Inspection on 03/02/06 for Cornflower Terrace, 5a

This inspection was carried out on 3rd February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cornflower Terrace, 5a 31/07/06

Cornflower Terrace, 5a 26/07/05

Cornflower Terrace, 5a 25/01/05

Cornflower Terrace, 5a 13/07/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Cornflower Terrace, 5a London SE22 OHH Lead Inspector Barbara Ryan Unannounced Inspection 3rd February 2006 9.30 Cornflower Terrace, 5a DS0000007074.V265310.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Cornflower Terrace, 5a DS0000007074.V265310.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cornflower Terrace, 5a DS0000007074.V265310.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cornflower Terrace, 5a Address London SE22 OHH Telephone number Fax number Email address 01/02Provider 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) 0208 299 2069 5acornflowerterrace@choicesupport.org.uk Choice Support Mrs Sian Clare Russell Hoolahan Care Home 3 Category(ies) of Learning disability (0) registration, with number of places Cornflower Terrace, 5a DS0000007074.V265310.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th July 2005 Brief Description of the Service: 5a Cornflower Terrace is a care home providing personal care and accommodation for 3 people with a learning disability. Choice Support Southwark, a voluntary organisation, owns it. The home is located on a residential street, set back from the other houses, in East Dulwich. The home is close to shops, pubs, the post office and other amenities. The home consists of a two-storey building. One bedroom is on the ground floor, and has en-suite bath and toilet, the other bedrooms on the first floor. All the homes bedrooms are single. There is no passenger lift. The home has a garden to the rear. Cornflower Terrace, 5a DS0000007074.V265310.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and carried out between 09.30 and 15.30 on 02/02/2006. All three residents were at home and spoken to during the inspection. Inspection methods included speaking to one staff member, the home manager and to all three residents, as well observation of care plans and a tour of the building. What the service does well: What has improved since the last inspection? 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. Cornflower Terrace, 5a DS0000007074.V265310.R01.S.doc Version 5.0 Page 6 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 Cornflower Terrace, 5a DS0000007074.V265310.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2, 5 Service users’ changing needs are known by the staff and they have a written contract stating terms and conditions. The organisation has an admissions policy that ensures that potential residential have information make decisions about the suitability of the placement. EVIDENCE: The home has a statement of purpose, which outlines their aims and objectives and the service they offer. The Staff member spoken to was not familiar with the wording of the document but had an understanding of the aims of the home i.e. to support service users to lead independent and fulfilling lives. Service users needs are known and reviewed. One service users contract was seen; it is the policy of the home for all service uses to have a written contract. There have been no new admissions to the home since the last inspection; there is a policy of the managing organisations to obtain an assessment for potential residential prior to admission, encourage introductory visits to the home and 12 weeks reviews of the placements with regard to a trial period at the home. Cornflower Terrace, 5a DS0000007074.V265310.R01.S.doc Version 5.0 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9, Service users know their needs are understood and that they are supported to make decisions about their lives. Service users are supported to develop skills to increase their independence. Risk assessments now look at what skills can be developed to increase independence whilst maintaining the service users’ safely and are reviewed at least every 12 months EVIDENCE: Service users have regular meetings with a familiar member of staff, were they are supported to make plans and set goals. There are regular service delivery plan meetings and annual reviews with the funding authority. The service users have a fortnightly residents meeting and staff support them to discuss and air their views and make decisions Service users have in the past had restriction placed on them with regard to accessing the fridge and freezer at night. The fridge and freezer remain padlocked at night. The home has looked at ways to provide service users with choices at night by offering one resident a choice fruits to take to her room at night and have placed a fridge in her room where she has access to cold drinks. The home has informed the funding authority and is awaiting a written Cornflower Terrace, 5a DS0000007074.V265310.R01.S.doc Version 5.0 Page 9 response; verbally they have been told that this is appropriate and that they have no concerns about this. Another service user has benefited from this action as they are now able to be sure that there will be basic foodstuffs in the fridge i.e. milk for their cornflakes when they get up. The manager has told me that she feels that all residents sleep better now the home is quieter at night, as no one is coming downstairs to the fridge. Risk assessments have been redrawn to include what services users do to maintain their own safely and skills training to support them to keep themselves safe. Goals for the future have been drawn up around each risk to support services users to developed increasing skills were possible around their own safely. All risk assessment have now been completed and will be taken to the team meeting to be signed. Risk assessments are reviewed 12 monthly or as required. Two service uses go unaccompanied for small trips to the local shops and staff are exploring how service users could be more involved in answering the front door and the phone. Cornflower Terrace, 5a DS0000007074.V265310.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13, 14, 16, 17 Service users have opportunities to participate in social and educational activities, that are age appropriate and enable them to develop skills and interests as well as develop relationships and maintain family contacts. Service uses are accessing local community facilities. Their rights and responsibilities are respected. Service users are supported to have a healthy and enjoyable diet. EVIDENCE: Service users have their own personal programme of activities, which include educational and leisure activities. These activities include using local community facilities such as the local pub and local church, as well a facility especially for people with learning disabilities. One service user’s care plan refers to exploring leisure and social activities for older people, which is becoming more appropriate for them. Service users spoke about their outing and activities and seemed confident to approach staff with requests for other trips out. One resident has an activities board in their room that has been used to support them more around choices and they complete this themselves and as far a possible with staff support, and is able to choose which staff member accompany them out. Cornflower Terrace, 5a DS0000007074.V265310.R01.S.doc Version 5.0 Page 11 Service users’ rooms are individual to them and personalised. One resident has a cat and has the cat’s food bowl in her room. Service users have a picture menu board in the kitchen that they fill in once a week. One service uses does not enjoy doing this and has a list of her favourite foods that are included in the weekly menus. Services users choose whether to eat in the kitchen at the dinning table or to eat in their rooms. There is a healthy eating programme in the home, and with the support and guidance of a dietician, two services users have reduced their weight. There is information in the kitchen around healthy eating and choices are offered to service users. Cornflower Terrace, 5a DS0000007074.V265310.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20, 21. Service users benefit from support that is appropriate to their needs, and have both their physical and emotional needs met. Service uses are supported to manage their own medications as much as is safely possible for the individual. Service users are supported around issues or illness and death. EVIDENCE: Service users’ needs are complex and at times there are issues around challenging behaviour. The home have engaged the support of a challenging behavioural specialist who has done an assessment and drawn up an action plan and strategies for staff to use for one resident; these have been recorded in her service information file. Information about the needs of the client, and about the possible underlying causes of the challenging behaviour have been given to staff and they are working with the strategies to try and resolve incidents which might occur both inside and outside the home, as they arise. Service users are supported to do as much as possible for themselves, but are supported and encouraged in areas where this is needed. All the service users looked well groomed and dressed in individual styles of clothing. The interactions between service users and staff seemed warm and relaxed. Two service users are on programmes to support them with self-medication; one service user is able to manage her medication on her own; the other Cornflower Terrace, 5a DS0000007074.V265310.R01.S.doc Version 5.0 Page 13 service user needs some staff support and prompting at present. Medication that is not part of the self-medication programme is kept in a locked cupboard in the kitchen. Service users are supported to access specialist medical support, one resident is reviewed regularly at Guys Hospital with regard to her epilepsy, and a dietician has been involved in support around health eating and weight reduction. Service users are supported around their emotional health and particularly around issues of conflict and upsets between service users. A challenging behavioural specialist is involved with one resident. Staff were able to respond to one resident who was upset with another in a sympathetic way to help defuse the situation. Service users are supported around issues to do with illness and death and have made plans to ensure their wishes are respected. There had been one issue with regard to a service users having been given a second dose of medication due to confusion where a staff member took medication out of the dossett box for another staff member to give, which is against company policy. This was picked up the next day, medical advice sought and followed. The staff member was given a competence test and training, this issue has also been re-looked at in the team meeting. Cornflower Terrace, 5a DS0000007074.V265310.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 The complaints and vulnerable adults procedures are in place. Service users have been supported to use the complaints procedure. Staff have not received any recent, specific training around protection from abuse, although this is planned. EVIDENCE: Service users have been supported to use the complaints procedure and all three have made complaints and have been supported through this process. Complaints are reported to the Complaints Office and a reference number is written in the complaints book by staff. A service manager or someone outside the home will then come down and investigate the complaint. With regard to protection from abuse, one service user has made a number of allegations of abuse in the past. There has been no training of care staff around issues of protection from abuse; a team day is planned for March or April 06 for all staff at the home. A staff member spoken to was clear about the need to report any concerns around abuse to her line manger or if necessary to another manager in the organisation. The home manager has confirmed that staff must record in as much detail as possible any information around any bruising or injury for any service user, this must include even small bruises. One service user has epilepsy and the manager has informed staff they must record information about any seizure witnessed as well as any evidence that the service users may have had a seizure in their room that was not witnessed. Cornflower Terrace, 5a DS0000007074.V265310.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25, 26 27, 30 The environment is pleasant, homely and comfortable. Service users have single bedrooms that suit their needs, are individually furnished, reflect their individual choices and are lockable by the residents. There are still issues from the last inspection around residents’ access the toilet and bathroom when they need to and staff using a resident’s en-suite bathroom at times. The home is clean and hygienic. EVIDENCE: The home has a communal living room, kitchen with dining table and a garden with seating. The home is pleasantly furnished and comfortable. The sitting room has a settee and easy chairs and large patio windows looking onto the garden. Service users’ bedrooms are individual and personalised. One service user did not have a chair in their room, but said this was their choice. Two service users have fridges in their bedrooms and all have a lockable storage unit. Two service users have keys to the cabinet and keys to their rooms. There is a small office on the ground floor with a bed for staff to sleep over at night. At the last inspection there was a requirement with regard to staff using the en-suite WC of one service user on the ground floor, rather than the bathroom and WC upstairs. The use of the upstairs WC has caused conflict between two Cornflower Terrace, 5a DS0000007074.V265310.R01.S.doc Version 5.0 Page 16 residents, particularly in the morning when both wish to bath and use the WC before going out. A plan is now in place to build a second WC and bathroom upstairs to resolve this problem if funding is agreed. If funding is not agreed for this there is a plan to build a second door into the en-suite bathroom downstairs so that the service user would not have staff going through their bedroom if they could not use the upstairs WC. The first option of building another bathroom and WC would benefit all service users, the resident downstairs would not have to share the WC with staff and conflict between the residents upstairs would significantly reduce. The home was clean and hygienic. Cornflower Terrace, 5a DS0000007074.V265310.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32,34, 35, 36 Service users benefit from staff that understand the aims of the home, are appropriately qualified and supervised. The managing organisation’s recruitment procedures contribute to the protection of the residents. Service users were confident in approaching staff. EVIDENCE: Pictures of staff are kept in the kitchen and office and service users know who is supporting them. A staff member spoken to was clear about her role in supporting service users to live independent and fulfilling lives. She had been to numerous in house training and refresher courses and completed her NVQ to level 2. All staff but one have completed their NVQ and this one will be starting soon. The staff member spoken to said that she felt supported to complete the course and was happy to have done it. The managing organisation has a NVQ training programme in place. A check of Choice Support recruitment records, looked at by another inspector at their head office, showed that the procedures followed are safe and comply with the legal requirements. Service uses were relaxed and confident in approaching staff. Cornflower Terrace, 5a DS0000007074.V265310.R01.S.doc Version 5.0 Page 18 Staff report that they receive supervision usually once a month; the aim is for at least every six weeks. Further training is planned around protection from abuse. Cornflower Terrace, 5a DS0000007074.V265310.R01.S.doc Version 5.0 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 Service users benefit from a well run home, they have opportunities to contribute their views about the running of the organisation and of the home they live in. Appropriate records are kept. EVIDENCE: The home manager is qualified to level 4 NVQ. The policy of the home is that all service users should have a written contract with the organisation. The home has procedures for recording and evidence of planning and maintaining up to date care plans Service uses all have their own building society accounts and are supported to go there once a week with a member of staff. All service users have a cash box, which is kept locked in the office and it is easy for them to ask for money. They all have a book and staff count the money at each handover and sign to say the amounts are correct. The organisation has a policy of home managers doing quarterly audits of their home, which they send to their head office. There are monthly visits by the Cornflower Terrace, 5a DS0000007074.V265310.R01.S.doc Version 5.0 Page 20 organisation to look at two specific areas; these are carried out by managers from other homes. Services users are involved in users group run by someone independent from the managing organisation, called the “Speaking Up Group” where they have a forum to express opinions and make suggestions. There is also a residents group meeting in this particular home. One service user from the home is involved in a working group that is looking at ways of involving service users in the recruitment procedure and there is a pilot scheme being run at present by the managing organisation to further explore the best way of involving service users. There are two fires exits, the front door and kitchen door. The front door has an alarm on it so is not double locked; at present the kitchen door is locked as a resident has gone out at night. The home is having an alarms fitted and at that point will be able to leave the kitchen door from being double locked. Cornflower Terrace, 5a DS0000007074.V265310.R01.S.doc Version 5.0 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 X X X 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 2 X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 X 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cornflower Terrace, 5a Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 X 3 X 3 X X DS0000007074.V265310.R01.S.doc Version 5.0 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 YA27 Regulation 23(2) j Requirement The Registered Person must ensure that clear plans with timescales and those responsible are made to provide a second toilet and bath on the first floor Timescale for action 02/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA42 Good Practice Recommendations As discussed and agreed with the Registered Person fit an alarm on the back kitchen door, which is used as a fire exit, so it will no longer need to be doubled locked. 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