Inspection on 04/05/05 for Croydon Road,78

This inspection was carried out on 4th May 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 but made no statutory requirements on the home.

Other inspections for this house

Croydon Road,78 12/06/07

Croydon Road,78 09/05/06

Croydon Road,78 08/11/05

Croydon Road,78 01/11/04

Croydon Road,78 25/05/04

Croydon Road,78 02/10/03

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

CARE HOME ADULTS 18-65 Croydon Road (78) 78 Croydon Road Penge London SE20 7AB Lead Inspector Rosemary Blenkinsopp Announced 4 May 2005 10:00 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 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 Stationary 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. Croydon Road (78) G51-G01 s6909 78 Croydon Rd AI v211464 040505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Croydon Road (78) Address 78 Croydon Road, Penge, London, SE20 7AB Telephone number Fax number Email 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 8676 9965 020 8676 9965 Community Options Limited Care Home 7 Category(ies) of Past or present alcohol dependence (7), Past or registration, with number present drug dependence (7), Mental disorder, of places excluding learning disability or dementia (7) Croydon Road (78) G51-G01 s6909 78 Croydon Rd AI v211464 040505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 01/11/04 Brief Description of the Service: This home is part of the Community Options group. Community Options has a number of facilities in the Bromley area. The home has its own dedicated manager and staff team, whilst senior management and personal support are provided centrally. The home is a detached house in a residential area of Penge. It is located close to the high street and is well served by public transport. The building itself is located over three floors accessed by stairs. There are no adaptations in this home as all residents are, primarily younger adults undergoing rehabilitation. The purpose of the home is rehabilitation to enable service users to live independently. Residents in this home have mental health disorder and are subject to the Care Programme Approach. This is a system of multi disciplinary monitoring and review to keep abreast of the individual’s mental health. Staff are provided throughout the 24-hour period, including waking staff. Multi disciplinary support is provided through the community. Croydon Road (78) G51-G01 s6909 78 Croydon Rd AI v211464 040505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was conducted as an announced visit of which the home was notified in advance. The premises were toured with the exception of some bedrooms, which residents did not wish the inspector to see. Records including care plans were inspected. Two residents were spoken to at length. The staff on duty were interviewed regarding their work and employment. No visitors attended for the inspection. Previous requirements and recommendations made had been addressed with the exception of those relating to care plans and risk assessments. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Croydon Road (78) G51-G01 s6909 78 Croydon Rd AI v211464 040505 Stage 4.doc Version 1.20 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Croydon Road (78) G51-G01 s6909 78 Croydon Rd AI v211464 040505 Stage 4.doc Version 1.20 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,3,4,5 Residents are involved in their placement and have information available on which to base their decision. EVIDENCE: In this home all residents are under the Care Programme Approach (CPA), which is a system of after care to ensure on going monitoring an reviews by suitably qualified / skilled staff. The information on two residents was viewed. Both contained a formal assessment and supporting information received under the Care Programme Approach. Terms and conditions of residency, individual residents agreements and a contract were in place. Documents were signed by residents. One resident had additional assessments from the Occupational Therapist. The inspector was advised that prospective residents are invited to the home for a meal although overnight stays are not always possible. Every resident is on a three-month trial period, which is included in his or her contract. In the event that the placement is failing then a multi disciplinary team review would be convened to look at further strategies or an alternative placement. Croydon Road (78) G51-G01 s6909 78 Croydon Rd AI v211464 040505 Stage 4.doc Version 1.20 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9,10 The care plans were not sufficiently detailed to carry out the care and supervision of the residents assessed and identified needs. Supporting risk assessment information must be comprehensive and current. EVIDENCE: Two care plans were viewed including one of a newly admitted resident. The care plans contained a number of sections including “ Peace of Mind”,”Being Respected”, “Making Decisions” etc. Although all of this information would provide a very comprehensive picture of the resident, it was not incorporated into the care plan. Residents are encouraged to be involved in care planning and sign as confirmation of agreement. The interventions section of the care plans was limited and the actions detailed would not address the identified needs. A monthly summary is recorded to outline the progress made. The recent reviews conducted under CPA were not on file. A system needs to be developed to ensure that the most updated reviews are in place and actioned. Generally, signatures and dates were missing on records. Care plans and risk assessments had been identified at the previous inspection as requiring action. Please see requirements 1 and 2. Croydon Road (78) G51-G01 s6909 78 Croydon Rd AI v211464 040505 Stage 4.doc Version 1.20 Page 9 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 standard(s) 11,13,14,15,16,17 The home provides good opportunities for the residents to be as independent as possible and develop appropriate links with the community. Leisure and social activities are encouraged. EVIDENCE: The residents in this home are under going rehabilitation into the community following episodes of mental health problems. The aim is to maximise daily living skills for more independent living. Residents are supported in all activities of daily living including shopping, budgeting, and leisure and accessing local health care. The residents with whom the inspector met, confirmed that since they had been in the home they had developed skills such as cooking and preparing a meal, use of public transport etc. Household tasks are included in the daily routines. Some residents access services such as the local MIND centre. One resident attends a computer course. A Community Options newsletter is good source of information in respect of development within the organisation. The home works in conjunction with Horizon Housing to facilitate employment for the residents. The scheme works in conjunction with local businesses, although currently no one in this home is employed. A wide range of leisure activities are available locally. One lady stated that she “ Goes Clubbing” in Croydon, until the early hours of morning. Staff must ensure Croydon Road (78) G51-G01 s6909 78 Croydon Rd AI v211464 040505 Stage 4.doc Version 1.20 Page 10 that the resident, who is vulnerable, is protected as far as they are able to do so within the confines of her not being detained under the Mental Health Act 1983. Croydon Road (78) G51-G01 s6909 78 Croydon Rd AI v211464 040505 Stage 4.doc Version 1.20 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 standard(s) 18,19,20. Health and personal care is appropriate to this type of resident and with the additional support of the multi disciplinary team for mental health issues, this should ensure that any deterioration is detected early. EVIDENCE: All residents attend services provided by the local community as well as attending multi disciplinary reviews under the CPA. All residents are registered with a local GP and attend as necessary. In the event that residents do attend health care provision it is sometimes not possible to obtain information. Avenues to obtain this information should be explored to ensure that all information is communicated, as appropriate, to staff involved with care of the individual resident. The medication systems and supporting records were to a satisfactory standard. The medication was securely stored and no over stocking evident. Staff confirmed that they had received training in medication and had under gone proficiency tests at regular intervals. Records for receipt of, and disposal of, medication were in place as were resident’s photographs and individual homely remedies. Separate record sheets were in place for “as required” medications. Currently one resident is at the initial stage of self-medicating under staff supervision. Self-medication is promoted in this home to maximise independence. Croydon Road (78) G51-G01 s6909 78 Croydon Rd AI v211464 040505 Stage 4.doc Version 1.20 Page 12 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 standard(s) 22 Opportunities and avenues for raising complaints and concerns are satisfactory. EVIDENCE: The CSCI has received no complaints regarding this service. The complaints record contained no entries. Information on how to complain was available and on display. Residents stated that they would speak to staff or other members of the multi disciplinary team if they had a concern. One resident is a representative on a Community Options committee, and she stated that she would raise concerns at the head office. In the event that a complaint is raised Community Options nominate a senior person within the organisation to investigate and report on the complaint. A copy of the investigation is retained on file and forwarded to the CSCI. Croydon Road (78) G51-G01 s6909 78 Croydon Rd AI v211464 040505 Stage 4.doc Version 1.20 Page 13 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 standard(s) 24,25,26,27,30 The home is suitable for the needs of the current residents, however any deterioration in mobility of residents would render the home unsuitable. EVIDENCE: The home was clean and tidy. Communal areas are homely with a selection of comfortable furnishings and fittings. The home has a designated smoking and no smoking area. Safety measures were in place including window restrictors on first floor and above. The garden was tidy and accessible .The kitchen is a large area, which is essential when residents are preparing their own meals. The inspector did note that there was a limited selection of crockery, cutlery and cooking utensils. One resident did state that at mealtimes there was insufficient crockery, cutlery etc when residents were cooking. Some residents do not wash up; further compounding the problem. Staff must ensure that sufficient support is given during these activities. Please see requirement 3. Croydon Road (78) G51-G01 s6909 78 Croydon Rd AI v211464 040505 Stage 4.doc Version 1.20 Page 14 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,35. The staff team is suitably trained to meet the needs of residents. Staffing levels are sufficient for the current dependency of residents. EVIDENCE: The three staff on duty confirmed that they had received induction both within the home and through the head office. Staff were aware of their roles and responsibilities and management structures. One care staff; advised the inspector that he had received training in statutory topics and those related to mental health issues. Other training had included dealing with benefits, bereavement and loss and team building. He confirmed that the bereavement training had been identified specifically as it was a need for his key resident. On checking the training certificates it was noted that many of the statutory training topics had lapsed this needs to be addressed. The staff member was knowledgeable about his key resident both in respect of his physical, psychological and social needs. He was able to detail the residents support networks, his likes and dislikes and support required. The staff team assist with supporting another Community Options home locally. Two staff cover the daytime period with one staff working flexi time. The weekends have a reduced number of staff, as there is less activity such as escorts etc. Staffing levels must be sufficient to meet residents needs including escort duties and levels should be kept under review and increased as residents needs dictate. Please see requirement 4 and 5. Croydon Road (78) G51-G01 s6909 78 Croydon Rd AI v211464 040505 Stage 4.doc Version 1.20 Page 15 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,39,41,42,43 The home is well managed with on going support provided through Community Options. Health and safety measures are in place to reduce any risks identified. EVIDENCE: The manager has not unde gone the CSCI process to be approved as the manager. The manager will need to apply and begin the process in order that she can be registered. She has worked in the home for some time and has a good knowledge of the service and resident group. On call senior management is available at all times for advice and support. A selection of health and safety service certificates were seen and found to be satisfactory and current. Fire drills including staff and residents are conducted approximately every three months. The names of those attending was recorded, however staff should sign to confirm all training. Records for the weekly fire alarm testing, monthly emergency lighting and the fire risk assessment were all available. Croydon Road (78) G51-G01 s6909 78 Croydon Rd AI v211464 040505 Stage 4.doc Version 1.20 Page 16 On going problems remain with the hot water temperatures. Warning signs are in place and clearly visible. Water temperature records are retained and routinely tested monthly. On the day of the inspection the water was tested in several outlets and found to be cool. Communication between the home and the housing association, who conduct the home’s maintenance, has resulted in several visits with little improvement. The staff must continue to monitor this and in the event that water is too hot that facility must be taken out of service, until it is safe to use. Please see requirement 6. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 Croydon Road (78) Score 2 Standard No 24 25 26 27 28 Score 3 3 3 3 x Version 1.20 Page 17 G51-G01 s6909 78 Croydon Rd AI v211464 040505 Stage 4.doc 7 8 9 10 LIFESTYLES 3 3 2 3 Score 29 30 STAFFING 2 x Standard No 11 12 13 14 15 16 17 3 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score 3 2 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 x Standard No 37 38 39 40 41 42 43 Score 2 x 3 x 3 3 3 Croydon Road (78) G51-G01 s6909 78 Croydon Rd AI v211464 040505 Stage 4.doc Version 1.20 Page 18 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 6 Regulation 15 Requirement The Manager must ensure residents care plans are comprehnsive in content and reflective of identified needs. Previous time frame 31/12/2004 The Manager must ensure that risk assessments are comprehensive in content to reduce the assessed risk . Previous time frame 31/12/2004 The Manager must ensure that sufficient equipment is available for residenst use. The Manager must ensue that all training is current. The Registerd Person must ensure that the manager applies for registration to CSCI Timescale for action 30/6/05 2. 9 13 30/6/05 3. 4. 5. 29 32 37 16 18 9 30/6/05 30/9/05 30/6/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 19 Good Practice Recommendations The manager should ensure all information is communicated as needed to staff. G51-G01 s6909 78 Croydon Rd AI v211464 040505 Stage 4.doc Version 1.20 Page 19 Croydon Road (78) Commission for Social Care Inspection River House 1 Maidstone Road Sidcup DA14 5RH 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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