Inspection on 22/05/07 for Elmers End Road

This inspection was carried out on 22nd May 2007.

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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Elmers End Road 12/05/09

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 08/07/2008.

CARE HOME ADULTS 18-65 Elmers End Road 23 Elmers End Road Anerley London SE20 7ST Lead Inspector Ann Wiseman Unannounced Inspection 22nd May 2007 13.30 DS0000006953.V336329.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 DS0000006953.V336329.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. DS0000006953.V336329.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elmers End Road Address 23 Elmers End Road Anerley London SE20 7ST 020 8776 6564 F/P 020 8776 6564 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) www.leonard-cheshire.org.uk Leonard Cheshire Mr Lindon Philander Care Home 5 Category(ies) of Learning disability (5) registration, with number of places DS0000006953.V336329.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th September 2006 Brief Description of the Service: 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. DS0000006953.V336329.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced Inspection and was carried out over two days. The Registered Manager was not at the house during the first visit but the two staff members on duty at the time were helpful throughout the visit. The Manager and Inspector meet at the house on a later date. The Inspector arrived just after lunch on the first visit, none of the People living in the home were around but soon arrived back from the day centre and the Inspector was able to meet them before she left. The home was quite clean and tidy and had a homely atmosphere. No major areas of concern were raised and the Inspector would like to thank everyone who helped during the Inspection. The Commission sent surveys to all of the Residents and their families and the response was good. What the service does well: What has improved since the last inspection? What they could do better: When the Inspector arrived for her first visit the bedrooms were dusty and the house was in need of a “spring clean” as doors, walls and paintwork were grubby. The Garden was also overgrown and old, discarded furniture was stored in it. Both issues were bought to the Managers attention and were addressed immediately. DS0000006953.V336329.R01.S.doc Version 5.2 Page 6 Repairs needed in one of the bathrooms have been outstanding for some time, one, a broken toilet, was addressed between the Inspectors two visits and another, a broken shower tray, is still waiting to be repaired. All of the bathrooms are out dated and are showing signs of wear; consideration should be given to updating them. 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. The summary of this inspection report can be made available in other formats on request. DS0000006953.V336329.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 DS0000006953.V336329.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. JUDGEMENT – we looked at outcomes for the following standard(s): All of the above standards have been assessed on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All necessary information for people to make an informed choice about the house is available. EVIDENCE: The house has a statement of purpose and a Residents Guide. They are in a style that is easy to read. There has not be any new Residents moved into Elmers End, this Client group have been together a long time. Policies and procedures are in place and the Manager is aware of the process required to receive new Service Users into the house. DS0000006953.V336329.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): All of the above area has been assessed during this Inspection. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New Care plans are being developed that reflects the needs and strengths of the Residents and records show that all of the people living in the home are consulted on and participate in all aspects of the running of it. Risk assessments are in place that supports the Residents to take risks as part of an independent lifestyle and information is stored appropriately. EVIDENCE: Care plans are in the process of being updated and put into another format in consultation with those living in the home. The Inspector was able to see one of the plans that have been finished. They are in an easy to read format and are designed to collect more data and information than the old ones and will reflect the needs and strengths of the Residents Examination of the records shows that all everyone in the home are consulted on and participate in all aspects of the running of the home. All of the DS0000006953.V336329.R01.S.doc Version 5.2 Page 10 Residents are supported to retain independence and to be self-determining in their day-to-day life. All of the people who live in the house help with some of the domestic chores, one of the Residents carries out the weekly fire alarm test, another helps to prepare meals and everyone does their own laundry. Risk assessments are developed to enable the Residents to retain independence; these risk assessments are realistic and accept that sometimes people have to take real risks to be empowered to take control of their lives and to maintain independence. One Resident who has epilepsy and poor mobility is supported to travel independently despite all of the difficulties he could face; safeguards and interventions have been put into place to minimize risks not to stop the activity. All records containing personal information were stored in a secure area and staff receive training about keeping information disclosed and confidences shared private. DS0000006953.V336329.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): All of the above standards have been examined on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. At Elmers End the Residents have the opportunity to take part in appropriate activities within the local community and are give opportunities for personal development. All of the Residents have close contact with their families and staff respect their rights and responsibilities. Mealtimes are relaxed and enjoyable. EVIDENCE: One resident has a job and others are doing computer courses, attend a local collage and day centre. The home is within easy reach of the local amenities and people enjoy going out to the local shops. The people living in the house enjoy eating out, using the trams, shopping and visiting the local cinema etc and take every opportunity to get out and about. The weekend before the Inspection the Residents and staff had taken part in the London and Kent regional World Vision Song Contest. They had worked hard to choose a song and the costumes. They decided to perform a West DS0000006953.V336329.R01.S.doc Version 5.2 Page 12 African tune with drums and dancing and put in a lot of practice. The practice paid off and they were awarded first prize. Everyone was happy to show off the trophy. The Residents are facilitated and encouraged to keep in contact with their families and friends and have regular visitors to the house. Sometimes they go and visit their families and the home is organising a summer BBQ when the families and friends will be invited. All of the Residents share responsibilities within the home; one carries out the weekly fire alarm checks and two of them run their own flat supported by staff. One of the Residents likes to help prepare the evening meal. The meal presented on the day of the Inspection, which was in plentiful portions, appeared appetising and was well presented. The kitchen was well stocked with supplies of fresh, frozen and dry supplies. DS0000006953.V336329.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): All of this area was judged during this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The People living in this home are supported in ways they prefer with their needs being assessed and met. Medication is managed appropriately. The Residents can be confident that they will be treated with respect and have their wishes met during illness, aging and death. EVIDENCE: Care plans stipulate preferences for personal support. The Manager and two staff members that were on duty all displayed a good knowledge of the clients needs and communicated well together. They talked about respecting peoples rights to make their own choice and to make decisions for themselves. The clients are registered with the local doctor and visits to the doctor and other health professional are recorded. Specialist support is accessed through the Bassets centre and the Central Learning Disability Centre. None of the Service Users manage their own medication and it was stored and recorded appropriately. The house has a medication policy and staff receive training around dispensing and handling of medication. The home has a policy that deals how they aim to manage those Service Users who are ill or dying. The home hopes to continue to care for the Service Users as long as their needs fall within the capability of the staff to care for them. DS0000006953.V336329.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Both of these standards have been assessed on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are recorded and dealt with as required and there is appropriate training in place to enable staff to identify and deal with abusive situations. EVIDENCE: The complaints procedure is to standard and is displayed throughout the house. The house has a copy of the guidance notes on whistle blowing and No Secrets and the Protection of Vulnerable Adults training is given. Both the Manager and the staff members interviewed knew the signs of abuse, and what steps would need to be taken and assured the Inspector that they would encourage and support any Resident who wished to make a complaint. The service have not had any complaints recorded since the last inspection and the nor have any been received at the Commission. DS0000006953.V336329.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): All of these standards have been judged during this Inspection. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is comfortable, homely, is a safe environment and suites the needs and lifestyles of the Service Users. The home was clean and hygienic. EVIDENCE: The Inspector was given a tour of the whole house and it was found to be comfortable and maintained quite well. Although the bathrooms provide sufficient privacy and meet the Clients needs, they are beginning to look out of dated and shabby and consideration should be given to updating them. One bathroom had both the shower and toilet out of action and in need of repair, both had been out of use for some time. On the return visit the toilet had been mended but the shower was still not in use. The building is owned by a housing association and the Inspector was told they can be slow to manage repairs. However a Requirement will be made for the shower to be put back into action as soon as possible. Please see Requirement 1 DS0000006953.V336329.R01.S.doc Version 5.2 Page 16 All but one of the bedrooms were individually furnished and decorated and reflected each individuals character and lifestyle. All were of a good size and most held the required furniture. One room stood out as being stark with little furniture and very few personal items. The Manager assured the Inspector that the room was furnished and decorated to the Residents wishes. The was no record on this persons file that he had requested not to have the required furniture in his room. The room is also in need of decoration. The Minimum standards allows that people living in Residential Care should have their wishes respected and can have their rooms furnished and decorated as they desire, but it is required if anyone does choose not to have the stated minimum furniture in their room, their wishes and desires must be recorded in the care plan with the reasons behind the decision if possible. Please see Requirement 2 The house was mainly clean and tidy on the first visit but was in the need of a thorough “spring clean” as the skirting boards and paintwork was grubby. By the Inspectors second visit to the service it had been well cleaned and tidied. Both the staff and the Residents do the cleaning work. The dinning room is large and shelving at the back of the room is still used to store polices and files. The Manager has informed the Inspector that he will soon be using a building in the garden as an office and will be transferring all of the files and folders out to the office once it has been made ready. This will be good, as it will make more room available for the sole use of the people living in the house and give the room a more homely appearance. The flat upstairs is well decorated the Residents that live there keep it clean and well ordered. DS0000006953.V336329.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): All of this area has been examined during this Inspection. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are aware of their roles and responsibilities, are qualified to work with this client group and are competent. The people living at Elmers End are protected by the homes Recruitment process and the well trained and supervised staff. EVIDENCE: This staff team has been together for many years and there have been no changes to it since the last Inspection. Previous checks on staff files have not revealed any omissions or shortcomings. The two staff members that the Inspector spoke with confirmed that their recruitment followed procedure and that they were asked to provide two references and underwent Criminal Records Bureau checks before they were able to take up their post. Both appeared to be knowledgeable about the people in their care and had a good understanding of their needs. It was obvious from observations during the Inspection that staff have built up a good relationship with the clients; the interaction between them was supportive and respectful, the staff member who told the Inspector about the win at the Singing Contest was genuinely pleased and proud of the Residents achievement. DS0000006953.V336329.R01.S.doc Version 5.2 Page 18 There was a very good response to the survey sent by the commission to all of the Residents and their families. The Residents were supported to reply by carers and were mainly positive and said they were able to do what they wanted, when they wanted to and that they were supported in a good way. Three of five Family members replied to the survey and were complimentary about the home and the way the staff supported the people living in the house. One Mother said, “They listen, they care for the individual and know them well” and “They act in a professional way which gives confidence.” All of the Care Staff have attained their NVQ2 qualification and receives regular training and supervision. The rotas that were examined indicate that sufficient staff are on duty while the residents are at home. The house is not normally staffed while the house is empty during the day but the rota is flexible enough to enable staff to be present if a resident is unable to go to their usual daytime activity for any reason or has an appointment. The Home has not used any agency or bank staff over the last year. DS0000006953.V336329.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): All of the above standards were judged on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Residents living at Elmers End benefit from a well run home with good leadership. They can feel confident that their views are listened to and that their rights and best interests will be protected by the homes policies, procedures and record keeping. EVIDENCE: The home appears to be well organised, the Manager seems to be competent and well liked and sets a high standard by example. An independent advocate chairs residents meetings and outcomes are addressed. Annual Surveys are taken and the format is in a style that is accessible to these Residents. Monthly Regulation 26 visits are carried out and copies of the reports are always sent to the Commission. These visits were required so that someone DS0000006953.V336329.R01.S.doc Version 5.2 Page 20 from outside of the home has an opportunity to visit and to speak to the Residents and Staff, to check that the required paperwork and policies are in place and to make sure the Residents and home are well looked after. The homes polices and procedures are robust and have been developed to underpin the Residents rights and best interests. Recordkeeping is appropriate and confidentiality is respected. Health and safety procedures are in place and records checked were found to be accurate and up to date. The response by the families to the survey sent out by the commission was positive and spoke highly of the Registered Manager. However a couple felt that by running two registered homes he may be over stretching himself. The Manager and Inspector discussed this matter and the Manager felt that he was capable of managing both homes and had been doing so for several years. He reassured the Inspector that he did not feel under stress and pointed out that both houses had consistently received good Inspection Reports. He also said that while his office was presently based at the other premises, a recent independent review of the organisation had advised that he should have a separate office space to work from and plans were in place to build an office in the grounds of Elmers End. Therefore he will be closer to the service and will have a better working environment. The Inspector has had not reason in the past to doubt his capabilities and is confident that the Registered Manager is well able to manage his workload and will maintain standards in both of the homes that are under his responsibility. DS0000006953.V336329.R01.S.doc Version 5.2 Page 21 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 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 2 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 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 3 3 3 3 3 3 3 3 3 DS0000006953.V336329.R01.S.doc Version 5.2 Page 22 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 2 Standard YA27 Regulation 23 23 Requirement The shower in the second floor bathroom must be repaired within the stated timescale. Residents that decline to have all the required furniture and fittings in their bedrooms must have their wishes recorded in their Care Plan Timescale for action 11/09/07 11/09/07 YA26 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 DS0000006953.V336329.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection SE London Area Office River House 1 Maidstone Road Sidcup Kent DA14 5RH National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000006953.V336329.R01.S.doc Version 5.2 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. 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