Inspection on 12/04/07 for Chatsworth Care - Tudor Lodge

This inspection was carried out on 12th April 2007.

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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Foxley Lane (121a)

Whitworth Lodge

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

CARE HOME ADULTS 18-65 Chatsworth Care – Tudor Lodge 45 The Gallop Sutton Surrey SM2 5RY Lead Inspector Peter Stanley Key Unannounced Inspection 12th April 2007 9:30am Chatsworth Care DS0000068330.V335805.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 Chatsworth Care DS0000068330.V335805.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. Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chatsworth Care – Tudor Lodge Address 45 The Gallop Sutton Surrey SM2 5RY 020 8239 0814 020 8335 3264 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) Gabrielle Anne Smith Graham Peter Smith Kerrie Louise Roach Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 6 people with moderate to severe learning disabilities Date of last inspection Brief Description of the Service: Tudor Lodge was registered on 6 November 2006 and was inspected for the first time by the CSCI on 12 April 2007. The home is an attractive doublefronted detached property, and is situated in a very pleasant residential road within a desirable and expensive area of Sutton. The house has been converted into a residential home for up to six young adults with moderate to severe learning disabilities, challenging behaviour, complex needs and autism. The home aims to provide a supportive, enabling and homely environment for its residents. The house has three floors, with three bedrooms on the ground floor, two bedrooms on the first floor and one bedroom on the second floor. All bedrooms on the ground and first floors have an en-suite bathroom or shower, and toilet facilities. The bedroom on the second floor has a separate bathroom across the corridor, which is for the service user’s own exclusive use. There is a visitor/staff toilet on the ground floor and a large visitor/staff bathroom on the first floor. All windows in the home have been fitted with window restrictors. The home also has two separate toilets for service users, and another toilet for the use of staff. The home has two large lounges, a conservatory, which overlooks the patio and garden, and a large kitchen/dining area. There is a large, attractive back garden, and at the front of the property there is provision for some off-street parking. Access to the garden is possible via the kitchen or through patio doors from the lounge. Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place on 12th April 2007, and lasted about six hours. The inspection involved discussion with the registered manager, Kerrie Roach, and with the training manager, Chris East, the deputy manager and other staff members who were on duty. There are currently four service users, who range in age from 18 to 25, two of whom were present during the inspection. The inspector had wide-ranging discussion regarding the home and its day-to-day running, and examined service user and staff records, and other documentation relating to the management of the home. Though the home has been open only a few months, there is every indication from this inspection that service users needs are generally being well met in this home. The inspector was impressed with the knowledge and understanding of service users’ needs displayed by the recently appointed manager. There was evidence of a positive and caring commitment by the manager and staff towards meeting the complex and challenging needs presented by service users, and in providing opportunities for enabling the development of individual abilities and potential. From the interactions observed between staff and service users, there was evidence of a focussed and enabling one-to-one approach, with evidence of respectful and caring engagement with service users, and attention to meeting individually expressed needs. Assessments and care plans are generally being completed to a high standard. All documentation examined was satisfactory and well maintained and in compliance with the national minimum care standards. Whilst the home has been open for only a few months (since 20/11/06), and this is its first inspection, there was sufficient evidence to indicate that service users are being provided with a good standard of care, and an enabling and inclusive home environment. Quality assurance feedback from service users, relatives and other stakeholders has not, as yet, been evidenced, though the necessary questionnaires and processes for obtaining this are in place. As a result of this inspection, there are just two requirements. These both relate to training; for service users to be fully protected, all staff must complete Sutton’s statutory vulnerable adult training, and must also complete accredited medication training. The inspector recognises that as this is a new home it will take several months for this training to be completed, hence longer time-scales have been applied. Staff at the home are being provided with regular training from an in-house qualified training officer, Chris East. This includes induction and training in adult abuse. There is regular POVA training every six months with updates for all staff. Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 6 Whilst the home is a new one, and has not, therefore, had the opportunity to complete questionnaires with service users, relatives and other stakeholders, it will need to do so during the coming months and complete a quality assurance audit report by the end of its’ first 12 months of operation. The inspector should like to extend his thanks to the manager, Kerrie Roach, and to the training officer, Chris East, and to staff and service users, for their assistance in helping to facilitate this inspection. What the service does well: Prospective service users are being provided with the information they require, in order to make an informed choice as to where to live. Service users have the opportunity to visit and stay overnight, before deciding whether the home is likely to meet their needs. The home is able to demonstrate that it has the capacity to meet service users’ assessed needs. Service users’ health, personal and social care needs are set out in an individual person-centred plan of care, and are being reviewed. Service users are being fully involved in the process of review and care planning. Service users are being assisted to participate fully in the day-to-day life and routines of the home, and are supported by staff in making decisions for themselves in their daily activities. Service users are being consulted regarding their views of issues that individually and collectively affect their lives within the home. Service users are thoroughly assessed regarding potential risks to their health and safety, and are enabled to take responsible risks wherever possible. Service users are being encouraged and enabled to develop personal and independent living skills, and have opportunities for accessing appropriate education, training and work experience. Service users are being provided with a wide and varied range of opportunities for participating in recreational and leisure activities, and have extensive contact and links with the local community. The home actively encourages service users to maintain family links and friendships both inside and outside of the home. Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 7 Service users’ rights and responsibilities are being recognised in their daily lives. Service users are being enabled to be as independent as possible within the constraints associated with their disabilities. Service users are being offered a nutritious and healthy diet in a congenial environment. Service users’ personal support and health care needs are being well met in this home, with support being planned and tailored according to the individual needs presented. The home has an appropriate and well-publicised complaints policy and procedure in place. Clear information for raising complaints is made available, and service users and their relatives/friends are encouraged to raise any concerns that they may have. Service users live in an environment, which is safe, well maintained and adapted for people with disabilities. Service users have access to sufficient and comfortable communal facilities. Service users’ rooms are safe, comfortable and pleasantly decorated, reflecting service users’ personal identities, and being suited to their individual needs. Service users’ toilets and bathrooms provide sufficient privacy and meet individual needs. The home presents as being clean and hygienic. Staff have clearly defined roles and responsibilities, and are sufficient in numbers to meet service users’ needs. Service users are having their needs well met by an appropriately trained and qualified staff group. Service users are being protected by appropriate recruitment policy and procedures. Service users are benefiting from well-supported and supervised staff. The home is being run competently, and in the best interests of the home’s service users. Service users’ rights and best interests are being safeguarded by the home’s record keeping, and by its policies and procedures. The health, safety and welfare of service users and staff are being appropriately promoted and protected. What has improved since the last inspection? Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 8 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. The summary of this inspection report can be made available in other formats on request. Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 9 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 Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 to 5 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Prospective service users are being provided with the information they require, in order to make an informed choice as to where to live. Service users have the opportunity to visit and stay overnight, before deciding whether the home is likely to meet their needs. The home is able to demonstrate that it has the capacity to meet service users’ assessed needs. Service users’ health, personal and social care needs are set out in an individual person-centred plan of care, and are being reviewed. Each service user is being provided with a service user agreement. These are being prepared in a format that is appropriate to the communication needs of the home’s service users. EVIDENCE: Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 11 10The home’s Statement of Purpose and Service User Handbook are both very comprehensive documents, and meet all the criteria detailed in this standard. The Service User Handbook provides an appropriate format (using pictures and symbols) for assisting the understanding of individual service users. The manager advised the inspector that the home is focussing on meeting the needs of younger service users within the 18 to 30 age range. There are currently four service users at the home, aged from 18 to 25, with two vacancies. The homes admissions policy is for the home’s manager or owner to ensure compatibility with other service users living at the home. Following referral, care management and specialist assessments are obtained. The procedure then involves initial visits from the care manager and parent/nearest relative, followed by a visit from the prospective service user to see the home and meet staff and service users. The manager and deputy manager then arrange to visit the prospective service user, completing their own assessment and requesting psychiatric or psychological reports where necessary. Wherever possible, the home tries to involve the care manager or close relative as an advocate, or seek an independent advocate from within the local area. Once a prospective service user has been assessed, and found to be compatible with others living at the home, he or she is encouraged to visit the home, then stay overnight, followed by another possible overnight stay, and culminating in a weekend stay. This process is designed to enable the prospective service user to become familiarised with the home prior to making a decision on whether to move in on a permanent basis. All four service users have moved into the home within the last few months, one of whom moved in within the week prior to inspection. The inspector examined the service users files and found that these included full assessments and up-to-date person-centred care plans. The service users’ health, personal and social care needs are set out in an individual plan of care. Care management assessments and risk assessments, and details of the service user’s history were evidenced. Assessment reports from psychiatrists and psychologists are being obtained, as required. Reviews are being completed within prescribed time-scales. Review notes generally indicate that there has been positive feedback from care managers and relatives regarding the home’s capacity to meet service users’ assessed needs, and help facilitate their independence and personal development. The inspector spent some time observing and interacting with service users, who are supported on a one-to-one basis by staff. The home currently has four service users, which vary from being moderate to severe in their diagnoses. Two service users were present during the inspection, both of whom presented as settled and happy in their environment, with staff being attentive to their Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 12 needs and supportive in their interactions. The home has a very homely and caring atmosphere, this being reflected in the attitudes of management and staff. An agreement or contract is to be developed and agreed with the prospective service user and his/her nearest relative, care manager or advocate, with a copy to be signed by the service user or his/her representative. The contract format uses pictures and symbols, which help to facilitate the service user’s understanding of its contents. The manager advised that contracts are currently being prepared in draft form and are waiting to be finalised and sent out. Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6 to 9 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users are having their health, personal and social care needs set out in an individual plan of care, and are being fully involved in the process of review and care planning. Service users are being assisted to participate fully in the day-to-day life and routines of the home, and are supported by staff in making decisions for themselves in their daily activities. Service users are being consulted regarding their views of issues that individually and collectively affect their lives within the home. Service users are thoroughly assessed regarding potential risks to their health and safety, and are enabled to take responsible risks wherever possible. Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 14 EVIDENCE: The inspector examined service users’ files. These include detailed service user plans, which are being reviewed and updated. Service user plans are comprehensive and follow a person centred plan approach. Service user plans provide information evidencing how service users’ care and support needs are being addressed, the involvement of service users and their relatives or representatives in drawing these up, and the service user’s right to make decisions in the process. The plans describe how service users will meet aspirations and achieve goals. All service users have six-monthly and annual reviews. The service user and the key worker attend review meetings, with close family members, friends and/or representatives being invited. The care manager is also invited for the statutory initial and twelve-monthly reviews. Service users are encouraged to make decisions regarding their day-to-day routines, activities and choices. There is substantial evidence of service users’ right to make decisions being respected, whether this is in the choice of activities, the use of leisure, choosing clothing or in developing skills and interests. As evidenced in care plans, service users are being consulted in respect of their day-to-day routines, their choice of food, and their choice of activities. There are a number of mechanisms in place for involving service users in the running of the home. Service users attend weekly meetings. These cover a range of issues, such as group activities and outings, and weekly menus, and are facilitated by the Manager or Deputy Manager. Each service user has a key worker who consults on a one to one basis and provides individualised support. Service users also receive regular visits from the home’s owners, Gabrielle and Graham Smith, who actively consult with both service users and staff. The home has a risk assessment procedure which details the risks and level of risk to service users. Service user files evidenced the completion of full and detailed risk assessments, together with risk management strategies agreed with service users. Service users’ potential for developing independence is encouraged and enabled wherever possible, subject to safe strategies for managing risks being in place. Risk assessments are scheduled to be reviewed on a six-monthly basis. Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11 to 17 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users are being encouraged and enabled to develop personal and independent living skills, and have opportunities for accessing appropriate education, training and work experience. Service users are being provided with a wide and varied range of opportunities for participating in recreational and leisure activities, and have extensive contact and links with the local community. The home actively encourages service users to maintain family links and friendships both inside and outside of the home. Service users’ rights and responsibilities are being recognised in their daily lives. Service users are being enabled to be as independent as possible within the constraints associated with their disabilities. Service users are being offered a nutritious and healthy diet in a congenial environment. Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 16 EVIDENCE: Service users are evidenced as being provided with extensive and varied opportunities for personal development and leisure activities. Service user files evidence that there are detailed individual programmes for service users, with service users participating in a wide range of educational, social and leisure activities. Service users participate in a variety of recreational and sporting activities such as swimming and horse-riding. Sutton Mencap provides access to a wide range of activities. One service user attends a local community college 4 days a week where there is a range of courses offered for people with learning difficulties. There is also a local youth club that is held on Sundays which three service users attend. The home actively encourages service users to access community facilities such as the local shops, and a local leisure centre. Service users are assisted to go shopping for food or clothes buying, and to attend community events when these arise. Trips out are arranged. These have included a recent day trip to Brighton and a riverboat trip. Service users are encouraged to access public transport, and to use taxis as and when required. The home does not currently have its own minibus. Service users are encouraged to maintain contact with family and friends, with opportunities for service users to visit family at home for occasional weekends, and to receive visits at the home. Service users are able to receive visitors at the home, including in the relative privacy of the conservatory or in their own rooms. There are no set visiting times though visitors are advised to phone prior to arranging to visit. Initial feedback received from relatives and friends at reviews, and when visiting, has been favourable, with visitors feeling that they are kept well informed and are made to feel welcome. The ethos of the home is orientated towards promoting independence and maximising choice and opportunities. Service users are encouraged to take responsibility for undertaking daily tasks such as cleaning and tidying their rooms, and preparing drinks, food and snacks. Service users rights and responsibilities are evidenced from care plans as being respected and recognised in their daily lives, with service users being enabled to be as independent as possible within the constraints associated with their disabilities. Staff at the home work with service users with the aim of increasing their motivation and confidence, and developing their independent living skills. The inspector observed that staff engage with service users in a positive and respectful way, and are enabling in their approach. Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 17 Mealtimes are flexible and take account of individuals’ work and activity schedules. Menus evidenced a wide choice of foods, offering a varied and nutritional diet. Professional advice is sought regarding dietary needs when this is required. Service users are consulted individually, and at service user meetings, as to which foods they would like, and are able to assist with shopping at a local supermarket. Service users are able to have an alternative dish provided if the main menu options do not appeal. Staff work alongside service users in preparing food, and with laying table and clearing up. Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18 to 20 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users’ personal support and health care needs are being well met in this home, with support being planned and tailored according to the individual needs presented. Generally, service users are being protected by the home’s medication policy and procedures. All staff need, however, to complete accredited medication training. EVIDENCE: As detailed in service users’ assessments and care plans, there is a varied range of personal support needs that are presented by service users. The support offered is provided according to individuals’ needs, wishes and goals. Inspection of care plans, together with observation and feedback provided from reviews, indicates that staff are enabling in promoting independence and meeting service users’ wishes and needs, and are providing both flexible and Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 19 focussed support. Service users are encouraged, wherever possible, to maintain responsibility for their own personal care, hygiene and appearance, with encouragement, prompting or assistance being given where this is required. Where service users require support with personal care, this is provided privately in their own rooms. All service users have access to their own bathroom or shower room. All service users at the home are registered with a local GP practice, where there is a GP with a special interest in learning disabilities. There is access to a community psychiatrist via Sutton’s Community Learning Disabilities Team, with visits being made to the home when required. The home also has access to services such as speech therapy and psychology via the GP, and to community dental and optician services. The manager, Kerrie Roach, demonstrated a sound awareness of the behavioural and healthcare needs of the home’s service users. There is an ongoing programme of induction and training in place, with staff being provided with training and advice relating to specialist needs such as autism, sensory impairment and challenging behaviour. The home has a clear policy and procedures in place for the receipt, recording, storage, handling, administration and disposal of medicines. Medication is kept in a locked cupboard on the first floor. The home employs the Boots blister pack system. All staff receive a comprehensive induction on the administering of medication to service users. Following their induction training the staff member is observed by the manager on three occasions before being allowed to administer medication to a service user. Two staff (one administering, one observing) are required to sign the MARS sheets following each dispensation of medication to a service user. The manager advised that a Boots pharmacist has recently visited the home and given advice to staff on medication issues, and that four staff have so far completed accredited medication training. The inspector discussed the need for all staff to complete this training, for which a requirement applies. Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home has an appropriate and well-publicised complaints policy and procedure in place. Clear information for raising complaints is made available, and service users and their relatives/friends are encouraged to raise any concerns that they may have. Generally, the home’s policies, procedures and practice indicate that service users are being protected from abuse and are living in a safe environment. However, for service users to be fully protected, all staff must complete Sutton’s statutory vulnerable adult training. EVIDENCE: The home has a complaints procedure that includes the relevant required information, including stages and times-scales, for the complaints process. This is produced in a format, using pictures and symbols, that is appropriate to meeting the communication needs of service users. Any complaints or concerns are recorded. No complaints have been received since the home opened on 20 November 2006. Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 21 The home has its own Protection and Prevention of Abuse policy, and Whistle Blowing policy. All staff are required to sign to indicate that they have read through the policy and procedure. Staff at the home are provided with regular training from an in-house qualified training officer, Chris East. This includes induction and training in adult abuse. There is regular POVA training every six months with updates for all staff. All staff are made fully aware of local statutory adult protection procedures. The inspector was advised, however, that staff have yet to complete Sutton’s multi-agency Vulnerable Adult training. Contact should be made with Sutton’s Training Department to arrange for the staff to undertake the training. A requirement applies. Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 to 30 Quality in this outcome area is excellent. This judgement has been made from evidence gathered both during and before the visit to this service. Service users live in an environment, which is safe, well maintained and adapted for people with disabilities. Service users have access to sufficient and comfortable communal facilities. Service users’ rooms are safe, comfortable and pleasantly decorated, reflecting service users’ personal identities, and being suited to their individual needs. Service users’ toilets and bathrooms provide sufficient privacy and meet individual needs. The home presents as being clean and hygienic. EVIDENCE: Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 23 The inspector completed an inspection of the premises. The home is situated in a quiet and very pleasant residential road within a much sought after area of Sutton. The home is a large detached property, with six bedrooms (for service users) spread between three floors. The home provides a very congenial and safe environment and has been adapted to meeting the needs of the service users. The home presents as very well maintained and is decorated to a high standard. The home has been pleasantly furnished, with modern-style furniture in all areas. There are two communal lounges, both of which are well laid out. These provide a pleasant and homely place to relax and spend time. The inspector met one service user who was sitting with her key worker in the television lounge, and who presented as being settled and happy with her environment. The other, larger lounge is comfortably furnished and opens out into a very attractive conservatory where service users can relax or entertain visitors. There is a large and well-equipped open-plan kitchen with a well laid-out dining area, giving it a very homely feel. The home has a very large, attractive garden at the rear which service users are encouraged to use and enjoy. One young service user was playing football with a staff member and presented as happy with his environment. Each service user has a bedroom, which has sufficient useable floor space to meet individual needs and lifestyles. Each service user on the ground and first floors has access to either an en suite bathroom/toilet, or a shower room/toilet. One service user’s room on the top floor is not ensuite, but has exclusive use of their own bathroom and toilet just across the corridor. Four of the six bedrooms are currently occupied. These are individualised and personalised by the service users, with all service users having a locked cupboard in their rooms. The home presents as safe and well adapted to the needs of the current residents, all of who are relatively young and able to mobilise freely around the home. The home has a risk assessment in place, and individual service users are risk assessed on admission. The home presented as being clean and pleasant, with high standards of hygiene being maintained throughout. Areas inspected included the kitchen, laundry room, communal areas and bedrooms. No concerns were identified. Staff are required to attend food hygiene and infection control training, and there are policies and procedures in place that relate to the maintenance of hygiene in the home. Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31 to 36 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Staff have clearly defined roles and responsibilities, and are sufficient in numbers to meet service users’ needs. Service users are having their needs well met by an appropriately trained and qualified staff group. Service users are being protected by appropriate recruitment policy and procedures. Service users are benefiting from well-supported and supervised staff. EVIDENCE: The inspector observed staff during the inspection and evidenced positive interaction with service users. The inspector spoke to two staff members, who indicated that they are feeling well supported at the home and are receiving the necessary induction, supervision and training. Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 25 Staff benefit from clarity of staff roles and responsibilities, with detailed job descriptions being in place. Each staff member attends an initial induction programme at the home, which is followed by a six-week period of observation and further training, with the new staff member working alongside an experienced staff member. There is an ongoing induction programme which is spread over 3 months and includes The Principles of Care, Understanding the organisation and role of the worker, Maintaining safety at work, Communication skills, Recognising and responding to abuse, and Developing as a worker. A three-month probationary period applies. All staff sign and date a record to indicate that they have read and understood each policy and procedure that has been put in place and reviewed. Staff Meetings provide a forum for discussing issues that relate to practice and the running of the home. The manager confirmed that these are being held on a regular monthly basis. The home currently has 10 full-time and 5 part-time staff, of whom 7 staff currently have an NVQ Level 2 (one of whom has an NVQ Level 3). Five other staff have registered for study leading to an NVQ level 2. The home is on track for meeting the 50 target in this regard. The registered manager, Kerrie Roach, is a qualified Learning Disability Nurse and has a relevant NVQ Level 4 and RMA (Registered Managers Award). She has had previous managerial experience, both as a deputy manager and as acting manager, in a residential home for older people with dementia. The deputy manager holds an NVQ level 3, an NVQ Assessors Award, a PDC in Management Care, and has recently completed studies leading to an NVQ Level 4 and an RMA (Registered Managers Award). Chatsworth Care has its own training manager, Chris East, who the inspector met during the inspection. She has responsibility for the training of staff within Tudor Lodge and its two companion homes, Dawson House (in Sutton) and Greenacres (in Banstead), and works closely with the homes’ managers in identifying and meeting training needs. A comprehensive on-going training programme has been developed, a copy of which was given to the inspector. This ensures that all staff receive training in working with service users who have learning disabilities, and autism, and with service users who present challenging behaviour. Training also covers First Aid, Fire Safety, Health and Safety, Food Hygiene, Infection Control, Moving and Handling, Medication, Abuse awareness and POVA (Protection of Vulnerable Adults), equality and diversity, and anti-discriminatory practice. The inspector viewed the staff rota, and was satisfied that the staffing complement for the home meets appropriate DOH guidelines, with a minimum of 4 staff being on each shift during the day, providing one-to-one support for service users. There are two waking staff on-call at night. Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 26 With the recent opening of this home, a new staff group has been recruited. Some staff have transferred across from other homes in the Chatsworth Care group. A satisfactory recruitment policy and procedure in place. This is based on equal opportunities principles and aims to ensure the protection of service users. The inspector examined a sample of staff files and completed checks on CRB certificates and recruitment procedures. All checks completed were found to be satisfactory and no concerns were evidenced. All staff receive regular six-weekly supervision, with supervision records being maintained. These are signed by the supervisee following each supervision session. Supervision is shared between the manager and deputy manager, with probationary reviews being completed with all new staff after their first 3 months. Supervision includes structured discussion regarding issues that relate to staff members’ practice, training and development. There is an appraisal process in place, which includes a self-evaluation form to be completed by each staff member. Appraisal is 12 monthly, and is scheduled to be undertaken in September/October 2007. Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 27 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37 to 42 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home is being run competently, and in the best interests of the home’s service users. While the home has quality assurance processes in place, it has yet to implement questionnaires and obtain the views of service users, relatives and professionals. Service users’ rights and best interests are being safeguarded by the home’s record keeping, and by its policies and procedures. The health, safety and welfare of service users and staff are being appropriately promoted and protected. Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 28 EVIDENCE: The registered manager, Kerrie Roach, completed her NVQ Level 4 and the RMA (Registered Managers Award) in August 2005. She is qualified as a Learning Disability Nurse and has had previous management experience of running a residential home, both as a deputy manager and as an acting manager. During the inspection, the inspector the manager displayed a good knowledge and understanding of the needs of this client group, and was able to demonstrate her competency regarding issues relating to the day-to-day running and management of the home. The inspector was impressed by the management approach within this home. The inspector’s observations, and the discussion which he has had with both service users and staff, evidenced that service users needs are generally being well met, and that there is a positive and enabling approach within the home. Both service users who were present during the inspection presented as being settled and happy within the home and as being well supported by staff. There was evidence to indicate that service users are being encouraged and enabled to participate in daily routines, activities and decision-making. Staff feedback indicates that they are feeling well supported by management and that their training and support needs are being addressed. The home has quality assurance processes in place, which includes questionnaires for service users, relatives/representatives, care managers/professionals and staff. The questionnaire for service users is presented in an appropriate format for service users, and includes the use of Makaton and verbal prompts. The home has been open a few months and has not, as yet, completed any surveys. While no requirement is being made on this inspection, the home will, however, need to prioritise the need for obtaining this and other feedback so as to evidence (in a quality assurance audit report) how well it is meeting its aims and objectives. From the evidence of this inspection, service users’ and staff records are generally being well maintained. Records and documentation examined by the inspector were found to be comprehensive, up to date and accurate. Service users are able to gain access to their records and any information held about them. In line with data protection, all records are being kept securely in lockable filing cabinets within an office on the top floor. The home has a comprehensive range of policies and procedures in place. These will need to be reviewed annually, and a full record maintained. This should indicate the date when each staff member staff has read each policy and procedure that has been initiated or reviewed. Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 29 Generally, the home presents as a safe environment in which to live. The home has completed health and safety and fire risk assessments. Health and safety certificates are in place from September 2006 for electrical installation, portable electrical appliances, fire alarm installation, emergency lighting and gas safety. The manager advised that all staff at the home have undertaken fire safety training, and that there are periodic fire drills. Other health and safety checks such as water temperature and fridge/freezer checks, and fire alarms tests, are being completed on a regular basis. Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 30 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 3 2 3 3 3 4 3 5 3 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 4 25 4 26 3 27 4 28 3 29 X 30 4 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 3 2 3 3 3 x Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 31 Are there any outstanding requirements from the last inspection? N/A 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 YA20 YA23 Regulation 12(1)(a), 18(1)(a) & (c) 13(6) Requirement All staff at the home must complete accredited medication training. All staff at the home must complete Sutton’s statutory adult protection training. Timescale for action 31/10/07 31/10/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Chatsworth Care DS0000068330.V335805.R01.S.doc Version 5.2 Page 33 - 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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