Inspection on 20/12/05 for Crebor Street

This inspection was carried out on 20th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Crebor Street 20/05/08

Crebor Street 04/08/06

Crebor Street 29/07/05

Crebor Street 14/10/04

Crebor Street 09/06/04

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 Crebor Street 2 Crebor Street London SE22 0HF Lead Inspector Lisa Wilde Unannounced Inspection 20th December 2005 10:00 Crebor Street DS0000060238.V271739.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 Crebor Street DS0000060238.V271739.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. Crebor Street DS0000060238.V271739.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Crebor Street Address 2 Crebor Street London SE22 0HF 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) 020 8693 3822 020 693 8198 Odyssey Care Solutions for Today Ms Tracy Anne Crockford Care Home 5 Category(ies) of Learning disability (0), Physical disability (0), registration, with number Sensory impairment (0) of places Crebor Street DS0000060238.V271739.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th July 2005 Brief Description of the Service: The home is registered to provide a residential care service for five people with learning disabilities. There are 5 single rooms. The home is made up of two houses converted to make one unit. It is located in a residential area of East Dulwich, close to public transport routes and local facilities, which include pubs, shops, restaurants and a post office. The home aims to provide support for the service users in any area of their daily lives to ensure that service users quality of life is maximised as well as enabling them to participate fully in the daily life of their home and community. The home is one of several homes run by the voluntary organisation Odyssey whos vision statement says that they are working towards A society where a learning disability is not a barrier to somebodys perceived value or ability to make a meaningful contribution . At the time of the inspection there was one vacancy. Crebor Street DS0000060238.V271739.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day in December 2005. The inspector spoke with the service users who were in the home, staff and the new manager. The new manager had only been in post since the day before this inspection so has not yet had time to make any impact on the service. However, she has been a manager at another Odyssey service for several years and knows the service users at this home. The service users said that they were very happy and liked everything at the home. One service user in particular said that they had no problems at all and enjoyed living there and doing the things that they do each week in the home and outside. What the service does well: What has improved since the last inspection? What they could do better: Crebor Street DS0000060238.V271739.R01.S.doc Version 5.0 Page 6 The standards assessed at this isnepction showed that the home must do more work to make sure that: • the service users’ guide provides people with all the information they need to make an informed choice about where to live and whether they are being offered everything that they should be. • service users’ prescribed creams are recorded when they are applied by staff. • training around the specific disability issues of the current service users is given to staff • the service users views and the views of their families form the basis of the improvement plans for the home. • the fire safety systems are checked weekly and fire drills are repeated if service users do not evacuate. 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. Crebor Street DS0000060238.V271739.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 Crebor Street DS0000060238.V271739.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 Service users and their families are not provided with all the information they need to make an informed choice about where to live and whether they are being offered everything that they should be. EVIDENCE: Some of the current service users at this home cannot read or write; however, the home is registered for learning disabilities and it is possible to draw up a service user guide in a language and format that could be understood by some people from those groups who may wish to use this home e.g. by using pictures, video and language that is more simple. There were previous requirements that the Service User Guide must be drawn up in a format that can be understood by more people from the service user groups for which the home is registered i.e learning disabilities and that the Service User Guide must cover all areas required by Regulation 5 and Standard 1. This had not yet been done and the requirements are repeated. (See Requirements 1 & 2) Crebor Street DS0000060238.V271739.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 Service users have in place detailed support guidelines and strengths and needs assessments that describe how staff will support service users day-today and also develop their skills and enable them to achieve any identified goals. These plans are reviewed regularly and changed whenever needs or goals change. EVIDENCE: The inspector examined the files and found a wide range of support guidelines in place to describe how staff are to support service users. Monthly summaries are done that assess how the service user has been over the period and identify work that has been done to enable them to meet identified goals. A full “Strengths and Needs” document is completed for all service users. Person Centred Planning a major piece of work that this organisation is currently working on in order to assist with identifying longer term goals for service users and support them in a way that focuses on their individuality. Crebor Street DS0000060238.V271739.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): 17 Service users choose their own food and join in with cooking as much as they are able. Menus are varied and service users are offered information and choices to make their diets more healthy and nutritious. EVIDENCE: There was a previous recommendation that the Registered Individuals should consider acquiring a computer with internet access for the service users to use in the home which has not been done. (See Recommendation 1) Service users choose their won food both while shopping and on the day they eat. There are menus in place for the main meals, which showed that a variety of options are available through the week. Service users are supported to try and eat more healthy alternatives. There are photos of food and meals available in the kitchen for service users to be able to identify what different types of foods are. One service user talked to the inspector about their food and he said he liked it. Crebor Street DS0000060238.V271739.R01.S.doc Version 5.0 Page 11 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 All service users’ health care needs are met by staff or by being supported to attend regular appointments with local GPs and clinics. Medication is generally managed and administered effectively and service users are protected by staff holding an understanding of what medication they are taking and what effects it may have. EVIDENCE: Files showed that service users’ health needs are monitored and visits to GPs or clinic are regularly made. Staff talked through in detail all the health care needs of service users and showed a full knowledge of how they could support service users to meet those needs. The medication records and stocks were checked and the inspector found that systems are operated effectively and few problems were found apart from the area of topical preparations and one recent medication error. Staff find it difficult to record the administration of creams regularly when they do this in the service users rooms and do not have the records with them when they do this. (See Requirement 3). Staff have been made aware of a new system in place to make sure that medication is given to one service user regularly in order for the recent error not to be repeated. The staff member who went Crebor Street DS0000060238.V271739.R01.S.doc Version 5.0 Page 12 through the medication with the inspector showed a detailed knowledge of all medication, their effects and the reasons why service users were taking them. Crebor Street DS0000060238.V271739.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): 23 Generally service users are protected by the organisation’s procedures round protection of vulnerable adults and staff being aware of their responsibilities. EVIDENCE: The organisation has a policy and procedure in place around adult abuse. The new manager was not sure yet whether the home has in the borough’s adult protection procedure available and was not sure if all staff have attended adult abuse training although new staff would be doing this as part of their induction. (See Requirements 4 & 5) There was a previous requirement that the Registered Individuals must ensure that they see all the Criminal Records Bureau forms for any agency staff to allow them to make judgements about any convictions or cautions they may have received. The new manager said that she would do this. Crebor Street DS0000060238.V271739.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, 26, 27, 28, 29 & 30 The home is clean, comfortable and homely throughout. Service user rooms are large enough and suit their individual lifestyles. None of the current service users have physical disabilities that require them to have specialist equipment or adaptations and this home would not be suitable for service users who cannot manage stairs. EVIDENCE: The home is comfortable and decorated in a homely manner. Service users bedrooms are personalised to their own tastes and at the last inspection the manger confirmed that they meet the size requirements of the standards. The toilets and bathrooms in the home ensure that privacy and dignity are maintained and currently the service users do not need any specialist adaptations or equipment as they do not have mobility issues. On the day of the inspection the home was clean and hygienic. The manager and staff stated that they do not believe the current sofa to be appropriate to the needs of the service user as it is old and somewhat difficult for the service users to get up from. Crebor Street DS0000060238.V271739.R01.S.doc Version 5.0 Page 15 There had been a previous requirement with regard to one service users bathroom that stated that it needed to be refurbished. The deputy manger had understood this to mean that a new bathroom suite was to be bought as the current suite was old fashioned and somewhat institutional. The bathroom had been retiled but the organisation was not willing to pay currently for any further refurbishment. There was a previous requirement that the Registered individuals should consider refurbishing and redecorating the olive coloured ensuite bathroom to bring it to the standard of other bathrooms in the home. This has not been done. (See Recommendation 2) There was a previous requirement that the Registered Manager must ensure that a new dryer is bought as a priority and this had been done. Crebor Street DS0000060238.V271739.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 Generally service users benefit from a fully trained, experienced and skilled staff team although training is needed in one area to make sure that the staff fully understand the needs of the current service users. EVIDENCE: Staff showed awareness and understanding of the individual service users needs throughout the inspection. Staff receive basic training in statutory issues and then further training in more specialist areas such as values and principles of care and attitudes to disabilities. There was a previous requirement that the Registered Individuals must ensure that staff receive training in the specific disability issues of the service users at the home such as autism. This has not yet been done and the requirement is repeated. (See Requirement 6). The new manager has not as yet had time to assess each member of staff’s training needs. All staff receive induction and foundation when they start employment and then begin the NVQ Level 2 or 3 in Care. The inspector will be assessing the organisation’s recruitment and personnel records at the head office at some point later in the year. Crebor Street DS0000060238.V271739.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 There is a new manager in post who is competent and fit to be in charge but who has not yet had time to take over the running of the home. Although a lot of work is done in the area of monitoring and seeking to find out what the service users want at this home, the service users views and the views of their families do not underpin the review and development process. Generally service users are protected by staff operating the health and safety procedures. The fire safety systems are not currently regularly checked. EVIDENCE: There was a previous requirement that the Responsible Individual must ensure that the Commission is provided with the plan to recruit to the manager and deputy post at the home which includes plans to ensure that the new management have opportunity for a thorough handover from the current deputy manager. A new manager is in post but only came to this service the day before this inspection. She has previously worked for several years at another Odyssey service and also knows these service users as she has worked Crebor Street DS0000060238.V271739.R01.S.doc Version 5.0 Page 18 with previously. She has not as yet put in an application to be registered with the Commission. (See Requirement 7) There was a previous requirement that the Registered Manager must ensure that an annual survey (or other form of annual audit) of service users families and other stakeholders takes place that then feeds into the annual review of the service and the local business plan and there was a previous recommendation that the Responsible Individuals should consider investigating and employing a professionally recognised quality assurance tool within the home. The home conducts annual reviews with the service users and completes quarterly returns to the borough organisation that report on identified indicators. There is a local business plan for the home. The home does not use an externally accredited quality assurance systems that focuses on the views of service users and the home does not conduct an annual review of the views of family and other stakeholders. The manager was not aware of any work that had been undertaken in this area since the last inspection although from an inspection of another home within the organisation the inspector was aware that the organisation has plans to include families and other stakeholders in their annual reviews of services. The previous requiremnt and recommendation are repeated in the meantime. (See Requirement 8 and Recommendation 3) There were previous recommendations that the Registered Manager should ensure that the monthly keywork session/activity reviews are collated and made part of the service users annual reviews and that the Registered Manager should consider using a video camera in the home to record service users thoughts and views, that can be taken into their review meetings and made part of an ongoing review process. These were made in consultation with the previous deputy manager and the new manager has not had the time yet to consider these (See Recommendations 4 & 5) The inspector examined all the health and safety checks and documentation and found most of it to be in order. Some of the weekly fire checks had been missed and at the last fire drill one service user had not evacuated but the drill had not been repeated. (See Requirements 9 & 10). On the tour of the building no health and safety problems were found. Crebor Street DS0000060238.V271739.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 2 X X X X Standard No 22 23 Score X 2 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 3 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X 2 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Crebor Street Score 3 X 2 X Standard No 37 38 39 40 41 42 43 Score 2 X 2 X X 2 X DS0000060238.V271739.R01.S.doc Version 5.0 Page 20 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 YA1 Regulation 5 Requirement The Registered Individuals must ensure that the Service User Guide must be drawn up in a format that can be understood by more people from the service user groups for which the home is registered i.e. learning disabilities. Previous requirement: Unmet timescale 31/11/05 The Registered Individuals must ensure that the Service User Guide must cover all areas required by Regulation 5 and Standard 1. Previous requirement: Unmet timescale 31/11/05 The Registered Manager must ensure that all prescribed topical preparations are recorded when they are administered. The Registered Manager must ensure that the borough’s adult protection procedure is available in the home and staff are fully aware of its contents. The Registered Manager must verify if all staff have attended adult abuse training and send the evidence to the Commission. DS0000060238.V271739.R01.S.doc Timescale for action 31/03/06 2. YA1 5 31/03/06 3. YA20 13 (2) 31/01/06 4. YA23 13 (6) 31/01/06 5 YA23 13 (6) 31/01/06 Crebor Street Version 5.0 Page 21 6. YA35 18 (1) (c) (i) 7. YA37 11(1)CSA 8. YA39 12(1)(3)& 24(3) 9. YA42 23 (4) (c) 10. YA42 23 (4) (e) Any staff who have not attended this training must do so. The Registered Individuals must ensure that staff receive training in the specific disability issues of the service users at the home such as autism. Previous requirement: Unmet timescale 31/12/05 The Responsible Individual must ensure that the new manger puts in an application to be registered with the Commission. The Registered Manager must ensure that an annual survey (or other form of annual audit) of service users families and other stakeholders takes place that then feeds into the annual review of the service and the local business plan. Previous requirement: Unmet timescale 31/12/05 The Registered Manager must ensure that weekly fire system tests take place and are recorded as planned. The Registered Manager must ensure that fire drills are repeated as soon as possible if service users do not evacuate satisfactorily. 31/03/06 31/01/06 31/03/06 31/01/06 31/01/06 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. 2. Refer to Standard YA14 YA24 Good Practice Recommendations The Registered Individuals should consider acquiring a computer with internet access for the service users to use in the home. The Registered individuals should consider refurbishing and redecorating the olive coloured en-suite bathroom to DS0000060238.V271739.R01.S.doc Version 5.0 Page 22 Crebor Street 3. 4. 5. YA39 YA39 YA39 bring it to the standard of other bathrooms in the home. The Responsible Individuals should consider investigating and employing a professionally recognised quality assurance tool within the home. The Registered Manager should ensure that the monthly keywork session/activity reviews are collated and made part of the service users annual reviews. The Registered Manager should consider using a video camera in the home to record service users thoughts and views, that can be taken into their review meetings and made part of an ongoing review process. Crebor Street DS0000060238.V271739.R01.S.doc Version 5.0 Page 23 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. Extracts may not be used or reproduced without the express permission of CSCI Crebor Street DS0000060238.V271739.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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