Inspection on 31/10/06 for Dove, The

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

Other inspections for this house

Dove, The 02/02/06

Dove, The 27/09/05

Dove, The 03/03/05

Dove, The 11/10/04

Dove, The 08/03/04

Dove, The 11/11/03

Dove, The 17/06/02

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

CARE HOME ADULTS 18-65 Dove, The 36, South Croxted Road London SE21 8BB Lead Inspector Ms Alison Pritchard Unannounced Inspection 31 October 2006 4:30pm st Dove, The DS0000007095.V301754.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 Dove, The DS0000007095.V301754.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. Dove, The DS0000007095.V301754.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dove, The Address 36, South Croxted Road London SE21 8BB 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 8761 4143 the_dove36@yahoo.co.uk www.larche.org.uk L`Arche Lambeth Marcela Friedlova Care Home 4 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (1) of places Dove, The DS0000007095.V301754.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 4 People with learning disabilities, one of whom may be over 65, can be accommodated within the home between September 2006 and January 2007. 2nd February 2006 Date of last inspection Brief Description of the Service: The Dove is a large semi detached Edwardian house located on a residential road in West Dulwich. It provides care and accommodation for up to four service users with learning disabilities and two members of staff. The Dove is one of five homes owned by L’Arche Lambeth, part of the national organisation, whose communities are based round small scale, everyday housing within local neighbourhoods. The home is on a bus route and close to local shops, restaurants and a large park. In October 2006 there were three residents. Potential residents are given information about The Dove using the home’s accessible service users’ guide (called an Easy Read guide). The document describes the house, the people who live there and the opportunities available. People interested in coming to live in the Dove would be invited to visit, initially for tea or a meal and then for longer periods as their interest develops. Any carer, supporter or Care Manager would also be welcome to visit. A ‘moving in’ manager is responsible for the process of welcoming someone to the L’Arche community and is available to answer questions from the potential member and their supporters. The post holder is skilled in accessible communication, including the use of Signalong and Makaton. The statement of purpose is also available, although this is not accessible. Copies of the most recent CSCI reports are offered to anyone interested in coming to the Dove. Although the reports are not yet accessible, members of the L’Arche community would talk someone through the main issues and answer any questions. The current weekly charges are from £902 to £950 (including a place in L’Arche Day provision). Additional charges would be made for individual (1:1) support needs. L’Arche funds an annual holiday but if a member chose to take an additional holiday the costs would be charged separately. No other additional charges are made. Dove, The DS0000007095.V301754.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and carried out over two days in late October and mid November 2006. The inspection was carried out over two days. The Registered Manager returned to the home towards the end of the first day of the inspection and then was on holiday. A second visit was made to ensure that the inspector had the opportunity to have discussions with the Registered Manager. The inspection methods included observation of care practice, discussion with residents, staff and the Registered Manager of the home, inspection of residents’ files, and a range of records and policy documents. Involved professionals, advocates and family members were sent survey forms so that they could contribute to the inspection process. Completed forms were received from a relative, a friend of the home and a health care professional. The CSCI also has access to information gathered through notifications from the home. All of this information has been taken into account in compiling this report. The inspection visit was well facilitated by the Registered Manager, residents and staff who were helpful and courteous throughout the process. What the service does well: What has improved since the last inspection? What they could do better: Care must be taken to ensure that records are made when medication is given to residents. Dove, The DS0000007095.V301754.R01.S.doc Version 5.2 Page 6 Fire drills must be conducted more frequently to ensure that residents are confident about the right action to take when fire alarms are activated. Damage to a wall near the light switch in the first floor WC needs repair to make sure the safety of residents and staff. 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. Dove, The DS0000007095.V301754.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 Dove, The DS0000007095.V301754.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, 3, 4, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Both the home and the potential resident has enough information to decide if The Dove is the right place for them to live. Admissions are managed with sensitivity and care. EVIDENCE: Potential residents are given information about using the home’s accessible service users’ guide (called an Easy Read guide). The document describes the house, the people who live there and the opportunities available. The statement of purpose is also available, although this is not accessible. People interested in coming to live in the Dove would be invited to visit, initially for tea or a meal and then for longer periods as their interest develops. Any carer, supporter or Care Manager would also be welcome to visit. A ‘moving in’ manager is responsible for the process of welcoming someone to the L’Arche community and is available to answer questions from the potential member and their supporters. The post holder is skilled in accessible communication, including the use of Signalong and Makaton. There have been two admissions to the home in recent months. Assessments of the people’s needs were used as part of the information gathering prior to the decision was made that the home was an appropriate placement. Both of Dove, The DS0000007095.V301754.R01.S.doc Version 5.2 Page 9 the new residents knew the home prior to their admission as they lived in other homes managed by L’Arche. The admission was discussed with the residents to ensure that they were happy with the move. People who care about the residents, including family members and an advocate, were also involved in the decision making. Staff from the residents’ previous placement assisted with the move, and transferred to The Dove to ensure that people familiar to the residents were involved with their care and could pass on important information to The Dove. This ensured consistency of care and helped the transition to go smoothly. Visits were made to the home on several occasions prior to admission. Dove, The DS0000007095.V301754.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, 8, 9, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The care planning system takes into account residents’ needs and goals. L’Arche has systems in place for the active involvement of residents in decision making about day-to-day issues and about the management of the organisation. EVIDENCE: Each of the residents has a file containing their personal information, support guidelines and planning decisions. The files were in good order and included notes from recent review meetings, information about people of importance to the resident and their social history. Residents are consulted about care planning matters through informal discussion and through their attendance at planning and review meetings. They are supported by advocates and family members whenever possible. Discussion with the Manager showed sensitivity to the impact of the house move on the newest residents and she has ensured that they are able to Dove, The DS0000007095.V301754.R01.S.doc Version 5.2 Page 11 continue with their previous care plan. The plan for the other resident recognises her preferences and long term goals. Residents have the opportunity to contribute to the day to day running of the home and the organisation through a number of formal and informal methods. These include informal discussion, weekly house meetings and the involvement of advocates. The residents, along with other members of the community, participate in L’Arche Community Council elections and the appointment of house leaders (managers). Members of the management team of L’Arche, including the Director, make themselves available to residents so that they can share their views. Risk assessments are in place to support residents in their participation in activities which involve some risk. They had been reviewed recently and are appropriate for the range of activities in which residents participate. Dove, The DS0000007095.V301754.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): 11, 12, 13, 14, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are supported to take part in an appropriate range of activities both in the home and in the local community. Residents all had holidays during the summer period. Residents benefit from the support staff give to help them to keep in touch with their families and friends. Meals are planned and prepared with the involvement of residents. EVIDENCE: The residents have the opportunity to join in a range of valued leisure and work activities in keeping with their needs and interests. All of the residents have day placements in L’Arche workshops including candle-making, weaving, stonework and gardening. The leisure activities followed by residents are age and culturally appropriate. One resident recently went to see a musical show in the West End, she said how much she had enjoyed the trip which had been a birthday treat. The L’Arche community is based on Christian values and there is careful Dove, The DS0000007095.V301754.R01.S.doc Version 5.2 Page 13 consideration of residents’ spiritual needs. Residents may choose to join in community faith groups, prayer meetings and attend Church. Residents take part in local community activities and use public transport, with support as necessary. Residents joined in community holidays during the summer period. The residents are supported to keep in touch with friends by making visits to them and receiving visitors in their own home. The daily routines of the home are flexible ac cording to residents’ activities and needs. The staff rota is arranged to take account of their activities so that support is available as necessary. All of the residents’ bedrooms are lockable and house assistants observed during the inspection were respectful of their privacy and rights. Residents choose when to spend time alone and this need and choice is recognised by house assistants. There are two pets in the home – a cat and a budgerigar. The residents are encouraged to share the responsibility for their care. The menu of the home is based on residents’ preferences. Residents said that they enjoyed the meals and they assist with their preparation. The menu showed that fresh fruit and vegetables are served regularly and that there is a wide range of meals available. Dove, The DS0000007095.V301754.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, 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents benefit from a pro-active approach to health care. The medication system would be safer if staff always make an entry on the medication administration record at the time a medicine is given. Sensitive support has helped residents and staff who have experienced bereavements recently. EVIDENCE: Observation of staff interaction with residents showed that they have respect for each other. The staff team is mixed, as is the resident group. This allows same gender care to be provided and there is consideration of how assistance should be given with personal hygiene tasks when needed. All of the residents were suitably dressed during the inspector’s visits to the home and their appearance enhanced their dignity. Each resident has a file which includes details of their health needs, information about specific health conditions and the outcome of appointments with a range of health care workers. The files showed that there has been careful attention to residents’ medical needs, that preventive health care Dove, The DS0000007095.V301754.R01.S.doc Version 5.2 Page 15 checks are made and that residents are supported to follow a healthy lifestyle. Positive feedback was received from a professional about the home’s ability to manage residents’ health care needs. Medication is stored safely. Records of medication administration on the second visit to the home showed that no entry had been made for one person for medication on the mornings of the 21st and 22nd November 2006. The medication was missing from the blister pack so the Registered Manager thought it likely that the item had been administered. Nevertheless staff must be sure to make the appropriate entry on the medication administration record at the time the resident takes the item. Other medication records were in good order. The residents and staff team have experienced bereavements over the last year. Sensitive support has been offered by staff members, along with specialist support in the form of bereavement counselling, for staff and residents. The team and other members of the L’Arche community have worked well to support the residents and each other through some very difficult periods in the life of the home. Dove, The DS0000007095.V301754.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The complaints and adult protection policies contribute to residents’ protection. EVIDENCE: There have been no complaints made about the home since the last inspection in February 2006. The residents are aware of how to raise a concern and a poster which uses pictures to describe the complaints procedure is displayed in the hallway of the home. Abuse awareness training is part of the L’Arche induction and foundation training undertaken by all staff in their first year of employment. The adult protection policy of the managing organisation is suitable for its purpose. There have been no investigations carried out under the adult protection procedures in the last year. Dove, The DS0000007095.V301754.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, 27, 28, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The residents benefit from the clean, homely and well decorated home which has been furnished and decorated with reference to their particular needs. EVIDENCE: The home is comfortable and homely. Redecoration has improved the appearance of some areas of the home, specifically the hallway, living room and landing area. The hall and stair carpet have been replaced and there is a laminated flooring on the landing area. The two most recently admitted residents have newly decorated bedrooms. The residents and people who know them well assisted with choosing the decoration and furnishings for their rooms. All of the bedrooms were attractive, homely and tidy. They are personalised with the residents’ own items. The fourth bedroom is currently unoccupied. The decoration takes account of residents’ particular needs, including a resident’s visual impairment. Dove, The DS0000007095.V301754.R01.S.doc Version 5.2 Page 18 Communal space consists of a living room a dining room and conservatory. In the communal areas there are personal items, including photographs of previous residents and other people the residents are fond of. On the ground floor is a shower room with a WC and there is a bathroom with WC and a separate WC on the first floor of the house. A bedroom on the ground floor (currently vacant) has en-suite facilities. The bathroom, shower room and WC all allow privacy and are suitable for the residents’ needs. An issue concerning safety in the WC is raised below at standard 42. Dove, The DS0000007095.V301754.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 the service. There are enough appropriately trained house assistants to meet the residents’ needs. Residents are protected through the safe recruitment procedures. EVIDENCE: In addition to the Registered Manager there are four full time house assistants working at the home and one assistant who works for 14 hours each week. Two of the house assistants used to work in the home in which the two most recently admitted residents lived. This has allowed a smooth transition for these residents so that the house assistants can assist the other staff to get to know the residents and their needs. The usual staffing levels are for two house assistants to be on duty between 7am and 10am and between 4pm and 8pm. One house assistant is available overnight from 8pm. These numbers are appropriate for the current needs of the residents. The staffing levels are increased if residents’ activities require additional house assistants to be available. After 8pm house assistants have access to on-call support from the Registered Manager or another manager from within L’Arche Lambeth. Dove, The DS0000007095.V301754.R01.S.doc Version 5.2 Page 20 There is an appropriate training and development plan for house assistants and the Registered Manager. The plan specifies the training which house assistants are required to undertake within set periods after they have joined the home as a house assistant. The plan is based on the specific needs of the residents and the core skills required for the house assistant role. A summary of recruitment records is kept at the home which was viewed during the visit. The records showed that appropriate checks and references have been taken up on house assistants. Dove, The DS0000007095.V301754.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 the service. EVIDENCE: The Manager of the home was registered under the Care Standards Act 2000 shortly before the inspection. She has worked at the home for some time as a house assistant prior to accepting the position of manager. She is familiar with the residents and their needs and with the policies and procedures of L’Arche Lambeth. Managers from L’Arche visit the home at intervals as required by the Care Homes Regulations. The records of the visits show that an appropriate range of issues is examined and that residents and staff have the opportunity to talk to the visitor. Dove, The DS0000007095.V301754.R01.S.doc Version 5.2 Page 22 It was noted that there was damage to the wall around the light switch in the first floor WC. This could present risks to residents and staff. It was pointed out to the Registered Manager who agreed to ensure that a repair was made. The most recent fire drill took place on 13th November 2006. The drill did not go well and one resident’s reaction would have placed her at risk in the event of a fire. The drill prior to this one had taken place in April 2006. It is generally recommended that fire drills take place at three monthly intervals, but this incident indicated that the frequency of drills be increased so that the resident becomes familiar with the best action to take in the event of the fire alarms being activated. Other records of health and safety checks were in good order. Dove, The DS0000007095.V301754.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 3 2 3 3 3 4 3 5 X 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 3 28 3 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 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 4 3 X 3 X X 2 X Dove, The DS0000007095.V301754.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 YA20 Regulation 13(2) Timescale for action The Registered Person must 11/12/06 ensure that the administration of medication is confirmed by an entry on the medication administration record. The Registered Person must 31/12/06 confirm that the repair has been made to the wall near the light switch in the first floor WC. The Registered Person must 11/12/06 ensure that fire drills are conducted at a minimum of three monthly intervals. Requirement 2. YA42 23(2)(b) 3. YA42 23(4)(e) 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 Dove, The DS0000007095.V301754.R01.S.doc Version 5.2 Page 25 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 Dove, The DS0000007095.V301754.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. 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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