Inspection on 15/11/05 for Cranley Gardens (14)

This inspection was carried out on 15th November 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. 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

Cranley Gardens (14) 23/08/06

Cranley Gardens (14) 20/06/05

Cranley Gardens (14) 19/10/04

Cranley Gardens (14) 26/07/04

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 Cranley Gardens (14) 14 Cranley Gardens Wallington Surrey SM6 9PR Lead Inspector Deborah Yapicioz Unannounced Inspection 15th November 2005 08:45 Cranley Gardens (14) DS0000007163.V265781.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 Cranley Gardens (14) DS0000007163.V265781.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. Cranley Gardens (14) DS0000007163.V265781.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cranley Gardens (14) Address 14 Cranley Gardens Wallington Surrey SM6 9PR 020 8647 9703 020 8405 8206 cranley@independencehomes.co.uk 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) Independence Homes Limited Christina Pantrini Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Cranley Gardens (14) DS0000007163.V265781.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th June 2005 Brief Description of the Service: Cranley Gardens is a residential care home that is registered with the Commission for Social Care Inspection to provide a service for up to six younger adults (18 to 65) with mild to moderate learning disabilities and epilepsy. All the service users currently residing at the home young females aged between their early twenties and thirties. Christina Pantrini has been in operational day-to-day control of the home since November 2003.The property itself is a spacious detached building situated in a quiet residential area of Wallington. There are six single rooms, one with its own en-suite facilities. On the ground floor there is an open plan L shaped lounge/dinning area and kitchen. There is also a large conservatory, attached to the lounge that leads out into the garden. A separate office/sleep-in room is provided on the ground floor and is accessible to both service users and staff. Other facilities include two toilets and baths, one of which has a shower. There is amble space at the front of the building for parking vehicles. Cranley Gardens (14) DS0000007163.V265781.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes second inspection for the year 2005/6. The inspection was unannounced and took place in the morning of 15th November when many of service users were at home. The home was inspected under the National Minimum Standards Care Homes for Younger Adults. The home manager was not on duty at the time of the inspection and Sharon Clark facilitated the inspection. The inspection was spent having a discussion with Ms Clark, looking at records, talking to service users and a tour of the premises. What the service does well: What has improved since the last inspection? What they could do better: There were no new issues identified as a result of this inspection. However the three issues identified at the previous inspections, which resulted in requirements being made have been carried over. The documentation relating to staff having regular recorded supervision sessions and an annual appraisal was not available as the home manager was not present. The third outstanding issue relates to service users contracts detailing individual terms Cranley Gardens (14) DS0000007163.V265781.R01.S.doc Version 5.0 Page 6 and condition, this remains outstanding as there was no copies in service users files. 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. Cranley Gardens (14) DS0000007163.V265781.R01.S.doc Version 5.0 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 Cranley Gardens (14) DS0000007163.V265781.R01.S.doc Version 5.0 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): 1,2,5 The home provides information and introduction opportunities for prospective service users and their families to make an informed choice about moving to the home. EVIDENCE: The home has a statement of purpose and a service users guide. Both documents contain the information required by the Standards, including the projects aims and objectives and the facilities and services provided. The home is in the process of updating the statement of purpose. The home has a procedure for introducing service users to a new residential placement, which includes the homes, own assessment process and introductory visits. New Service users are only admitted to the home once a full assessment of their needs; compiled by their care manager or other relevant person has been received. Any new service users to the home will only be considered once compatibility with the current service users is established. Service users contracts were not in place at the time of the inspection there fore the requirement: “The registered person must ensure the homes new contracts/statement of terms and conditions of occupancy agreed between the home and the service users specify the rooms to be occupied; fees charged, what they cover, and the cost of extras not covered by the basis cost of the placement”: remains in place. Cranley Gardens (14) DS0000007163.V265781.R01.S.doc Version 5.0 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, The service users have comprehensive individual care plans with detailed information on their needs and personal goals. Individual care plans include consultation with service users and are regularly updated by the key-worker to reflect current needs. EVIDENCE: Each of the service users has an individual tailored care plan. The care plans are on the service users file and is a record of their aims and goals as well as their achievements. Care plans looked at during the inspection include medical information, a missing persons profile, diaries, training records, records of choices, contacts, risk assessments, and an assessment of care needs. The care plans are reviewed regularly and copies of the service users most recent reviews where on the service users files. The staff team completes daily care notes, which form a useful tool in monitoring changing needs, and ensuring goal/targets can be met. The home also monitors seizure activity and completes monthly reports. Cranley Gardens (14) DS0000007163.V265781.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): 11,16,17, The service users at the home are offered the opportunity to engage in age appropriate activities with an emphasis on using community based facilities. The daily routines and house rules promote residents’ rights and encourage independence as far as possible. Dietary needs are catered for with meals that are nutritionally well balanced, nicely presented, and clearly based on the service users food and drink preferences, providing them with daily variation and healthy eating options. EVIDENCE: It is part of the role of the staff team to encourage service users at the home to maintain and develop independent living skills. The service users have a weekly activity timetable and details of the service users weekly commitments are also recorded on service users files. There is a strong emphasis on service users using the community facilities. Many of the service users have voluntary or paid employment outside the home. One of the service users explained that she is in the process of looking for a job. Meals are organised each Monday. The service users choose the menus, which are displayed on a board in the kitchen. Healthy eating options are in place and individual dietary needs are taken into account. For example one of the service Cranley Gardens (14) DS0000007163.V265781.R01.S.doc Version 5.0 Page 11 users has a plan in place to eat less cheese. During the inspection the service users were observed helping out with chores around the house. Cranley Gardens (14) DS0000007163.V265781.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): 18,20,21 Personal care is carried out in a way that residents prefer so that dignity and choice are maintained. Residents’ physical and emotional health needs are detailed in personal plans to offer consist care in this area. EVIDENCE: The home has a policy on the receipt, recording, storage, handling, administration and disposal of medication. The service users at Cranley Gardens are encouraged to self medicate and risk assessments are completed. All service users are registered with a local General Practitioner and have access to community health facilities such as opticians, chiropodist and dentists as required. On the morning of the inspection a physiotherapist was visiting the home to assess a service user for travel training. The staff team keep a record of any medical appointments attended on the service users files. Any seizures are recorded and each service user has access to a neurologist. The level of personal support a service user needs would be detailed at their review and recorded in their personal file. The home provides consistency and continuity through designated key workers Incident forms are completed following any accidents. Each of the service users files looked at during the inspection contained a form detaining the specific wishes of the service users in the event of their death or a serious illness. The service users had signed these forms. Cranley Gardens (14) DS0000007163.V265781.R01.S.doc Version 5.0 Page 13 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 There is complaints policy and procedure, which facilitates good access to the complaints system for the residents, their family or their representatives. The home has the appropriate policies in place to ensure the protection of vulnerable service users. EVIDENCE: The complaints procedure was clear and contained all of the elements required to meet standard 22 including a minimum response time of less than 28 days. The home has a copy of the local authority Adult Protection Policy on site and the staff team receive training on these issues. Cranley Gardens (14) DS0000007163.V265781.R01.S.doc Version 5.0 Page 14 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): 24,25,29 The general décor of the home is good providing a comfortable, clean and safe environment for service users to live in. Service user’s bedrooms provide privacy and reflect individual interests and preferences. EVIDENCE: The home is situated in a residential road close to Wallington town centre. The house is also well situated to access community facilities in Croydon and Sutton. It is close to rail and bus links. The ground floor of the home has an open plan lounge/dining /kitchen area with a separate office and conservatory. Many areas of the home have been redecorated over the last twelve months. The home was comfortable, bright, well ventilated and free from offensive odours on the day of the inspection. The home’s premises are in keeping with the local community and appear suitable for their purpose. Cranley Gardens (14) DS0000007163.V265781.R01.S.doc Version 5.0 Page 15 The bedrooms at the home are furnished and decorated to reflect the individual tastes of the service users. There are photographs of family and friends in many of the rooms as well as DVDs, videos and personal items. The service users are fully mobile and there are no environmental adaptations in the home with the exception of handrails, which have been fitted where deemed necessary. The bedrooms have mattress alarms fitted, to alert staff to nocturnal seizures. The rooms are also fitted with listening devices to help staff monitor service users seizures, particularly at night. The service users have all signed a consent form for the use of the monitors, which is kept on their file. Cranley Gardens (14) DS0000007163.V265781.R01.S.doc Version 5.0 Page 16 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): 35,36 Although the staff team at the home have a range of skills and abilities, which enable them to meet the needs of the service users living at the home, there is a need to ensure that they receive supervision on a regular basis to safeguard the quality of care. There is a robust recruitment system in place, which is a safeguard to offer protection to the homes service users. EVIDENCE: It is company policy that all new employees are not permitted to start work until two satisfactory references from their previous employees have been confirmed. Criminal Records Check and POVA checks are also undertaken. The home offers training opportunities to staff at all levels within the home. New members of staff complete an induction programme covering various subjects including health and safety, fire drills, and introductions to service users and other staff. The staff team at the home have been able to access various training courses including National Vocational Qualifications at level two and three. Future training planned includes first aid, manual handling and medication. As the home manager was not on duty at the time of the unannounced inspection the requirements made at the previous inspection around supervision and appraisals will be carried over and checked at a later date. Cranley Gardens (14) DS0000007163.V265781.R01.S.doc Version 5.0 Page 17 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): 37,39,42 The home appears to be well managed. Health and safety arrangements are adequate to ensure potential risks to service users health and safety are as far as reasonably possible identified and minimised. EVIDENCE: Christine Panting has been the manager of Cranley Gardens since 2004 and was not on duty at the time of the inspection. The management approach of the manager appears to be a very ‘open’ and inclusive one. Both staff and service users are encouraged to participate in the day-to-day operation of the home and to give their opinion about the way the service is delivered. The service users spoken to during the inspection felt that their views were listened to and they could speak to the staff team if they had any issues. Cranley Gardens (14) DS0000007163.V265781.R01.S.doc Version 5.0 Page 18 The home has regular reviews for the service users and their representatives. The home has checklists in place which detail the time and date that equipment checks such as water temperatures, bed alarms and sound monitors took place. A monthly health and safety check is also completed by the home. Cranley Gardens (14) DS0000007163.V265781.R01.S.doc Version 5.0 Page 19 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 x X 2 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 X X X 3 X LIFESTYLES Standard No Score 11 3 12 X 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X X X X 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cranley Gardens (14) Score 3 X 3 3 Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 X DS0000007163.V265781.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA5 Regulation 5(1)(c) Requirement The registered person must ensure the homes new contracts/statement of terms and conditions of occupancy agreed between the home and the service users specify the rooms to be occupied; fees charged, what they cover, and the cost of extras not covered by the basis cost of the placement The registered person must ensure all staff working at the home has an annual appraisal with their line manager to review performance against job descriptions and agree career development plans The registered person must ensure all staff receive regular supervision sessions Timescale for action 30/01/06 2. YA36 18(2) 30/01/06 3. YA36 18(1)(2) 30/01/06 Cranley Gardens (14) DS0000007163.V265781.R01.S.doc Version 5.0 Page 21 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 Cranley Gardens (14) DS0000007163.V265781.R01.S.doc Version 5.0 Page 22 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 Cranley Gardens (14) DS0000007163.V265781.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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