Inspection on 30/10/08 for Fenwick Road, 29

This inspection was carried out on 30th October 2008.

CSCI found this care home to be providing an Excellent 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

Fenwick Road, 29 01/11/06

Fenwick Road, 29 07/01/06

Fenwick Road, 29 24/06/05

Fenwick Road, 29 24/02/05

Fenwick Road, 29 14/06/04

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 29/01/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Fenwick Road, 29 Fenwick Road, 29 London SE15 4HS     The quality rating for this care home is:   three star excellent 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: Lynne Field     Date: 0 7 1 1 2 0 0 8 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. the things that people have said are important to them: They reflect 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. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Fenwick Road, 29 Fenwick Road, 29 London SE15 4HS 02077325261 02077325261 fenwick@saffronland.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Saffronland Homes care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 3 The registered person may provide the following category of service only: Care Home Only - Code 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 Date of last inspection Brief description of the care home The home provides care for three adults with learning difficulties. It is managed by the Saffronland group, which is a private provider. The house is an end of terrace property between Peckham and East Dulwich and is well located for transport links, local shops and community facilities. Each resident has their own room, one of which is en-suite. There is a front and back garden and on-road parking. On the day of the visit there were no vacancies and weekly fees are from #1932-27. 3 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 26 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: three star excellent 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 peterchart Poor Adequate Good Excellent How we did our inspection: The unannounced inspection was carried out over two half days in October and November 2008. We met all the residents and spoke to three staff during the course of the inspection and all were very positive. We checked relevant policies and procedures as well as tenants files, the care plans and building maintenance records. The second visit was to meet the new manager and access files that were unavailable on the first day. We spent time speaking to the manager about how the service was being developed and the senior carer. During these visits we were able to observe how staff interacted with residents and how residents responded to staff, which were very positive. The manager was very positive about the development of the service. She spoke about how staff are supported and encouraged in their personal and professional development which enables them to support the residents become more independent. Care Homes for Adults (18-65 years) Page 5 of 26 Care Homes for Adults (18-65 years) Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 26 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 8 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have information available to them in an accessible format. They have the opportunity to test the service to help them make a decision about whether it will be able to meet their needs. Evidence: Checked the statement of purpose and service user guide and this has been reviewed and it is in accessible format. The registered manager said they had not admitted any resident since the previous inspection but they would follow the organizations procedures if a vacancy arose and prospective residents would have the opportunity to visit the home to help them decide if it could met their assessed needs. We saw copies of assessments in residents files. Residents have an up to date statement of terms and conditions in their files. Care Homes for Adults (18-65 years) Page 9 of 26 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. Care plans are thorough and reflect residents needs and goals. Residents participation in the running of the home has been encouraged where feasible, with the support of the care staff. Risk assessment reviews take place and are recorded. Staff have easy access to this information, which is kept, in the homes office. Evidence: Care plans we were shown give a thorough description of residents behaviours, reactions and preferences and how the resident was to be treated. We were told the home would have best interest meetings for residents should it be necessary to make a decisions about aspects of their care and other areas such as a financial decisions are needed. We were shown copies of the minutes of the meetings and saw this Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: included the resident, their relative, who was consulted, staff from the home and other professionals involved. Records of the meeting and outcomes were kept on the residents file. We were shown detailed and up to date person centred plans. Staff told us they reviewed indvidual plans with each of the residents. One relative said they were involved in these plans. Person centered plans are written in an acccessable format and contain records of achievments and goals. We observed through the inspection residents being consulted on aspects of their daily lives, such as what they wanted to wear and did they want to go out. Risk assessments were in place for all aspects of the residents daily lives, including outside activities. These were reviewed at appropriate intervals. The registered manager and staff we spoke to said they would be reviewed beore the alotted time scale if some aspect of the residents life indicated the risk had changed. Care Homes for Adults (18-65 years) Page 11 of 26 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. Residents are enabled to lead varied lives including taking part in age, peer and culturally appropriate activities, leisure activities in the local community. Staff are sensitive to residents needs and wishes and they are actively encouraged to develop daily living and social skills. Residents are encouraged to choose a healthy diet. Evidence: We saw the residents activities timetable, which includes developing independent living skills within the range of the residents abilities. The timetable includes a full list of the residents interests and activities they participate in during the course of the week. These activities are assessed in person-centered plans and in review meetings. Daily Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: records show that residents are free to join in the activity or not as they wish. They make good use of community facilities including shops, church, pubs and restaurants. We were told and could see from the documentation supported to maintain links with family and friends and to develop personal relationships, where possible. Each resident has a cultural needs assessment on file and there is a record and history of their life and background. It includes information about each residents cultural and ethnic background and information from their early childhood through to the present day, is ongoing and staff continue to add to it and develop it as necessary. The staff said the menu for residents was discussed at their team meeting and the emphasis is on healthy eating and catering for residents cultural needs. Individualized menus designed to reflect each residents health and cultural needs. One resident has been prescribed food suplements for the times they are not able to eat. Care Homes for Adults (18-65 years) Page 13 of 26 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. Care plans are detailed and cover all aspects of a residents life including physical and emotional well being. Residents receive personal support in the way they prefer. Medication is managed and administered safely by the staff following the homes medication policies and procedures. Evidence: We found residents care files contain information for staff on how residents prefer their personal care to be given. The home operates a key worker system with each resident having a named member of staff from within the team to co-ordinate their support and care planning. Each resident possesses an individualised health action plan / booklet. The record of health appointments attended indicated that staff supports each resident if this is what Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: the resident requires, to attend an appropriate range of healthcare appointments in line with their individual healthcare needs. Staff said they monitor residents health needs and support residents to keep appointments and health care professionals including community pharmacist. We were able to see relevant documentation kept in the residents files such as the outcomes of reviews and outpatients visits. Residents are supported to attend their medication reviews and attend other individual health care appointments as well as their more routine services such as dentistry and chiropody. Residents medication is stored securely in a locked medication cabinet in the staff office. Residents had medication reviews and routine blood tests. Copies of the results were recorded in their personal file in their health care booklet. Homely remedies are signed as being able to be given by the GP. We checked the medication with the member of staff on duty and this was correct. We were shown the report by the local pharmacist who comes into the home every six months to check the medication. This indicated there were no issues that needed to be addressed by the home. We were told staff have medication training and medication administration records as part of their induction and the organisation have medication training in their refresher program. The manager said if staff made a medication error, this would be discussed in supervision and they would be sent on medication refresher training immediately. Care Homes for Adults (18-65 years) Page 15 of 26 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. Residents are protected by the homes policies and procedures. Complaints are handled in an appropriate manner and the complaints policy is in an accessible format. Evidence: We checked the complaints book and noted there were no complaints. The home has a complaints policy. This has been written in an accessible format and a copy of this is in the residents guide. A member of staff said they are aware of abuse and protection policies and how to deal with cases of suspected abuse. Any suspicions are reported to the manager to deal with, who will deal with it in an appropriate way following the homes adult protection policies and procedures. The manager said if there was a safe guarding protection issue, the home would follow the organizations safe guarding protection policy and the policy of the placing authority. We saw the residents finance book in which all financial transactions are recorded. These checked and recorded by two staff for each transaction. Residents financial Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: records were inspected and were found to be in order. Care Homes for Adults (18-65 years) Page 17 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a comfortable, well-maintained environment. The home is bright, clean, comfortable and safe. Residents rooms are comfortable and are decorated to reflect their personalities. Evidence: The manager and one resident gave us a tour of the house. The home that was set up three years ago is comfortable homely warm and well maintained. It is well sited for transport links and local facilities. The home is cleaned daily to keep it clean and free of unpleasant odours. There is a pleasant, accessible garden to the rear. The bedrooms are individual in style which are of good size and personalised as well as reflecting the culture of the resident. There is a comfortable lounge and a kitchen diner that leads onto the garden. We were told the kitchen is due to be refurbished and will be adapted to meet the residents needs. There is a large sensory room on the top floor. One resident has an en suite bathroom and other bathrooms are welcoming and well equipped. Adaptations needed to maximise independence are assessed for and provided. The laundry which is at the bottom of the garden that had ben repainted to meet the requirement stated in the last inspection report. Care Homes for Adults (18-65 years) Page 18 of 26 Care Homes for Adults (18-65 years) Page 19 of 26 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. The organizations recruitment records show that the procedures followed are safe, thorough and comply with the legal requirements. The home is supported by an effective staff team that know the residents well. Residents receive good support from experienced and well-trained staff. Having regular staff meetings and formal supervision supports the staff in personal and professional issues and development. Evidence: The manager told us that recruitment includes formal interview, taking up two references, CRB checks and POVA checks prior to appointment and all staff have an employment contract which include details of their terms and conditions of employment. Staffing levels monitored at intervals and at service reviews to assess any changes to individual needs. Staffing levels are adjusted to meet these needs on a week to week basis. This was reflected on the rota we saw. We checked four staff files to assess compliance with Regulation 19 of the Care Homes Regulations 2001. The files were in good order and had the required checks and references, including Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: Enhanced CRB checks, two references, full work histories and verification that they are physically and mentally fit for their work. We were told there is a supervision policy in place and individual training needs are set out in staff annual appraisals. Two members of staff had completed NVQ2 in promoting independence and two other staff has obtained NVQ3 in promoting independence. During the inspection we were able to speak to two members of staff who confirmed they had staff supervision every six weeks. They said they had training in person centered planning, medication refresher training, working with families and the protection of vulnerable adult training was in the training programme. The home has a In house trainer for manual handling and there is Makaton training for all staff. Other recent training included Health and Safety, Food Hygiene and Fire Training. Staff said they had regular staff meetings and supervision. We saw copies of their supervision records held on file. The manager told us the training is aimed at updating and improving staff skills. There continues to be an emphasis on POVA training and all staff attend this to refresh their knowledge and this is discussed in supervision and at staff meetings. Care Homes for Adults (18-65 years) Page 21 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a clear management structure in place to ensure that the service received by residents is consistent, well managed and planned. There is a formalized system of quality monitoring and annual development that means residents can be sure that their views were fully taken into account in planning the service. Records were clear and well kept. The home is safe and the working practices and associated records ensure that the health and safety of residents is promoted. Evidence: Since the last inspection in November 2006 there has been a change of manager. The registered manager worked in the service and became the registered manager in January 2008. She has over 4 years management experience and has gained the Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: Registered Managers Award and NVQ4. When we spoke to the registered manager during the inspection she demonstrated a clear understanding of the needs of the residents and her responsibilities in ensuring that the home meets the registration standards. She has clear ideas about how the service should be run for the residents benefit. Staff are trained not to impose their own personal standards on residents and are encouraged to show an interest in the residents history, lifestyle and culture in an effort to promote personalized care and support. Staff training is scheduled in respect of health & safety, abuse, food & hygiene on a rolling programmer every three to twelve months. Manual handling for all employees have been completed by newly appointed in-house trainer. The home conducts quality control annual surveys through questionnaires as well as the organization conducting regular Regulation 26 visits, which are kept on file and we were able to view. These visits are robust to protect residents from the possibility of abuse. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Adults (18-65 years) Page 24 of 26 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 Requirement Timescale for action 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 Requirement Timescale for action 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 25 of 26 Helpline: 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 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 © (2008) 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 26 of 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. 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!