50 DS0000007109.V271992.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 DS0000007109.V271992.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. DS0000007109.V271992.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Camilla Road, 56 Address 56 Camilla Road London SE16 3NL 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) 0207 231 7878 Choice Support Miss Barbara Eileen Francis Care Home 2 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places DS0000007109.V271992.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2 (TWO) people male or female with physical and learning disabilities. Date of last inspection Brief Description of the Service: 56 Camilla Road is a residential care home providing accommodation and care services for two people with learning disabilities. It is part of a larger organisation, Choice Support Southwark, which operates many other homes in the borough. The home, a three-bed roomed house, is set out over two floors. The bedrooms are located on the first floor. The ground floor and the rear garden are wheelchair accessible. Habinteg Housing Association owns the property. It is located in a residential street, close to shops, public transport, and community service. The building blends in well with other houses on the same estate. The two service users, a man and a woman, have lived in the home for many years. DS0000007109.V271992.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place in the afternoon of a weekday, 16th December 2005, and lasted two and a half hours. During the visit the inspector met one member of care staff, who was key worker to one of the residents. A range of documents was examined and a tour of the building took place. The inspector met both residents. Residents were not able to communicate verbally with the inspector, but were able to show their preferences and mood to staff through gestures and body language. What the service does well: What has improved since the last inspection? What they could do better: Documentation and filing at the home would benefit from clarification, and the Daily Working file is in need of updating and review to ensure that it supports care planning in the home. The staff are trying to resolve difficulties relating to escorting one resident to activities, which needs to be addressed as a matter of priority. Meals at the home are of a good quality, but would benefit from forward planning to avoid too much repetition. DS0000007109.V271992.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. DS0000007109.V271992.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 DS0000007109.V271992.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): N/A These standards were not assessed at this unannounced inspection visit. EVIDENCE: At the previous inspection visit (July 2005), standard 2 was assessed and was found to be met. DS0000007109.V271992.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 Service users have individual plans that reflect their needs and personal goals. However, documentation at the home would benefit from clarification. The good practice seen in the home’s Person Centred Planning (PCP) documentation should be extended. EVIDENCE: The home maintains a range of documentation relating to the assessment of and care planning for residents. There were three case files for each service user held in the office. A file marked ‘File 2’ contained information that was described as ‘Service Delivery Plan’. A file marked ‘File 3’ was described as the ‘Service User File’. It was unclear to the inspector how it was decided what information went in each file, as one file was indexed to have Health Care Profile, but the other had Health reports. There was some duplication – both files contained correspondence from the neurology department regarding the residents’ appointments with them. DS0000007109.V271992.R01.S.doc Version 5.0 Page 10 Another file was also in the office, labelled File 3A. The inspector was unclear as to the purpose of this file. One was examined (which had a resident’s name on the label) and was found to contain inappropriate information (i.e. a letter to the manager from the Commission, and information relating to the holiday arrangements of the other resident of the home. Choice Support has implemented a standard system of recording throughout all of their care homes, and individual homes will not be able to make major changes individually. Therefore, a new Requirement is made that Choice Support review the systems in place to ensure that they support the care planning process, and promote quality of service delivery appropriate to each individual home. Case files indicated that Reviews are regularly held that involve the resident, advocates, relatives and any health or care professional involved in the residents’ care. The member of staff on duty explained to the inspector how the home was implementing Person Centred Planning (PCP), and showed her an example of what they called the resident’s Passport. This consisted of a ring binder file, with comprehensive details about the resident, written from their perspective, and linked to photographs. This was thoughtfully done and provided a meaningful insight into the preferences and weekly routines of the resident. The member of staff demonstrated a clear understanding of the Passport and how it could be used to promote the best interest of the resident. This is to be commended. However, the inspector reviewed the Daily Working file in the home, which is the day-to-day working file used by staff on duty to check daily and record tasks including the residents’ routines. The file contained details of the rota, checklists for activities and the record of food eaten by the residents. Some of the charts had not been completed recently, and some were blank. Some of the guidelines and photographs in the Daily Working file were old and in need of updating. This would benefit from review, and being linked to the good practice being developed in PCP planning. A new Requirement is made in respect of this. DS0000007109.V271992.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, 14, 15, 17 Service users have opportunities to participate in the local community, and to develop relationships. The staff are trying to resolve difficulties relating to escorting one resident to activities, which needs to be addressed as a matter of priority. Meals at the home are of a good quality, but would benefit from forward planning to avoid too much repetition. EVIDENCE: At the start of this inspection visit, the member of staff and both residents had just returned from a shopping trip, and had had lunch. One resident returned to her room to listen to ambient music, and could be heard laughing and enjoying this activity. The other resident was in the lounge, watching football on the T.V. DS0000007109.V271992.R01.S.doc Version 5.0 Page 12 The inspector examined the case files of this resident, which indicated that were difficulties relating to him attending activities, including football matches. As he is a keen fan of Millwall football club, this is an important part of his life and previously he had been able to attend all home matches with support from a member of staff. It emerged that there had been changes in the staff group at the home, including that the resident’s key worker had left. In handing over to the new key worker, it was identified that black and ethnic minority staff would be at personal risk in attending this activity. The inspector was informed that Choice Support were looking for volunteers to take over this role. This is clearly a priority for the resident and consideration must be given to all options to meet this need, including providing funding if necessary. The resident’s files also indicated that there had been other activities that were set as goals, which had not yet taken place. This included going sailing, and horse riding at Mudshute, which had not taken place “due to difficulties in finding the location”. Although records showed that the resident was continuing to enjoy day-to-day activities such as attending classes and gong for drives, the manager must ensure that these less frequent activities are carried out. The record of food eaten by the residents showed that individual meals were fairly healthy, but there was some repetition. One week, the residents had had fish on four occasions. On another week, they had had spaghetti four times. On another, macaroni three times. Staff were aware that the disabilities of the residents means that they prefer to maintain a routine and dislike change. However, there was a lack of food options in stock, which would limit the range of meals that staff could prepare on any given day. There is scope for a more imaginative approach to meal planning, linked to identifying preferences through the PCP process. This could enable staff to plan a more varied menu in advance, and ensure that a range of ingredients were in stock for staff to prepare. The resident’s key worker had arranged for him to have contact with an estranged relative. He reported that when they met for the first time in many years, this was a meaningful and emotional experience for them both and the key worker was planning to follow this up. This is good practice. DS0000007109.V271992.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 Service users receive personal support in the way that they prefer, and due consideration is given to their emotional as well as health needs. EVIDENCE: Although the residents were non-verbal, they are able to indicate their mood and preferences through their body language and gestures. The member of staff on duty showed in-depth awareness of each resident’s preferences and how they communicate. This included how they indicate that they are not happy with the care that they are being given, and this can be a particular issue when they are not familiar with the member of staff. For this reason, efforts are made to fill staff vacancies promptly, and minimise use of Agency or temporary staff. Residents receive personal care from both male and female staff, and the member of staff described how residents would be able to indicate if this was unacceptable to them. Case records indicated that health issues are thoroughly addressed, including dentistry, neurology, and chiropody as well as routine physical health checks. The residents’ Passports contain section to detail feelings and relationships, and the member of staff on duty talked about how this was addressed in the home. DS0000007109.V271992.R01.S.doc Version 5.0 Page 14 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): N/A These standards were not assessed at this unannounced inspection visit. EVIDENCE: At the previous inspection visit (July 2005), both of these standards were assessed and were found to be met. There have been no complaints or vulnerable adults procedures made since that time. DS0000007109.V271992.R01.S.doc Version 5.0 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 the following standard(s): 24, 27, 28, 30 Service users live in a homely, clean and safe environment, which meets their individual needs. EVIDENCE: The building is located on a relatively quiet residential street, very close to shops and transport links. There is a parking space to the front and ample onstreet parking. The home is very domestic in its layout, decoration and furnishings. The ground floor consists of a kitchen/diner, a lounge, a sensory room with specialist equipment, and a shower/toilet. This latter is used almost exclusively by one resident, which the member of staff on duty reported was linked to promoting hygiene. Shared rooms are of a good size, with sufficient seating for both residents and either staff or guests. There are three bedrooms on the upper floor, one of which is used as an office/sleep-in room by staff. There is also a bathroom/toilet. Residents’ bedrooms were seen to be decorated and personalised to reflect their interests and tastes. All areas seen by the inspector were clean to a high standard, and very tidy. DS0000007109.V271992.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Service users benefit from support by trained and competent staff. Consistency of care is promoted by ensuring that regular, permanent staff are used. EVIDENCE: At the time of this inspection visit, there was one member of staff on duty. The rota indicated that additional staff are rostered to be on duty if required to meet the needs of the residents. As noted in ‘Personal Care’ above, efforts had been made to fill staff vacancies and reduce the use of Agency staff. This benefits the residents, who can be distressed by having unfamiliar staff on duty, and it also promotes consistency of care. The member of staff reported that he had attended a range of training, including Moving & Handling, Person Centred Planning, Medication, Autism, and Sexuality. He reported that the standard of training was good, and had found the training on Autism particularly useful. The training was clearly linked to day-to-day care practice. The training on Sexuality of service users had raised a number of issues, and consideration was being given to reviewing what was relevant to the particular needs of the individuals at the home. The report of the last inspection visit (July 2005) made a Recommendation that information be provided to the Commission regarding staff participation in NVQ training. This Recommendation remains in place. DS0000007109.V271992.R01.S.doc Version 5.0 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): 41, 42 Records held at the home indicated that service users safety and welfare is promoted and protected. EVIDENCE: The home maintains a comprehensive Health & Safety file, which contained upto-date records relating to gas and electrical safety, as well as Risk Assessments and information on Health & Safety issues. The report of the last inspection visit (July 2005) made a Requirement that the fire drills take place at quarterly intervals. The manager had taken action to address this. Records held at the home indicated that two fire drills had taken place since July. There was also a separate record indicating that weekly checks of fire alarms and equipment are carried out. This Requirement is met. DS0000007109.V271992.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X 3 3 X 3 LIFESTYLES Standard No Score 11 X 12 3 13 X 14 2 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X Standard No 37 38 39 40 41 42 43 Score X X X X 3 3 X DS0000007109.V271992.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 15(1)(2) Requirement The Registered Person must, in consultation with care managers, review record keeping and documentation used for care planning in Choice Support homes. The outcome of the review, with timescales for any action to be implemented, to be notified to CSCI in writing. The Registered Manager must review and revised the Daily Working file, to ensure that it is updated and used effectively to support care planning in the home. Guidelines and photographs are to be updated, and action taken to ensure that recording sheets are completed regularly. The Registered Manager must take action to ensure that service users are enabled to participate in planned activities, and to achieve goals set in Care Reviews. This is to include making arrangements for an escort to be provided to enable a resident to attend football matches regularly. DS0000007109.V271992.R01.S.doc Timescale for action 01/05/06 2 YA6 12, 15(1)(2) 01/03/06 3 YA14 16(2) n 18(1)a 01/02/06 Version 5.0 Page 20 4 YA17 16(2)i The Registered Manager must review meal planning and preparation in the home, and ensure that staff are able to prepare a variety of meals that meet service users tastes and preferences. 01/03/06 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 YA32 Good Practice Recommendations Information on whether staff members have achieved NVQ qualification should be forwarded to the CSCI for inclusion in the final report. 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