Inspection on 06/12/05 for Emmanuel Care Services Ltd

This inspection was carried out on 6th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Emmanuel Care Services Ltd 09/04/09

Emmanuel Care Services Ltd 16/04/08

Emmanuel Care Services Ltd 25/05/07

Emmanuel Care Services Ltd 02/05/06

Emmanuel Care Services Ltd 13/06/05

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

CARE HOME ADULTS 18-65 Emmanuel Care Services Ltd 33 Disraeli Close Thamesmead SE28 8AP Lead Inspector Elizabeth Brunton Unannounced Inspection 6th December 2005 10:00 Emmanuel Care Services Ltd DS0000042496.V267776.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Emmanuel Care Services Ltd DS0000042496.V267776.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Emmanuel Care Services Ltd DS0000042496.V267776.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Emmanuel Care Services Ltd Address 33 Disraeli Close Thamesmead SE28 8AP 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) 0208 3105111 0208 3105111 Mrs Remi Konan Mrs Remi Konan Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Emmanuel Care Services Ltd DS0000042496.V267776.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th June 2005 Brief Description of the Service: Emmanuel Care Services was registered in February 2005 to provide care for up to three adults with learning disabilities. The provider of the home is also the manager. The home is a three-storey semi-detached house situated in central Thamesmead. A bus service connects with the town centre and all local facilities. There is one single bedroom on the ground floor and two further single bedrooms on the third floor. None of the bedrooms are en-suite but two rooms have wash basins installed. On the second floor, there is a lounge and kitchen/diner and there is a bathroom with shower and toilet on the second floor and a toilet on the ground floor. There is a small, enclosed paved garden at the rear of the property. The provider had recently applied for the home’s registration to be changed, so that up to three adults with mental disorder (excluding dementia and learning disability) could be accommodated. No clients had yet been placed in the home and there were no staff yet in post. Emmanuel Care Services Ltd DS0000042496.V267776.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection started at 10.00 am and one inspector was in the home for two-and-a-half hours. There were no residents and also no staff yet in post, so the provider/manager was spoken to, the building inspected and records seen. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Emmanuel Care Services Ltd DS0000042496.V267776.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Emmanuel Care Services Ltd DS0000042496.V267776.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 A service user guide was available but further work was needed on the statement of purpose. Full assessment information about potential residents was to be obtained. EVIDENCE: Additions needed to be made to he home’s statement of purpose at the last inspection and it now also needed to be amended in line with the provider’s application to accommodate clients with mental disorder. The service users’ guide included the necessary information. (see requirement 1) It was not possible to fully inspect other standards, as no residents had so far been placed in the home. The provider/manager was planning to ask for full assessment information about any potential residents. Emmanuel Care Services Ltd DS0000042496.V267776.R01.S.doc Version 5.0 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 8 & 9 A care plan format was in place and the provider/manager intended to promote independence and residents’ involvement in the running of the home. EVIDENCE: It was not possible to fully inspect any of the above standards, as there were no residents. Care plan and risk assessment formats were in place but had not yet been used. Multi-disciplinary risk assessments were to be obtained for new residents, together with risk management plans. A lockable filing cabinet was available for storing confidential records. The provider/manager said she planned to support residents in learning skills and increasing their independence, with the aim of eventually moving on to live independently in the community. She also planned to have regular meetings with residents and to involve and consult them about the running of the home. Emmanuel Care Services Ltd DS0000042496.V267776.R01.S.doc Version 5.0 Page 9 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14, 15 & 17 The home planned to support residents in activities outside the home and to involve residents in providing varied and nutritious meals. EVIDENCE: It was not possible to fully inspect any of the above standards, as there were no residents. The provider/manager planned to support residents in finding work, continuing in education, attending day centres, participating in leisure time activities and in maintaining contact with family and friends. Residents were to be involved in the choice and preparation of meals and in food shopping. Varied and nutritious meals were planned. Emmanuel Care Services Ltd DS0000042496.V267776.R01.S.doc Version 5.0 Page 10 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 The services of local health care professionals and lockable storage of medication were available. EVIDENCE: It was not possible to fully inspect any of the above standards, as there were no residents. The provider/manager was aware that residents were likely to have varying needs for personal care and support. Bedroom door keys were to be provided. Residents could be registered with GPs at a local health centre, where dental treatment, chiropody and physiotherapy were also available. Medication was to be stored in a lockable medicine cabinet and the provider/manager agreed that care staff, when recruited, would need medication training. Emmanuel Care Services Ltd DS0000042496.V267776.R01.S.doc Version 5.0 Page 11 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): 22 & 23 A complaints procedure was in place but the home’s adult protection policy and procedure was incomplete. EVIDENCE: It was not possible to fully inspect the above standards, as there were no residents. The home had a complaints procedure and information about making a complaint was included in the service users’ guide. There was a copy of Greenwich Social Services adult protection procedure and a whistle blowing policy. Further work was needed on the home’s own policy, procedure and guidance to staff on adult protection. (see requirement 2) Emmanuel Care Services Ltd DS0000042496.V267776.R01.S.doc Version 5.0 Page 12 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 & 30 The accommodation was of a good standard. EVIDENCE: The home was clean, well decorated and furnished and there was adequate communal space for three residents. Two of the bedrooms were of a good size and one was smaller. Radiators were protected and windows were fitted with restrainers. There was a small, rear paved garden. Emmanuel Care Services Ltd DS0000042496.V267776.R01.S.doc Version 5.0 Page 13 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 Staff recruitment had been more thorough than at the last inspection and there were now few gaps. EVIDENCE: It was not possible to fully inspect the above standards, as there were no residents or staff in the home. The provider/manager had interviewed and undertaken pre-employment checks on five prospective care staff. Though employment had been offered to these staff, it had not been financially possible to give contracts of employment, as there were no residents. The provider/manager said that at least three of these staff were ready to start work in the home at very short notice. The recruitment records for the five prospective staff were inspected. Completed application forms, satisfactory CRB checks and photo ID was in place for all applicants. A second reference and evidence of NVQ qualification was needed for two staff. At the previous inspection, the provider/manager had been asked to make additions to the staff application form and to record selection interviews and this had been done. Some changes were needed in the reference request letter and format and these were set out, together with the outstanding references and evidence of qualifications, in a letter to the provider/manager. (see requirements 3 & 4) Emmanuel Care Services Ltd DS0000042496.V267776.R01.S.doc Version 5.0 Page 14 The provider/manager hoped that one of the staff to whom she had offered employment and who had NVQ qualification, would become the deputy manager, after further training. The plan was for there to normally be one member of staff on duty, day and night, for up to three residents. However, the provider/manager agreed that additional staff would be rostered on duty, when this was needed by the particular resident group. According to records, all prospective care staff either had or were working towards NVQ or other relevant qualifications and had some previous, relevant experience. The provider/manager said that she was identifying sources of further training for staff. As none of the home’s prospective staff had previous experience in working with people with mental disorder, this training would need to be provided at an early stage. (see requirement 5) Emmanuel Care Services Ltd DS0000042496.V267776.R01.S.doc Version 5.0 Page 15 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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 & 42 The provider/manager was committed to providing a service and had relevant previous experience. The health and safety of service users had been protected. EVIDENCE: It was not possible to fully inspect the above standards, as there were no residents or staff in the home. The provider/manager had been registered as fit to both provide and manage the home. She had relevant experience, was enthusiastic and committed and had worked hard to set up the home. The provider/manager had a qualification, which she said was equivalent to NVQ level 4 in management and care, though this still needed to be confirmed. The building appeared to be safe and no hazards or risks to the safety of residents were identified. The home had been inspected by the fire authority Emmanuel Care Services Ltd DS0000042496.V267776.R01.S.doc Version 5.0 Page 16 prior to registration and smoke alarms, fire extinguishers and blanket fitted, as required by the fire authority. Fire fighting equipment was checked in December 2004 and was due to be checked again shortly. Gas and electrical installations were inspected in January 2005 and the certificates seen before the home was registered. The provider/manager said she had provisionally arranged the necessary insurance cover and that this would be put in place before service users moved in. She was asked to provide the CSCI with a copy of this, when the time came. (see requirement 6) Emmanuel Care Services Ltd DS0000042496.V267776.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 X X X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X 3 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 X 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 2 X 2 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Emmanuel Care Services Ltd Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 X X X X 3 x DS0000042496.V267776.R01.S.doc Version 5.0 Page 18 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA1 Regulation 4 Requirement The homes statement of purpose must be amended, so as to include all items listed under schedule 1 to the regulations The home ‘s policy, procedure and guidance to staff on adult protection must be more comprehensive. Satisfactory references and copies of qualifications must be obtained before staff commences work, as set out in a letter to the provider/manager from the inspector, dated 07/12/05. Additions must be made to the homes reference request letter and reference format, as set out in a letter to the provider/manager from the inspector, dated 07/12/05. Training in medication and mental disorder must be arranged, so that it can be provided for staff, without delay, once they start work. A copy of the homes insurance certificate must be sent to the CSCI, when residents move into the home. Timescale for action 01/02/06 2 YA23 13(6) 01/02/06 3 YA34 19 01/02/06 4 YA34 19 01/02/06 5 YA35 18(1) 01/02/06 10. YA43 25(2) 01/02/06 Emmanuel Care Services Ltd DS0000042496.V267776.R01.S.doc Version 5.0 Page 19 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 Emmanuel Care Services Ltd DS0000042496.V267776.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Emmanuel Care Services Ltd DS0000042496.V267776.R01.S.doc Version 5.0 Page 21 - 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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