Inspection on 16/05/05 for Conifers

This inspection was carried out on 16th May 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

Conifers 30/05/07

Conifers 04/07/06

Conifers 26/10/05

Conifers 11/10/04

Conifers 05/04/04

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

CARE HOME ADULTS 18-65 Conifers 44 Broad Green Avenue West Croydon Surrey CR0 2ST Lead Inspector James OHara Announced 16 May 2005 09:30 th 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 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 Stationary 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. Conifers G53-G53 S25773 Conifers V187270 160505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Conifers Address 44 Broad Green Avenue West Croydon Surrey CR0 2ST 020 8665 0237 020 8683 2329 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Milton Anthony Wilson Mrs Yvonne Wilson Mrs Yvonne Wilson Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Conifers G53-G53 S25773 Conifers V187270 160505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: A variation has been granted to allow one specified resident over the age of 65 to be admitted. Date of last inspection 11/10/04 Brief Description of the Service: Conifers is located in a quiet avenue off a busy thoroughfare close to the centre of Croydon. There is access to local buses and trains, facilities and amenities are all easily accessible.The home has been registered to provide support to six people with learning disabilities and includes a variation for one service user who is over the age of sixtyfive, at present six people live in the home. The home comprises of four floors with the living room, kitchen and laundry in the basement, two bedrooms and a bathroom with access to the back garden on the ground floor, two bedrooms and a bathroom on the second floor and two bedrooms a shower room and a toilet on the top floor. Most of the service users who presently live at the home have done so since the home opened and all know each other very well. The proprietor who is also the registered manager owns the property. Conifers G53-G53 S25773 Conifers V187270 160505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was inspected under the National Minimum Standards Care Homes for Younger Adults. The inspection took place over one day. Methods of inspection included a tour of the premises observation of contact between staff and service users, discussion with service users, a member of staff and the home registered manager/provider. Records examined included service user plans care manager needs assessments and risk assessments, medication records, complaints, staffing records, health and safety and fire records. Requirements and recommendations from the previous inspection were also discussed with the registered manager/provider. What the service does well: What has improved since the last inspection? What they could do better: As a result of this inspection there are three new requirements and six new recommendations. The three requirements centre round minor repairs needed in the home and the recommendations are aimed at updating and improving what the home does at present. The general condition of the home is good but Conifers G53-G53 S25773 Conifers V187270 160505 Stage 4.doc Version 1.30 Page 6 it would benefit from a rolling programme of redecoration and refurbishment. The registered manager and a member of staff have completed training on Person Centred Planning and this approach would benefit both the home and the service users. The inspector would like to thank the service users and their relatives for their help and feedback and staff and management of the home for their support on the day of the inspection. 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. Conifers G53-G53 S25773 Conifers V187270 160505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Conifers G53-G53 S25773 Conifers V187270 160505 Stage 4.doc Version 1.30 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 standard(s) 1, 2 and 3. Information available to prospective service users is good, no new service user has moved to the home since the last inspection however all the procedures are in place should they be needed. EVIDENCE: The home has a Statement of Purpose and a Service User Guide however these need to be reviewed and updated. The Statement of Purpose and Service User Guide should be updated and home should record the Service User Guide and the homes complaints procedure on audiotape for the service user who uses this communication method. Service user files sampled indicated that care managers assess their service users needs annually. As recommended at the last inspection the registered manager sought epilepsy refresher training for the staff. The house diary indicated a date that the epilepsy nurse was due to visit the home but there was no recorded evidence that she came the home. A member of staff on shift confirmed that he had refresher training from the epilepsy nurse on that day. The home should ensure that it keeps a record of all visitors to the home. Conifers G53-G53 S25773 Conifers V187270 160505 Stage 4.doc Version 1.30 Page 9 Conifers G53-G53 S25773 Conifers V187270 160505 Stage 4.doc Version 1.30 Page 10 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 standard(s) 6, 7, 8 and 9. The home achieves a good degree of co-operation with the placing local authority and service users have regular care manager and service user reviews. EVIDENCE: Service users have annual care manager reviews and service users reviews are completed on a regular six monthly basis. However the care manager/service user reviews follow the same format and are completed in the third person. The wording and the overall ownership of these reviews were discussed and it was agreed that the home should move to the Person Centred Plan approach that should run along side care management reviews. This would give ownership of the plan to the individual service user, the service user can then decide who comes to the meeting the venue and what he/she wishes to talk about. Each service user should have a Person Centred Plan completed every six months. At the previous inspection a member of staff said that he and the registered manager had recently attended training on Person Centred Planning. Risk assessments are regularly reviewed by the registered manager however risk assessments should be reviewed at the care managers reviews and future Person Centred Plan reviews. Conifers G53-G53 S25773 Conifers V187270 160505 Stage 4.doc Version 1.30 Page 11 Three service users said that they are involved in planning the weekly meals in the home. One service user said that he liked to do the shopping. The home facilitates regular monthly service user meetings were the service users discuss issues in the home such as holidays and social activities. Conifers G53-G53 S25773 Conifers V187270 160505 Stage 4.doc Version 1.30 Page 12 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 standard(s) 11, 12, 13, 14 and 17. The home promotes service users independence; service users are encouraged to become part of the local community. EVIDENCE: One service user has an interest in trains and has a large model railway in his bedroom; he also attends a local model railway club and is a keen train spotter, he also works at the Big Bus Company. Other service users have jobs attend day services, college and the pop in club. Each service user is independent in the way they wish to be and said that they were not restricted in any way. One service user say’s that he attends Church on a regular basis and has become very involved with a group who attend the Church. He said that he meets with the group on a daily basis and they are helping him with his reading and writing. He has been given audiotapes of the New Testament that he listens to in his bedroom. Considering when he moved to the home in August 2003 he suffered from health and weight problems and refused to leave his bedroom, the home has supported/encouraged him to find Conifers G53-G53 S25773 Conifers V187270 160505 Stage 4.doc Version 1.30 Page 13 meaningful appropriate activities that he enjoys. He said that he is very happy at the home and happy with his social arrangements. Daily menus appeared to offer service users a balanced diet and included plenty of fruit, vegetables, fish and chicken. Three service users said that they are involved in planning the weekly meals in the home. Conifers G53-G53 S25773 Conifers V187270 160505 Stage 4.doc Version 1.30 Page 14 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 standard(s) 19 and 20. The arrangements made for the health care needs of the service users appear to be good and the home has the support of a local pharmacist for advice on medication. EVIDENCE: One service user explained that he had a seizure last week. Records examined indicated that this had been appropriately recorded and the service user had been to see his General Practitioner about this. None of the service users self medicate. Self-medication risk assessments are in place in all of the service users files. All service users are registered with a local General Practitioner. The home keeps a record of service user/General Practitioner appointments detailing the reason for appointment, outcome and any advice given by the Doctor. Health care needs including optical, chiropody and dental health are recorded in appointment monitoring forms located in the service user files. Conifers G53-G53 S25773 Conifers V187270 160505 Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23. The home has an appropriate complaints procedure and a copy of Croydon Adult Protection Procedure that is used in conjunction with the homes own abuse policy. EVIDENCE: There have been no complaints received or directed at the home in the last twelve months. All service users were aware of the homes complaints procedure and were able to say who they would complain to, and if need be would contact the Commission for Social Care Inspection. A relatives comment card returned to the Commission for Social Care Inspection as feedback indicated that they were not aware of the homes complaints procedures. The registered provider should send a copy of the homes complaints procedures to all of the service users relatives. Also see recommendation in “Choice of Home” section of this report. Conifers G53-G53 S25773 Conifers V187270 160505 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 27, and 30. The general condition of the home is good but it would benefit from a rolling programme of redecoration and refurbishment. EVIDENCE: The home meets the required space and facility standards, the service users rooms are large and personalised to their wishes. There are two bathrooms, one shower room and separate toilet all within easy reach of service users rooms. The toilets in the basement and the top floor of the house require new toilet seats and the bath on the second floor requires resealing. The home does not currently keep a record of hot water temperatures. The registered manager must ensure that the home keeps a weekly record of hot water temperatures. The home should maintain regulation of water temperature close to 43oC. The plug socket on the top floor landing requires refitting. The home has a good sized and well-kept garden at the rear of the property, which is tended by the service users. Conifers G53-G53 S25773 Conifers V187270 160505 Stage 4.doc Version 1.30 Page 17 The registered manager should develop a rolling programme of redecoration and refurbishment. The home was clean and free of offensive odours on the day of the inspection. Conifers G53-G53 S25773 Conifers V187270 160505 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 34, 35 and 36. The home has a small well-established staff team that have worked together for a number of years, this has benefited the service users, providing stability and consistency while dealing with service users individual needs. EVIDENCE: Recent staff training records indicate that staff has attended training on moving and handling, first aid, health and safety and fire safety. Staff Criminal Record Bureau Checks for all staff had been shown to the inspector at the last inspection. One member of staff has recently completed his NVQ level 2 and another member of staff is due to complete this qualification. The registered managers husband who also works as part of the staff team is completing NVQ level 3. The home is on course to meet NVQ targets within the required time-scales. Staff receive regular supervision and appraisals. Conifers G53-G53 S25773 Conifers V187270 160505 Stage 4.doc Version 1.30 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42. The registered manager has worked at the home since it opened seven years ago and has a City and Guilds Qualification in the Advanced Management in Care. EVIDENCE: The home has a quality monitoring system in the form of service user, relatives and visitors questionnaires. Comments recorded in the questionnaires from service users and their relatives were very positive. The home has a monthly Quality Assurance form that monitors catering, housekeeping, administration, health and safety, staff training, service user reviews, fire drills and fire equipment checks. As recommended at the last inspection the registered manager now completes the Quality Monitoring form on a regular monthly basis and signs and dates when this has been completed. Evidence was seen of Portable Appliance Testing Certificate 01/02/05, Legionella Testing Certificate 29/04/05, Landlords Gas Safety Certificate 28/07/04 and fire alarm and fire equipment was checked on 08/03/05. Conifers G53-G53 S25773 Conifers V187270 160505 Stage 4.doc Version 1.30 Page 20 Conifers G53-G53 S25773 Conifers V187270 160505 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x 2 2 x 3 Standard No 11 12 13 14 15 16 17 3 4 4 3 x x 3 Standard No 31 32 33 34 35 36 Score 3 3 x 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Conifers Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x G53-G53 S25773 Conifers V187270 160505 Stage 4.doc Version 1.30 Page 22 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 27 Regulation 23(2)b. Requirement The toilets in the basement and the top floor of the house require new toilet seats and the bath on the second floor requires resealing. The registered manager must ensure that the home keeps a weekly record of hot water temperatures. The plug socket on the top floor landing requires refitting. Timescale for action 31/07/05 2. 27 13(4)a. 31/07/05 3. 28 13(4)a. 31/07/05 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 1 Good Practice Recommendations The Statement of Purpose and Service User Guide should be updated and home should record the Service User Guide and the homes complaints procedure on audiotape for the service user who uses this communication method. The home should ensure that it keeps a record of all visitors to the home. Each service user should have a Person Centred Plan completed every six months. G53-G53 S25773 Conifers V187270 160505 Stage 4.doc Version 1.30 Page 23 2. 3. Conifers 3 6 4. 5. 6. 9 22 28 Risk assessments should be reviewed at the care managers reviews and Person Centred Plan reviews. The registered provider should send a copy of the homes complaints procedures to all of the service users relatives. The registered manager should develop a rolling programme of redecoration and refurbishment. Conifers G53-G53 S25773 Conifers V187270 160505 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor, Grosvenor House 125 High Street, Croydon CR0 9XP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Conifers G53-G53 S25773 Conifers V187270 160505 Stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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