Inspection on 08/12/05 for Cassland Road (1)

This inspection was carried out on 8th 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Cassland Road (1) 21/11/07

Cassland Road (1) 09/02/07

Cassland Road (1) 20/09/05

Cassland Road (1) 17/03/05

Cassland Road (1) 11/10/04

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Townley Road, 2-3

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Cherry Tree House

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

CARE HOMES FOR OLDER PEOPLE Cassland Road (1) 1 Cassland Road Thornton Heath Croydon Surrey CR7 8RN Lead Inspector David Pennells Unannounced Inspection 8th December 2005 14:30 X10015.doc Version 1.40 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 Cassland Road (1) DS0000028101.V272572.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 Older People. 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. Cassland Road (1) DS0000028101.V272572.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Cassland Road (1) Address 1 Cassland Road Thornton Heath Croydon Surrey CR7 8RN 020 8665 0074 020 8665 0074 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) Mrs Sevalacion Boodnah Mrs Sevalacion Boodnah Care Home 4 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (4) of places Cassland Road (1) DS0000028101.V272572.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The provision of care in the service known as 1 Cassland Road is restricted to the registered provider only. The provision of care in the service known as 1 Cassland Road is restricted to the registered provider only. If at any time the registered provider is unable to manage the home, the registered provider will nominate a person who will be agreed with the Commission for Social Care Inspection. A variation has been granted to allow two specified service users under the age of 65 to be accommodated. 20th September 2005 2. Date of last inspection Brief Description of the Service: Cassland House is registered to provide care for up to four older (aged 65 ) service users with a mental health problem (excluding learning disabilities and dementia). The home holds a variation currently to allow two service users who are under the age of 65 to reside at the home, but one of these two has recently attained his sixty-fifth birthday joining the other two service users who are between 65 and 70. The other service user is significantly younger - being aged 54 - but blends in well with the three ‘older’ service users. The property itself is ideally situated just off Thornton Heath High Street, within a few yards of retail outlets of many and varying descriptions. Banks, pubs and medical health centres are also close by. The new local authority Sports Centre - including swimming pool, fitness classes and gym facilities - is also just a few hundred yards away. Transport links are also excellent, with bus stops dotted along the High Street and the local railway station about a four minutes walk away. Local places of worship (Anglican, Methodist, Roman Catholic, Hindu) are also within about the same walking distance. The premises are immaculately kept - clean and well furnished, and provide a very pleasant, comfortable environment for the service users. It is a ‘nonsmoking’ home. One bedroom is located at the front of the house on the ground floor and three upstairs. One upstairs bedroom has an ensuite facility. The proprietor also has a bedroom on the first floor - from which she is ‘on-call’ at nights. There is a shower and toilet on the first floor and a bath and toilet on the ground floor. The main communal area is a large open plan lounge (with massive TV screen DVD) and dining area, with kitchen off - facing out onto a well-planted rear patio area which has garden chairs and a table and parasol for enjoying the hotter weather. A remote-controlled awning also ensures that the lounge does not ‘overheat’ in the summer. Cassland Road (1) DS0000028101.V272572.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced weekday inspection visit was conducted over two hours from mid-afternoon to approaching teatime. The proprietor/manager Mrs Boodnah (known as ‘Sheila’ to the service users) was just leaving to accompany a service user to an appointment at the Westways Resource Centre - and this she carried on doing, leaving the inspector with service users and a carer to assist him. During the absence of the manager the inspector checked written documentation, chatted to service users and staff and inspected the ground floor accommodation. After the return of the manager the inspector toured the first floor, meeting another service user and then chatted through the outcome of the visit before leaving the house. The inspector is grateful to the service users, the staff and proprietor for the welcome and hospitality shown to him during the visit. The general impression one gains, is that of a large family home with four extra members of the family being present - alongside Mrs Boodnah and her husband. The ‘family’ atmosphere is tangible, with familiarity between service users and service providers being very positive and appreciative. The house is generally a ‘quiet’ house with a low-key, calm atmosphere. Service users use their own space as well as the home’s communal facilities. Service users express their individuality and preferences through engaging (or not) with the local community - and organising their own lifestyles. What the service does well: What has improved since the last inspection? Medication returns are now being properly recorded in a book, which the pharmacist is signing to confirm receipt of this surplus medication. Cassland Road (1) DS0000028101.V272572.R01.S.doc Version 5.1 Page 6 Staff records have improved, and policies and procedures previously required to be in place are now present at the home in draft form. Records of payments of personal allowances to a service user have now been updated and are currently in place. Fire alarm checks are now recording additionally the observations of the ‘dorgard’ electronic door holders responding to the alarms. 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. Cassland Road (1) DS0000028101.V272572.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cassland Road (1) DS0000028101.V272572.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None specifically inspected on this visit. Each service user placed at the home can be sure that the multi-disciplinary CPA devised for them is used as a blueprint for their care plan used at the home, and that therefore their needs will be well met. EVIDENCE: No service user has changed at the home since the last inspection – and indeed the service user group is generally very stable / static. The above judgement statement accompanied the last inspection visit – reflecting the assessment of Standard 3, the key standard in this section. Four male service users are resident at the home; the first to live at Cassland Road with Mrs Boodnah has been there since 1992. The majority of service users have joined the home in the past five years, arriving in 2000, 2004 and 2005 respectively. The home does not provide intermediate care and therefore the standard (6) does not apply in this regard. Cassland Road (1) DS0000028101.V272572.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 & 9. Service users can expect the home to provide an agreed programme of care in line with their Care Planned Approach, covering their medical, social and emotional needs - though the home should ensure more detailed records are kept in order to fully support each service user for assessments and reviews, and should ensure more frequent in-house reviews. Service users can expect their health needs to be met through the home supporting and encouraging appropriate engagement with health care professionals. Assistance with medication regimes can also be relied upon, with medication regimes now satisfactorily fully documented and in place, thus ensuring safe and consistent assistance with medication-related issues. Service users can expect their privacy and dignity to be upheld at all times. EVIDENCE: The edited judgement statements above cover the two followed-up standards, and the other two key standards that were checked at the last inspection visit. Cassland Road (1) DS0000028101.V272572.R01.S.doc Version 5.1 Page 10 Care Plans seen were all based on up-to-date CPAs that had been devised by the multi-disciplinary Community Mental Health Team and which identified the needs of the individual and the role the home would play in the wider context as well as giving a clear lead to the home on how to deal with any crisis issues. Risk assessments for service users were found to be appropriate and detailed. The home provides a service focused on providing long-term care to service users who generally have a chronic condition, and so whom expect to live at the home for some time. Currently, records of a service user’s lifestyle / progress / successes, however, are not ‘mapped’ very closely; the inspector expects the proprietor to adopt a routine of regular reporting (preferably daily, and minimally every 2/3 days) to ensure that sufficient information is kept to inform assessments and reviews. The proprietor is ‘in the process’ of implementing a new format for Care Planning and recording, but as yet this new ‘purple folder system’ is not in place. It is hoped that this new format will encourage more frequent reviewing – in house – of the individual care plans; most needed revisiting / updating, having been created at the early part of the year. Medication storage, recording and processes were examined – with the ‘Returns’ book being checked to ensure the pharmacist was now involved in acknowledging receipt of any surplus medication. All was found to be in order. Cassland Road (1) DS0000028101.V272572.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14. Service users can expect to receive care and attention appropriate to their needs and wishes, whilst ongoing contact with local contacts, friends and relatives is encouraged, and a warm welcome awaits such visitors. Service users can be expected to assert their independence, whilst the home will ensure support and encourage as provided, as appropriate, to each individual service user. The home respects the rights of individuals to be involved or to ‘watch from the sidelines’ if this is their preference. Service users can expect to be encouraged to adopt a lifestyle involving choice and self-determination / control. The home can be relied on to provide a satisfying, nutritious and filling diet, meeting individually expressed needs and aiming to ensure the wellbeing of the service users. EVIDENCE: The above judgement statements cover all four standards – in successive order - the first two and the last being statements from the last inspection visit that found all three to be ‘met’. This inspection visit found the third to be met also. Cassland Road (1) DS0000028101.V272572.R01.S.doc Version 5.1 Page 12 Service users have previously positively indicated that they did not wish to be involved in greater decision-making about life at the home – but did value being informed of impending changes. One service user was clear that activities are not their preference; they prefer to sit quietly in their room, when not conducting their own decision-making with regard to activities. Each service user has their own particular ‘lifestyle’ – from one service user not ever wishing to leave the house, to another who is often ‘out and about’, both during the week and at weekends. The local Gym, Swimming Pool and a Snooker Club in Croydon are popular haunts for this particular service user. In between these two extremes, another service user has a regular routine of going for a regular ‘constitutional’ each morning. The fourth service user is keen to go out shopping – both to Tesco’s [the large local supermarket] and to the local butchers shop or the newsagents shopping for one or everyone. Cassland Road (1) DS0000028101.V272572.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None inspected at this visit. Service users can be assured that complaints will be taken seriously and addressed swiftly and effectively by the proprietors. Service users can be assured that that the proprietor acts to safeguard them from discrimination, abuse or neglect. EVIDENCE: Neither of these standards was fully inspected at this visit to the house; both were found ‘met’ at the last visit. The only outstanding issue – a request that the “NCSC” become the “CSCI” in the typed Complaints Procedure (whilst the address and contact telephone number were correct) is being dealt with imminently, the inspector was informed. Cassland Road (1) DS0000028101.V272572.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None fully inspected at this visit. Service users can expect to enjoy the facilities of a well-maintained, clean and pleasant environment in which to live, with privacy and dignity supported by all having single bedrooms, a good number of bathing and toilet facilities, and good communal facilities, both inside and out. EVIDENCE: The above judgement statement is as was printed in the last inspection report – the entire set of standards being found ‘met’. During the inspector’s tour of the house and examination of premises and health & safety related documents present, nothing was found to contradict the inspector’s opinions formulated in September 2005 – namely that the house met all the key and supplementary standards. Cassland Road (1) DS0000028101.V272572.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28, 29 & 30. Service users can be assured that the proprietor and staff members will ensure they are supported and protected at all times, through the provision of competent and informed care and employment practices. EVIDENCE: Mrs Boodnah runs this service, with her husband’s background support, on a day-to-day basis. She supports each of the four men who are resident at the home, though all service users can express themselves independently - and are generally physically fit to undertake their own personal care, so the ‘loading’ on the proprietor is relatively light in this regard, leaving her to ensure that the psychological and housekeeping needs are met. There is always at least one person on site at the house available to service users. Mrs Boodnah employs her sister, principally, and another relative, to cover her absences from the home. Both are qualified to a suitable level: the former to Registered Nurse level, and the latter as a qualified care assistant. Both have been familiar with the house and service users for some time and therefore induction and foundation programmes are inappropriate to them. Concerns about references for the part-time staff have now been resolved and Staff files are in line with the regulatory requirements as expressed in revised Schedule 2 of the regulations. It is advised that a ‘checklist’ against these Regulations be used as an index for each staff file – this will enable ease of file creation in the future for new members of staff. Cassland Road (1) DS0000028101.V272572.R01.S.doc Version 5.1 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38. The home is well run by a proprietor who has a clear concern for the service users, and a determination to develop and maintain a high standard of service – resulting in an ongoing high standard of care. The home is clearly run to the benefit and best interests of service users, with precautions in place to guarantee safety and evidence best practice. Policies and procedures at the home generally support the service in handling issues arising now and in the future. Health and safety issues at the home are generally well covered, excepting minor outstanding issues that are planned to be addressed by the proprietor within a short timescale. Cassland Road (1) DS0000028101.V272572.R01.S.doc Version 5.1 Page 17 EVIDENCE: The above judgement statements are transferred from the previous inspection document and amended where issues have been addressed. The home is run as a family business with Mrs Boodnah in charge, assisted in the background by her husband, and assisted by her sister at times. Mrs Boodnah is undertaking her Registered Manager Award with DCL in Crystal Palace; and has, she informed the inspector, three units left to complete, to be qualified to the level required by the National Minimum Standards. A need for Mrs Boodnah and other staff to undertake First Aid training is identified under Standard 38. One service user fully handles their own financial affairs; the others have either family or care management assisting, with the proprietor acting as Appointee to one service user. In this latter case, the money is paid to her and she then passes on the weekly personal allowance amount to the service user. Records are now being suitably kept of payments to this service user. The home has a generally comprehensive set of policies and procedures; the Commission’s policies and procedures list in the pre-inspection questionnaire was signed ‘in the negative’ against some policies and these are now present in the home in ‘draft’ form. They should now be formally adopted. Outstanding issues cover: Fire drills must be conducted at a frequency that enables the involvement of any additional staff members who may additionally work at the home. Both the proprietor and her husband have been involved in such events, but other staff members are yet to be involved in drills – this must be implemented urgently. First Aid competency is necessary to staff providing the ‘solo’ input of care to the service user group at the home. All staff providing a service at the home must be qualified in First Aid - to ensure that such cover is provided ‘24/7’. This outstanding issue is being addressed; the proprietor stated that a course had recently been cancelled; she provided the inspector with evidence that a course will be attended in January 2006 to cover this requirement. Gas Soundness testing is noted to be overdue for its annual test on 06/11/05; such annual checks must be carried out regularly without fail. The proprietors agreed to copy in the inspector when the tests had been completed. Cassland Road (1) DS0000028101.V272572.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 3 29 3 30 N/A MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X 3 2 Cassland Road (1) DS0000028101.V272572.R01.S.doc Version 5.1 Page 19 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 OP7 Regulation 14 & 15 Requirement Care plans should be more regularly updated / reviewed / revisited; the ‘OP’ standard of a monthly frequency of reviews may be reduced to a full 6monthly audit (in line with younger adults standard); however, this is the absolute minimum. The new care planning system (‘purple folders’) must now be fully adopted. The proprietor is required to commence regularly recording details of service user’s progress at the home; assessments and reviews cannot be informed unless fuller details are held. (Timescale of 20/11/05 not met.) Fire drills must be conducted at least six monthly, preferably involving any staff who may additionally work at the home. Staff other than the proprietor and her husband must be involved in drills urgently. DS0000028101.V272572.R01.S.doc Timescale for action 31/01/06 2. OP7 15(2) 31/01/06 3. OP38 23(4) 31/01/06 Cassland Road (1) Version 5.1 Page 20 4. OP38 13(4) All staff providing a service at the home must be qualified in First Aid - to ensure that such cover is provided ‘24/7’. (Timescale of 20/11/05 not met; the proprietor has booked a course in January 2006 to cover this requirement.) Gas soundness testing is noted to overdue for its annual test on 06/11/05; such annual checks must be carried out regularly without fail. 31/01/06 5. OP38 23(2)(c) 31/12/05 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 OP16 Good Practice Recommendations That the Complaints Procedure kept in the home should be updated to ensure that the title of the Commission (no longer the ‘NCSC’) should be amended to ensure that service users, friends and relatives have an accurate knowledge of who to contact if they so wish. The policy is due for review in the next month or so. That a checklist – using revised Schedule 2 of the Care Homes Regulations 2001 should be used as a ‘checklist’ for staff file contents - for both current staff and any future recruits, thus ensuring all necessary statutory documentation is fully and competently kept. That the Registered Proprietor / Manager should be qualified to NVQ Level 4 in Management and Care (The Registered Manager’s Award) by the end of 2005. This issue is ongoing; the proprietor is currently continuing on her NVQ Level 4 / RMA Course and reports she is 2/3rds of the way through the Units. 2. OP29 3. OP31 Cassland Road (1) DS0000028101.V272572.R01.S.doc Version 5.1 Page 21 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 Cassland Road (1) DS0000028101.V272572.R01.S.doc Version 5.1 Page 22 - 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. 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