Inspection on 31/07/06 for Cornflower Terrace, 5a

This inspection was carried out on 31st July 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cornflower Terrace, 5a 03/02/06

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 Ms Alison Pritchard Unannounced Inspection 31st July 2006 2:10pm Cornflower Terrace, 5a DS0000007074.V301772.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 Cornflower Terrace, 5a DS0000007074.V301772.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. Cornflower Terrace, 5a DS0000007074.V301772.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cornflower Terrace, 5a Address London SE22 OHH 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) 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.V301772.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd February 2006 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 owns and runs the home. 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 is a two-storey building. One bedroom is on the ground floor, and has an en-suite bath and toilet, the other bedrooms are on the first floor and their occupants share a bathroom. All the homes bedrooms are single. There is no passenger lift. The home has a garden to the rear. In July 2006 there were three residents living at the home. The Registered Manager has stated that she would use the house brochure to make information about the home and Choice Support available to potential residents. In order to make CSCI inspection reports available to potential residents she stated that this would depend upon the needs of the person but various options would be available including large print, the use of photographs and widgets format or taped on video or cassette. The current residents pay fees each month between £32.95 and £65.05. Funding authorities pay the remaining costs of the placements. Residents pay between £15 and £25 a week for food, depending on individual circumstances. Cornflower Terrace, 5a DS0000007074.V301772.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and carried out an afternoon and early evening in late July 2006. The inspection methods included observation of care practice, discussions with two of the three residents, discussion with staff and the Registered Manager of the home, inspection of service user and staff files, as well as a range of records and policy documents. Residents’ relatives and involved professionals were sent survey forms so that they could contribute to the inspection process. Responses were received from health care professional. These responses have been taken into account in this report and the Inspector is grateful for the contributions. The CSCI also has access to information about the home gathered through notifications from the home. All of this information has been taken into account in compiling this report. The inspection was well facilitated by the residents, staff and the Registered Manager of the home who were helpful and courteous throughout the process. What the service does well: What has improved since the last inspection? What they could do better: There have been a number of staff changes recently as some members of the team have been unavoidably unavailable for work. This has led to greater use of temporary staff at the home and residents reported missing some members of the permanent staff team of whom they are fond. A sheet relating to one resident was out of date and needs amendment to be accurate. This is of particular importance as it could be used if the resident were to be missing from the home. Cornflower Terrace, 5a DS0000007074.V301772.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cornflower Terrace, 5a DS0000007074.V301772.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cornflower Terrace, 5a DS0000007074.V301772.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The policies and procedures for admission ensure that both the home and the potential resident have enough information to decide whether it would be an appropriate place for the person to live. EVIDENCE: The Registered Manager has stated that she would use the house brochure to make information about the home and Choice Support available to potential residents. In order to make CSCI inspection reports available to potential residents she stated that this would depend upon the needs of the person but various options would be available including large print, the use of photographs and widgets format or taped on video or cassette. There have been no new admissions to the home for a significant period. The policy of the managing organisation is for assessments to be sought prior to admission and for introductory visits to be arranged. After admission the policy is for placements to be subject to a twelve week trial period. Each resident has a statement of terms and conditions about their residency at the home. Cornflower Terrace, 5a DS0000007074.V301772.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, 10, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Care planning contributes to good quality care for residents which reflects the residents’ needs and wishes. A risk management system contributes to safe care practices. Residents are consulted about the running of the home through residents’ meetings, reviews and general discussion. EVIDENCE: The home is introducing person centred planning as a model for the care planning for residents. The care plans are individualised and accessible to residents through the use of plain English, photographs and symbols. There are detailed guidelines about how best to support residents with particular tasks and activities and these are backed up by risk assessments when this is necessary. In one instance the photograph and description of a resident on a personal profile form was inaccurate. The inspector was concerned that should the resident ever be missing this document would not provide accurate information and it is recommended that this is updated. Cornflower Terrace, 5a DS0000007074.V301772.R01.S.doc Version 5.2 Page 10 In some instances the home uses written agreements between the resident and the home about their rights and responsibilities. Care plans are subject to regular review, they, and the placements of two of the residents, had been reviewed during the week prior to the inspection. Residents are consulted as part of the review process. Residents’ meetings are held regularly, there had been six meetings held since the beginning of May 2006. The issues under discussion included menu planning, activities and other issues of general concern to residents. Choice Support is registered under the Data Protection Act and there is a confidentiality policy to ensure that staff handle residents’ personal information with care. Cornflower Terrace, 5a DS0000007074.V301772.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are supported to take part in an appropriate range of activities both in the home and in the local community. The meals provided are nutritious and take good account of residents’ health care needs. EVIDENCE: The residents follow a range of activities which reflect their interests and needs and are decided through the care planning process. On the day of the inspection one resident had been to the local library, another had been shopping and the third had been to her place of work. Other activities include attending church, an art class, cinema trips, visits to the pub, attending social clubs, one of which reflects the resident’s cultural background, bowling and line dancing. The home uses pictorial activity charts so that residents can choose activities easily and so they are aware of the plans for the day. Cornflower Terrace, 5a DS0000007074.V301772.R01.S.doc Version 5.2 Page 12 All of the residents are supported to make and receive visits to and from family members and friends. The visitors’ policy allows visits at all reasonable times and at other times by prior arrangements. Residents have keys to their rooms, and other than at night, because of risks, have free access around the home. The routines of the home are flexible and are focussed on the residents’ needs. Staff showed respect to residents in their interaction with them. Observation confirmed that residents are able to choose to spend time alone if they wish and staff will respect their privacy. The residents take part in menu planning through residents’ meetings and there is good regard for their health needs when the menu is being planned. Cornflower Terrace, 5a DS0000007074.V301772.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents benefit from the careful attention which is paid to their physical, medical and emotional needs. EVIDENCE: The residents are able to contribute to the care planning system and their views are taken into account when care is provided. An advocate is involved with the residents and is a regular visitor to the home. She is invited to contribute to issues of importance to the residents. There is good use of a home diary to ensure that residents are supported to attend a range of health care appointments. The home has good relationships with health care professionals involved with the residents and this is of benefit to them. Members of the multi-disciplinary team which focuses on the needs of people with learning disabilities are involved with the home and offer specialist support and advice. When residents need a medical procedure for which they are unable to give informed consent the home arranges best interests meetings so that people involved with their care can contribute their views to the decision. Cornflower Terrace, 5a DS0000007074.V301772.R01.S.doc Version 5.2 Page 14 Two of the residents are being supported to self medicate. Medication reviews take place appropriately and are recorded. The medication administration records were in good order. An audit was carried out by a pharmacist from Southwark PCT in February 2006, the overall judgement that they made was good and included the comments ‘excellent medicines management and record keeping.’ Two health care professionals who responded to the CSCI comment card expressed their satisfaction with the overall care provided by the home to residents. Cornflower Terrace, 5a DS0000007074.V301772.R01.S.doc Version 5.2 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 the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The residents benefit from appropriate and safe arrangements for dealing with complaints and the protection of residents. EVIDENCE: The complaints and adult protection procedures of the managing organisation meet the standards required. Residents are able to raise issues of concern with staff and the Registered Manager and this has led to investigations under, as appropriate, the adult protection or complaints procedure. In the last twelve months there were six complaints recorded in the complaints book. Three of these were upheld, two were not upheld and one did not have an outcome recorded. A query has been made of the Registered Manager about the results of this matter. The team has recently undertaken a day’s training on adult protection issues. There are safe procedures for dealing with residents’ finances. The procedures ensure that there is clarity about who is responsible for valuables held on behalf of residents and that these are checked at staff handover times. Cornflower Terrace, 5a DS0000007074.V301772.R01.S.doc Version 5.2 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 the following standard(s): 24, 25, 26, 27, 28, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents benefit from a building which is homely, clean and safe. EVIDENCE: The communal space consists of a large living room and a kitchen with a dining table. Both of the communal rooms have access to the garden. Each of the residents has their own bedroom. One of the bedrooms has an en-suite WC and bath, the others residents share a bathroom. There are plans to create an en-suite WC and shower room in one of the upper floor bedrooms. This will benefit both the resident of the room and other resident, with whom she currently shares a bathroom. The bedrooms are personalised, comfortable, homely and equipped with a lockable space and fitted with a lock for residents to use. Staff have an office on the ground floor which is also used as a staff sleeping in room. In order to manage risk to one of the service users adaptations have been made to the doors to the garden, including fitting an alarm to the back door and fitting a lock to the garden gate. The home is cleaned to a satisfactory standard. Cornflower Terrace, 5a DS0000007074.V301772.R01.S.doc Version 5.2 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, 33, 35, 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. There are staff on duty in sufficient numbers to meet residents’ needs. However this is only achieved through the use of bank staff. EVIDENCE: On the day of the inspection visit the Registered Manager was rota-ed to work between 9am and 5pm. There was one member of staff working between 7am and 3pm, having slept in the home the night before and two staff working between 12 noon and 7pm and 10am until 4.30pm respectively. This meant that between 10am and 7pm there is always at least two care staff on duty, with this rising to 12noon and 3pm. While these numbers are adequate for the residents’ needs the staffing levels have only been achieved recently through the use of bank staff. One of the staff on duty on the day of the inspector’s visit to the home was a member of the bank team and this was her first shift at the home. A thorough and documented induction had been carried out by the manager of the home. During the week of the inspection it was planned that four bank staff would be covering shifts. There is a range of reasons for the unavailability of permanent staff. While it is understood that these are largely beyond the control of the Cornflower Terrace, 5a DS0000007074.V301772.R01.S.doc Version 5.2 Page 18 manager of the home and senior staff within Choice Support its impact on the residents has been significant. Two of the residents told that inspector that they were missing other members of staff, of whom they are particularly fond. As staff are unable to reassure the residents about when these people may return to work at the home this is a difficult situation to deal with. The recruitment records were not inspected on this occasion but were seen by the inspector in August 2005. At that time the records were in good order. Five members of care staff have achieved NVQ 2 or above. There is a training and development plan for the home. It covers a good range of topics relevant to the residents’ needs including autism, dealing with challenging behaviour, person centred care planning and report writing. Cornflower Terrace, 5a DS0000007074.V301772.R01.S.doc Version 5.2 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, 38, 39, 42, 43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. There are good management systems in the home, careful monitoring of the quality of care and health and safety systems are well managed. EVIDENCE: The manager of the home has been registered under the Care Standards Act since 2003. She is working towards achieving NVQ level 4. The indications of the inspection are that management arrangements were good and that staff are supported in their work. The service manager is involved with the home and provides support for the manager. Managers visit each month on behalf of the registered provider, they visit on an unannounced basis and include discussion with staff in the visit. The reports of the visits are sent to the CSCI. The service manager is also a regular visitor. All of these systems contribute to the quality monitoring systems. Cornflower Terrace, 5a DS0000007074.V301772.R01.S.doc Version 5.2 Page 20 Health and safety records were up to date and in good order. The gas and electric systems were passed as satisfactory in January 2006 (gas) and April 2004 (electric). The most recent test of portable electrical appliances was carried out in April 2006 and the fire safety systems were last serviced in February 2006. the fire safety risk assessment was done in September 2005 and includes provision for regular checks of the system and fire drills, all of which are carried out. There is a business plan for Choice Support and a copy of this is available along with information about how the identified goals in the plan relate to this house. Cornflower Terrace, 5a DS0000007074.V301772.R01.S.doc Version 5.2 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 Standard No Score 1 3 2 3 3 X 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 3 25 3 26 3 27 2 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 2 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 2 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 3 X 3 3 3 X X 3 3 Cornflower Terrace, 5a DS0000007074.V301772.R01.S.doc Version 5.2 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 Timescale for action The Registered Person must 01/10/06 ensure that clear plans with timescales and those responsible are made to provide a second toilet and bath on the first floor. This was within timescale at the time of the inspection. It is understood that the plans are well advanced but the timescale for the work is not yet established. The CSCI should be informed when the work is planned to be undertaken. The time scale for compliance with this is extended. 2. YA9 17(1)(a) The Registered Person must 01/10/06 ensure that the photographs and descriptions of residents on personal profile forms are accurate. The Registered Person must 01/10/06 ensure that efforts are made to minimise the effect of staff changes and the use of temporary staff on residents. Requirement 3. YA33 18(1)(b) Cornflower Terrace, 5a DS0000007074.V301772.R01.S.doc Version 5.2 Page 23 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 Cornflower Terrace, 5a DS0000007074.V301772.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH 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. 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