Inspection on 12/05/09 for Elmers End Road

This inspection was carried out on 12th May 2009.

CQC found this care home to be providing an Adequate service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Elmers End Road 22/05/07

Elmers End Road 20/09/06

Elmers End Road 10/01/06

Elmers End Road 01/06/05

Elmers End Road 28/01/05

Elmers End Road 23/08/04

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 08/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Elmers End Road 23 Elmers End Road Anerley London SE20 7ST The quality rating for this care home is: one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Janet Pitt Date: 1 2 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 30 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Elmers End Road 23 Elmers End Road Anerley London SE20 7ST 02087766564 F/P02087766564 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Leonard Cheshire Disability care home 5 Number of places (if applicable): Under 65 Over 65 5 0 learning disability Additional conditions: The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of service users who can be accommodated is: 5 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 30 A bit about the care home Elmers End is home for five young adults who have a learning disability. It is maintained in a domestic style and is located in a residential area of Penge, close to local shops. The home has three floors and the stairs to the two top floors are steep, there is no lift so Elmers End would not be suitable for persons with significant mobility difficulties. It is part of the Leonard Cheshire Foundation. Service users in this home are encouraged and enabled to be as independent as possible. Each service user attends the local day centres five days a week. Visits to their families are encouraged, including overnight stays. Leisure facilities in the local community are also accessed. Group holidays are organised by the home and staff accompany service users as appropriate. There is a staff team of five, including the Manager. Staff members in the home are recruited and trained through the Leonard Cheshire Foundation. Staff covers the house 24 hours a day. All local health provision is accessed. Specialist support is offered via staff at day centres and Bassett?s Centre. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 30 How we did our inspection: This is what the inspector did when they were at the care home The Quality Rating for this service is one star. This means that the people who use this service experience adequate quality outcomes. One inspector undertook this unannounced inspection. We spent a total of six hours on a site visit. During this time we looked around the home and inspected files relating to care. We were able to meet and talk with individuals who live in the home and gain their views on the care they receive. We also spoke with the manager and some members of the staff team. The home provided us with a copy of their Annual Quality Assurance Assessment [AQAA], information from this has been included in the report. The Care Quality Commission [CQC] sent surveys to the people that live in the home. Two people responded. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well What has got better from the last inspection What the care home could do better We cannot be confident that health and safety within the home is maintained as major work is needed to make sure that environment is suitable for individuals to live in. Care Homes for Adults (18-65 years) Page 8 of 30 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Janet Pitt 33 Greycoat Street London SW1P 2QF 02079792000 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 9 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Individuals can be sure that their needs will be identified prior to them moving into the home. However, more work is needed to make sure that the person is central to how their needs are to be met. Care is needed to make sure that peoples rights are maintained. Evidence: The home stated in its AQAA that Admission to the home will only take place if the service is confident that staff has the skills, ability and qualification to meet the needs of the prospective service user. We found in individuals files that an assessment of need had been made prior to them moving in. Acceptable risk and needs were identified in the initial Individual Service Plan [ISP]. Risks covers included handling of finances, vulnerability when travelling and risk to other people when in the community. Each person had a contract of what care they were to receive and a tenancy agreement between themselves and the company that owns the building. Leonard Cheshire do not own Elmers End premises. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: We noted that peoples rights were not consistently protected and promoted. There is a need to address an individuals right to chose their next of kin. Family members are being named as next of kin even if a person is married. There is a need to demonstrate that care is person centred. The home has a duty to put the individual at the centre of care and not treat any family wishes as priority, unless they hold legal powers. Elmers End plans to review their brochure in the next twelve months and develop care planning further. The staff wish to make sure they work within the Mental Capacity Act. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Individuals are able to chose how they spend their day. Support is given by staff if necessary. Activities are carried out within a risk assessed framework. Evidence: The homes AQAA told us that annual surveys are undertaken to gain the views of people that live in the home. Any action needed is carried out. The home reported that there was positive feedback about the quality of care and support by staff. We received two surveys from people who live at Elmers End. The surveys had been completed with aid of key worker. Both respondents stated that their individual needs and choices had been met. During the site visit we found that individuals accessed the community on a daily basis. As mentioned previously one person was going out to do some food shopping for supper with the support of staff. Each person has individual plans for how they spend their day. Time was factored in Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: for free time. People were supported in managing finances. Risk assessments regarding this were in place. Staff identify whether people would like to use public transport or taxis when they go out. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home should continue to promote independent skills. Individuals who live in the home are able to maintain and develop links with the local community. Opportunities for paid employment and study are available. Evidence: The AQAA indicates that people who live in the home are supported to be independent. Support is given for shopping, food preparation and domestic chores. Individuals can attend day centres or go out to work if they chose. One comment in the AQAA was as follows All service users are encouraged to be involved in the domestic routines of the home and this is carried out with staff support eg washing bedroom cleaning, putting out rubbish and house shopping. People spoken with said that they were able to do cooking and one person was on their way to the shops with a member of staff to buy some ingredients for the evening Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: meal. The home has plans to improve the computer access for individuals, as some people are attending computer courses and wish to practice their skills at home. We spoke with people who lived in the home, they were able to confirm that they visited day centres of their choice. One person returned from working nearby and was happy to tell us of the job that they had been doing. The manager stated that individuals are paid the national minimum wage and receive staff benefits. Daily records evidenced people going to the gateway Club , where individuals can be involved in acting and dancing and perform in a show yearly. Also, discos are held at the club regularly. Other people eat out in restaurants or visit the pub. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Medications are handled safely in the home. Personal and healthcare support is provided appropriately by staff according to the persons needs and wants. Appointments are made with other health professionals when needed and people are supported to attend these. Evidence: Elmers End states in its AQAA that they have good support from their general practice which includes district nurses as well as doctors. Medication is provided in blister packs and staff have received training in administration and handling. This was confirmed by staff at the time of the site visit. The home has plans to improve by enabling individuals to self medicate. Other areas that the service considers it needs to address are same gender care preferences and support at the time of bereavement. The manager reported that personal relationship support workshops are held for people that live at Elmers End. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: We found evidence in plans of visits by other health professionals. eg GP, dentist, social worker and optician. One persons plan had list of cleaning duties and meal preparation, their daily routine was well detailed, ie assists with dinner, goes swimming, goes to gateway club. Makaton sign language books were used for some people to aid with their communication. We saw one person communicating using words and sign language, that the staff understood. End of life support plans are in place for people, but more detail is needed to make sure that staff are aware of arrangements that have to be made. For example one person had a funeral plan, but there was no further information showing whether the persons wanted to be cremated or buried and if they wished to have a religious ceremony or not. The people that live in the home are supported with their daily personal and healthcare needs. When we inspected daily records we saw evidence of one to one sessions between key workers and individuals. Also people going out, visiting family and friends, and visiting the pub. When assistance or prompting had been needed with personal hygiene needs, this had been recorded. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People can be confident that they will be protected from harm by the policies and procedures relating to safeguarding and complaints handling. Staff are aware of what needs to be done if there are any issues. Evidence: People are provided with a copy of the Have your say leaflet when they arrive in the home. We found also that copies were available in the home at the time of the site visit. The home reported in its AQAA that there is an advocacy service available to make sure that individuals are appropriately represented. The home acknowledges that there could be improvement in communication when individuals raise concerns in order that issues can be resolved at a local level. People we spoke with at the time of the site visit said they had no concerns and they would feel able to go to staff with any issues. The surveys we received also stated that people did not have any concerns or complaints. We have not received any formal complaints about Elmers End. There have been no Safeguarding investigations. Staff confirmed that they had received training recently in Safeguarding Adults and were aware of what needs to be done if there are any concerns. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People do not live in a home that is always suitable for their needs. Although they are able to personalise their rooms, communal areas are in need of refurbishment and upgrading. Evidence: We were able to look around the home. Individuals have personalised their rooms and specialist equipment is available if needed. We are extremely concerned that despite the management of the service being proactive, the landlord of the building has failed to repair the shower on the first floor. We understand that when the requirement was made in 2007 the shower was repaired. However, it became out of action in again February 2008 and has not been repaired since. CQC appreciates that the building is not owned by the provider, but work is urgently required to make sure that people live in a safe and maintained environment. People are able to access a large level garden, but at the time of the site visit the garden was untidy and not accessible. The grass was extremely long and needed cutting. The fabric of the home generally is poor and the majority of areas require Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: refurbishment and updating. The manager reported that no major work had undertaken in the home since his arrival several years ago. Some ceiling had been painted in rooms such as the kitchen, but this only served to highlight how tired and worn the walls, tiles and units were. The flooring of the kitchen and some of the bathrooms did not look clean. The flooring requires replacing to make sure that it is sealed and can be cleaned properly. Where repairs had been carried out the seal between the flooring and the sides of the bath allowed dirt to accumulate. In the lounge there is a gas heater that is no longer in use, this has yet to be removed. Paintwork throughout the house was chipped and tired looking. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who live at Elmers End can be assured that recruitment procedures will be followed. The individuals are supported by a stable staff team who are trained and competent to carry out their role. Evidence: We found that no one new has been recruited in the past few years. Evidence we hold from previous inspections informs us that there have been no issues with recruitment procedures. The home states in its AQAA that when staff are recruited their policy is followed and checks are made. Each new member of staff will have a three month probationary period. Each current member of staff has regular development and supervision sessions. This was confirmed with the members of staff we spoke with during the site visit. Staff said that they had undertaken mental health awareness and communication training during the past twelve months. The manager reported that he is looking at re structuring rota to minimise the use of agency and bank staff. He said there is a training matrix in place to identify when mandatory training is needed. One person is currently doing a food hygiene course. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: The manager has attended a deprivation of liberty workshop. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People live in a home that is run by a competent manager. However, the relationship with the landlord does not make sure that peoples health and safety is protected. Evidence: The service states in its AQAA that it works within the policy and procedures for health and safety. However, we have concerns over health and safety in relation to the environment and the inability of the home to progress the works. We understand the landlord is responsible for the fabric of the building is apparently not progressing maintaince works. We require an action plan from the home to demonstrate when maintainence will be carried out. The manager has worked at Elmers End for a number of years. He also has responsibility for another home nearby. During the site visit we saw him communicating well with the people that live in the home and staff who were on duty. The AQAA told us that an annual survey of service users is conducted. The results are analysed by an outside agency and an anonymised report is received. An action plan is discussed with people that live at Elmers End. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action 1 27 23 The shower in the second floor bathroom must be repaired within the stated timescale. 11/09/2007 Evidence provided to indicate that work had been done, but subsequently the issue occured again. Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action 1 42 23 A plan of action detailing when maintainence works will be carried out. 30/09/2009 This will make sure that people live in a safe and well maintained home. Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 2 12 Individuals must be at the centre of the assessment. Evidence is needed that information within the assessment is supported by the person. 14/10/2009 This will make sure that individuals rights are protected. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 28 of 30 1 20 It is recommended that individuals support plans for end of life care contain sufficient detail to make sure that their wishes will be carried out. Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone : or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 30 of 30 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!