Inspection on 23/08/06 for Cranley Gardens (14)

This inspection was carried out on 23rd August 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cranley Gardens (14) 15/11/05

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 Key Unannounced Inspection 23rd August 2006 12:30 Cranley Gardens (14) DS0000007163.V307619.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 Cranley Gardens (14) DS0000007163.V307619.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. Cranley Gardens (14) DS0000007163.V307619.R01.S.doc Version 5.2 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.V307619.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th November 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.V307619.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes first inspection for the year 2006/2007 and was an unannounced visit, which took place on 23rd August 2006. The home was inspected under the National Minimum Standards Care Homes for Younger Adults. Christine Pantrini is the home manager and she facilitated the inspection. Methods of inspection included talking with the service users, a tour of the premises, and observation of contact between staff and service users and discussions with the manager and deputy manager. Over the last twelve months the management team have kept the Commission for Social Care Inspection informed of any significant incidents involving the service users and the Croydon Office has received reports of the monthly visits carried out by the registered provider. Records examined during the inspection included service user plans, care manager assessments, risk assessments, medication records, complaints, staffing records, health and safety and fire records. The inspector would like to thank the service user, the staff team and management team for their help in facilitating the inspection What the service does well: What has improved since the last inspection? There has been some progress in implementing contracts between the home and service users a draft format has been sent to the Commission for Social Care Inspection, Croydon office for consultation. Cranley Gardens (14) DS0000007163.V307619.R01.S.doc Version 5.2 Page 6 There has been an improvement in the level of staff supervision at the home, which has brought it in to line with the National Minimum Standards. 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. Cranley Gardens (14) DS0000007163.V307619.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 Cranley Gardens (14) DS0000007163.V307619.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): 1,2,5, Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides introduction opportunities for prospective service users and their families to make an informed choice about moving to the home, however a statement of purpose and a service users guide is not yet generally available. EVIDENCE: The home is part of the “Independence Homes” group and the inspector was informed that the company has nearly completed the process of devising a corporate service users guide and statement of purpose for all the homes in the area. This will also include information relevant to individual homes. The home has a preadmission procedure. 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. The home manager confirmed that cultural and religious issues were also discussed at the time of referral to the home and ways of meeting these needs would be included in the service users care plans. Cranley Gardens (14) DS0000007163.V307619.R01.S.doc Version 5.2 Page 9 Although the home has had no new service users since the last inspection assessments have been completed for the current group of service users. The home has a varied training programme available to build on the skills of the staff team. All new members of staff have to complete ”Familiarisation” training which includes health and safety issues and dealing with Epilepsy. The staff team have refresher training every six months, which keeps people updated on new drugs and current thinking. New staff to the home “shadow” established members of staff as part of their induction. Prospective service users have an opportunity to visit and live at the home on a trial basis before deciding to move in. There has been some progress in implementing contracts between the home and service users a draft format has been sent to the Commission for Social Care Inspection, Croydon office for consultation. Cranley Gardens (14) DS0000007163.V307619.R01.S.doc Version 5.2 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 the following standard(s): 6,7,9, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users have comprehensive individual care plans with 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 and service users wishes. EVIDENCE: Comprehensive care plans are generated from initial and ongoing assessments and liaison with relevant specialist services as needs were identified. This provides staff with detailed information that enables a continuity of care to be maintained. Individual plans of care were sampled and each contained relevant health and social care information, daily records, involvement with healthcare professionals, an action plan and regular reviews that demonstrated involvement, consultation and agreement of each service user on their plan of care. The staff team completes daily care notes, which form a useful tool in monitoring changing needs, and ensuring goal/targets can be met. A monthly report detailing seizures and any areas of concern are sent to the company’s head office for action/monitoring. Overall, plans were being reviewed regularly and involved relatives and other professionals. The inspector was informed that the home manager and the deputy manager have attended the Person Centred Planning for facilitators course run by the London Cranley Gardens (14) DS0000007163.V307619.R01.S.doc Version 5.2 Page 11 Borough of Sutton and Person Centred Planning principles will be incorporated into the care planning process at the home. The home operates a risk management system and individual assessments are on service users files. Copies of individual risk assessments were seen on the service users file and cover a variety of situations including learning new skills and bathing, as well as going out in the community. There are also risk assessments relating to the environment and staff under the health and safety at work act. Risk assessments are reviewed regularly. Cranley Gardens (14) DS0000007163.V307619.R01.S.doc Version 5.2 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 the following standard(s): 12,13,15,16,17, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users have a varied programme of social activities organised by the staff team to reflect service users individual interests. The home has an open visitors policy to ensure friendships and family links are maintained. EVIDENCE: Many of the service users at Cranley Gardens are in paid and voluntary employment. These include positions at Sainsbury’s, working for a local councillor, McDonalds, local charity shops and an urban farm. The service users at the home are also supported to access appropriate activities through local colleges. One of the service users told the inspector that she is in the process of applying for a beauty course with the support of her key worker and other staff members. Details of the service users daily activities and commitments are kept on the service users file and were seen during the inspection. Cranley Gardens (14) DS0000007163.V307619.R01.S.doc Version 5.2 Page 13 Three of the service users are working towards moving out of the home into independent living units. To help prepare them for this they budget, plan, shop for and cook their own meals. The service users are on the electoral register and can vote if they wish to. Each of the service users has an individual holiday and the service users spoken to during the inspection were looking forward to their planned holiday in Crete. There is a strong emphasis on service users using the community facilities. The home is keen to maintain the service users family links. Visitors are welcomed and the service users families are invited to their reviews. There is an open visitors policy. Friends and boyfriends are also welcome to visit. One family member spoken to during the inspection said he always felt welcome at the home. The house rules and daily routines are as flexible as possible, bearing in mind the weekday commitments of the service users. At the weekends there is more flexibility with breakfast and bedtimes. The service users are given a choice of having keys to their bedrooms and the front door of the home. The service users open their own mail and can have assistance from the staff team to read it if they wish. Cranley Gardens (14) DS0000007163.V307619.R01.S.doc Version 5.2 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 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 this service. 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. Residents’ medication is well managed to ensure good health. EVIDENCE: 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. Information relating to personal and healthcare needs, including both routine and one off health interventions remain well recorded. Care plans and specific strategies identify individual and specialist needs, which also reflect any changing needs. Detailed records were in place and involvement with specialist services highlighted where necessary. E.g. regular medication reviews and recording of seizure activity. Medication practices continue to be well managed. The service users at Cranley Gardens are encouraged to self medicate and risk assessments are completed. The home has a policy and procedure in place for the receipt, recording, storage, handling, administration and disposal of medication. As part of their induction staff at the home attend a “familiarisation” course, which includes medication training. All of the staff team are trained in the administration of rectal Diazepam. Records examined showed that all medicines are recorded on Cranley Gardens (14) DS0000007163.V307619.R01.S.doc Version 5.2 Page 15 Medicine Administration Record Sheets, which were up to date at the time of the inspection. The level of support a service user needs with their personal care would be discussed at their review and recorded on their individual plan. The home has various aids to alert staff if one of the service users has a seizure these include bed alarms, foot alarms and audio alarms. Each service users also has an emergency pack of medication. Risk assessments are in place for all the service users in respect of bathing. To minimise risks associated with service users having a seizure in the bath it is the homes policy that staff remain close to bathrooms and chat to the service users in order to provide discreet supervision at all times. Cranley Gardens (14) DS0000007163.V307619.R01.S.doc Version 5.2 Page 16 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 this service. 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 home has a clear complaints policy, which includes the timescales and the process of the investigation. The home has a copy of Sutton’s Vulnerable Adults Policy and Procedures All of the staff team have completed training in the area of adult abuse. The staff team spoken to during the inspection were aware of the complaints procedure and the adult protection policy and were aware of the need to report any incidents. Cranley Gardens (14) DS0000007163.V307619.R01.S.doc Version 5.2 Page 17 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): 24,25,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. The home’s premises are in keeping with the local community and appear suitable for their purpose. 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. The standard of décor and cleanliness throughout the home remains good. Further home improvements have been carried out such as the refurbishment of the upstairs bathroom. Each of the service users in the home has a single room. All of the rooms have been personalised and decorated to reflect their individual taste. Bedrooms viewed provided sufficient and suitable furniture. Service users spoken to during the inspection said they liked their bedrooms. Cranley Gardens (14) DS0000007163.V307619.R01.S.doc Version 5.2 Page 18 The home has appropriate laundry facilities separate from the food preparation areas. The washing machine is capable of washing clothes at high temperatures, which helps with the control of infection. The laundry has suitable flooring. There is a locked cupboard for the Control of Substances Hazardous to Health products. On the day of the inspection the home was clean, bright and well ventilated. The home has policies and procedures on the disposal of clinical waste. Cranley Gardens (14) DS0000007163.V307619.R01.S.doc Version 5.2 Page 19 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): 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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 EVIDENCE: There are at least two members of staff on duty in the home at any one time. At night there is one waking and one sleep in member of staff. The staff team at the home are issued with job descriptions, setting out the role and responsibilities of the staff at the home. It is company policy that new employees are not permitted to start work until two satisfactory references from their previous employees have been confirmed. Criminal Records Checks are also undertaken. The home has regular staff meetings; records of the issues discussed are on file at the home. The staff team must sign to say that they have read any policies and procedures. The staff team at the home receive supervision from the management team. All supervisions were up to date at the time of the inspection. The home offers training opportunities to staff at all levels within the home and a record of training courses attended are kept on staff files. The staff team at the home have been able to access various training courses including National Vocational Qualifications at level two and three, as well as basic food hygiene, health and safety and adult protection training. New members of staff complete an Cranley Gardens (14) DS0000007163.V307619.R01.S.doc Version 5.2 Page 20 induction programme (familiarisation training) covering various subjects including health and safety. Copies of staff induction were kept on file, which were available for inspection. Issues of respect and how to treat service users with dignity is incorporated into the induction training of new staff. During the inspection staff were observed to be treating service users in a pleasant, friendly manner. Service users spoken to during the inspection felt that the staff team are nice to them treated them well and respected their privacy. Cranley Gardens (14) DS0000007163.V307619.R01.S.doc Version 5.2 Page 21 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management style appears to be transparent with clear lines of accountability. In the main health and safety arrangements are adequate to ensure potential risks to service users health and safety are so far as reasonably possible identified and minimised. EVIDENCE: Christine Panting has been the manager of Cranley Gardens since 2004. Ms Pantrini is in the process of completing the registered managers award at National Vocational Qualification level four. She is confident that she will have completed the course by November 2006. There was a clear line of accountability within the home and the manager demonstrated a good knowledge of the service users and the staff team. Cranley Gardens (14) DS0000007163.V307619.R01.S.doc Version 5.2 Page 22 In addition, the home maintains good links with other professionals and service users relatives. The service users spoken to during the inspection said that the manager was someone they would talk to about any problems as well as other staff members. The home has regular service users meetings so that their views can be taken into account. The home also has a key worker system Records required for the safety and well being of service users are in place including accidents, water temperatures, complaints, incidents, food records, fire records, staff and service users case files, medication records and so forth. Administration and record keeping at this home is generally of a good standard. All staff must attend mandatory health and safety training including moving and handling. The home has a health and safety policy in place. Environmental risk assessments are in place. A first aid box and a fire blanket are situated in the kitchen. There are fire extinguishers throughout the house and fire drills are up to date. Coloured chopping boards and knives were seen in the kitchen. Health and safety law posters issued by the health and safety executive were also on display. The home is working towards the “Investors in People Ward”. A representative of the registered provider visits the home regularly and copies of the visit report are sent to the Commission for Social Care Inspection Corydon office. Cranley Gardens (14) DS0000007163.V307619.R01.S.doc Version 5.2 Page 23 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 2 2 3 3 X 4 X 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 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Cranley Gardens (14) DS0000007163.V307619.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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 YA1 Regulation Sch 2 Requirement The home manager must ensure a statement of purpose and service users guide is in place. Timescale for action 30/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cranley Gardens (14) DS0000007163.V307619.R01.S.doc Version 5.2 Page 25 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.V307619.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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