Inspection on 23/10/07 for Fontenoy Road

This inspection was carried out on 23rd October 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 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Fontenoy Road 15/11/06

Fontenoy Road 12/12/05

Fontenoy Road 30/06/05

Fontenoy Road 26/11/04

Fontenoy Road 05/08/04

Fontenoy Road 16/02/04

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 Fontenoy Road 10 Fontenoy Road London SW12 9LU Lead Inspector Simon Smith Unannounced Inspection 23rd October 2007 1:30 Fontenoy Road DS0000010190.V354178.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 Fontenoy Road DS0000010190.V354178.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. Fontenoy Road DS0000010190.V354178.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fontenoy Road Address 10 Fontenoy Road London SW12 9LU Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8675 1000 jamesa@threshold.org.uk www.stepforward.org.uk Metropolitan Support Trust Ms Alison Cameron James Care Home 12 Category(ies) of Learning disability (11), Physical disability (1) registration, with number of places Fontenoy Road DS0000010190.V354178.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th November 2006 Brief Description of the Service: 10 Fontenoy Road is a care home registered for a maximum of twelve adults with a learning disability, although only eleven beds are used. Staff support is available 24 hours a day. The service is managed by the Metropolitan Support Trust. All placements are funded by the London Borough of Wandsworth. The home is situated in a pleasant residential area and has good access to local community facilities, open spaces and public transport networks. Off-street parking is available to the front of home and there is a rear garden. Information about the home is available in the Statement of Purpose. A DVD is currently being produced, which is designed to provide information for existing and prospective new tenants. Fontenoy Road DS0000010190.V354178.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector used evidence from a range of sources when making judgements about the home. These included visiting the home and talking to tenants, staff and the deputy manager. Some written information was checked, including staff and tenants’ files. The inspector was made welcome during the visit and wishes to thank all those who gave their views about the home. Surveys were made available to tenants, their relatives and staff. Two tenants and one family member returned surveys to the CSCI. Tenants said that they like living at the home and feel well cared for. Tenants also said that that staff provide good support when they need it and that they would feel confident speaking to staff if they had a problem or complaint. The family member said that she visits the home every week and is made welcome. The family member also said that the home meets the different needs of tenants and that staff keep her informed about her relative. Staff spoken to during the inspection said that they get good support to do their jobs and that they work well as a team. The deputy manager was in charge of the home at the time of inspection, although the manager was due to return to the home in November. Staff interacted positively with tenants and knew their needs well. Most tenants were out during the day, although there was a lively and homely atmosphere when people arrived home during the afternoon. Tenants were clearly comfortable and confident in their environment and chose how they spent their time at home. The home met 25 of 31 National Minimum Standards assessed at this visit. One Standard was exceeded and five Standards were almost met. What the service does well: Tenants receive good support to lead full and varied lives. Tenants receive an individualised service according to their needs and preferences. Tenants’ participation in their community is promoted. There are good opportunities for tenants to develop their skills and abilities. Tenants and staff are able to contribute their ideas to the running of the home. The home provides a stable staff and management team. Fontenoy Road DS0000010190.V354178.R01.S.doc Version 5.2 Page 6 Staff work well with other professionals involved in tenants’ care. 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. The summary of this inspection report can be made available in other formats on request. Fontenoy Road DS0000010190.V354178.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 Fontenoy Road DS0000010190.V354178.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): Standards 1, 2, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information about the home is available to residents. Residents’ needs are effectively assessed. The home has a clear Admissions procedure. Residents are issued with a contract that sets out their terms and conditions of residence. EVIDENCE: There is a written Statement of Purpose, which includes the home’s aims and objectives, and a Service User Guide. The deputy manager said that a DVD is being produced, which is designed to provide information for prospective new tenants to help them decide whether they want to move to the home. The DVD is also designed to give existing tenants information about their rights and responsibilities. Each tenant has the terms and conditions of their placement set out in an Assured Tenancy Agreement. Fontenoy Road DS0000010190.V354178.R01.S.doc Version 5.2 Page 9 The deputy manager said that placing authority social workers provide the home with assessments for prospective new tenants. Staff from the home then visit the prospective new tenant and arrange trial visits to the home. Tenants’ files contained comprehensive needs assessments. Fontenoy Road DS0000010190.V354178.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All tenants have an up to date care plan. Care plans record tenants’ needs and strengths and provide guidance for staff delivering care. Tenants are involved in the development of their care plans. Tenants receive good support to make choices about their lives. The home carries out risk assessments where necessary but some of these needed review. EVIDENCE: Fontenoy Road DS0000010190.V354178.R01.S.doc Version 5.2 Page 11 Residents’ care plans contained good individualised information about their strengths and needs. There was evidence that care plans are regularly reviewed and updated. Separate care plans had been developed for specific goals, such as developing skills and finding employment. There was evidence that tenants are involved in developing their care plans. Staff demonstrated a good knowledge of tenants’ needs and a commitment to supporting tenants in making decisions about their lives. The service consults significant others, such as family members and care managers, where appropriate about tenants’ care. Tenants said that they are able to choose how they spend their time at the home and that they are consulted about how the home runs. Tenants also said that they are able to make decisions about their lives and that staff provide support in this area if they need it. The home carries out risk assessments to support tenants in taking risks as part of an independent lifestyle. Most had evidence of regular review but a small number need to be reviewed more frequently to take account of possible changes in need. For example one tenant’s risk assessment to support independent travel was last reviewed in May 2005. See Requirement 1. Fontenoy Road DS0000010190.V354178.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 – 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 11, 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Tenants lead varied and fulfilling lives. Tenants have active social lives and are involved in their local community. Tenants’ rights and responsibilities are promoted in their daily lives. Tenants receive good support to develop and maintain relationships with their families. Tenants are able to contribute to the home’s menu and receive support to prepare meals. EVIDENCE: Fontenoy Road DS0000010190.V354178.R01.S.doc Version 5.2 Page 13 Tenants lead busy and fulfilling lives and receive good support to access a range of opportunities. Some tenants have regular employment in transport, administration and catering. Some tenants travel independently. Most tenants attend a local resource centre for several days each week. The deputy manager said that resource centre workers have a good working relationship with the home and often contribute to tenants’ reviews. Tenants said that they enjoy events held at the home, such as barbecues, and occasional outings. All tenants are supported to take an annual holiday. Tenants also said that they use local parks, shops, cafes and pubs. A meal out is often arranged at weekends, which tenants said they look forward to. Most tenants have some contact with their families. The deputy manager provided examples of ways in which the home had supported tenants’ attempts to develop relationships with their family members. Interaction between staff and tenants was positive during the inspection. Tenants’ wishes and needs are clearly identified in their individual plans. Staff used appropriate forms of address when speaking to tenants. Tenants’ rights and responsibilities are recognised in their daily lives. Tenants said they enjoy the food provided at the home and that they can ask for dishes to be included on the menu. Tenants also said they can have alternatives to the menu if they wish. Two tenants said they often prepare their own meals. The home has a large living/dining room, which was the focus of socialising during the early evening. Fontenoy Road DS0000010190.V354178.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Tenants’ healthcare needs are met. Tenants are supported to access specialist healthcare resources where necessary. The home works co-operatively with other professionals in delivering tenants’ care. The home should ensure that the signatures of all staff authorised to administer medication are recorded. EVIDENCE: Staff on duty demonstrated a good knowledge of tenants’ healthcare needs and care plans contained guidance for staff delivering care. The inspection provided evidence that specialist health professionals are involved in tenants’ care where necessary. For example one tenant had input from a speech and Fontenoy Road DS0000010190.V354178.R01.S.doc Version 5.2 Page 15 language therapist to develop communication strategies. Tenants with ongoing conditions, such as epilepsy, also have access to specialist care and regular monitoring. Medication is stored in the home’s office. All medication coming into or leaving the home is recorded. There was evidence that the community team psychiatrist reviews tenants’ medication. Sample signatures for staff authorised to administer medication are held on file but some signatures were missing. This included the shift leader during the inspection, who had responsibility for medication. Fontenoy Road DS0000010190.V354178.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate procedures are in place for the management of complaints. Residents feel confident about raising concerns with staff. Training is provided for staff in the Protection of Vulnerable Adults, though some staff need to attend refresher training. EVIDENCE: The home has an appropriate Complaints procedure. There have been no complaints made about the home since the last inspection. Tenants said that they knew who to speak to if they were unhappy about something at the home and that they would feel confident about raising concerns with staff. The home works within the ‘Joint Policy on Suspected Abuse of Vulnerable Adults’. The policy offers definitions of abuse and provides guidance for staff in the recognition and reporting of abuse. Training is provided for staff in the Protection of Vulnerable Adults training but the training record indicated that some staff need refresher training in this area. This issue was also raised following the last inspection of the home. See Requirement Fontenoy Road DS0000010190.V354178.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 25, 28 and 30 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, safe and well maintained. The communal rooms of the home are welcoming and homely. Residents’ bedrooms reflect individual preferences. Standards of hygiene were generally good. EVIDENCE: The home is situated in a pleasant residential area and has good access to local community facilities, open spaces and public transport networks. Offstreet parking is available to the front of home and there is a rear garden. Fontenoy Road DS0000010190.V354178.R01.S.doc Version 5.2 Page 18 The shared rooms of the home include a large lounge/dining room, a second lounge and a large kitchen. Tenants’ bedrooms are on the ground floor and first floor of the home. The bedrooms seen were personalised and reflected individual tastes and preferences. Standards of hygiene were generally good but the extractor fan hood in the kitchen needed cleaning and the filter should be replaced. See Requirement 3. Some areas of the home have been improved since the last inspection. There is now a patio in the rear garden, which makes the area more accessible to tenants, and a ground floor bathroom has been renovated. Fontenoy Road DS0000010190.V354178.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 33, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home benefits from a stable staff and management team. Staff know tenants’ needs well. Staff are appointed following an appropriate recruitment and selection procedure. Staff receive good support to do their jobs. Staff have access to training appropriate to their roles but some staff need to attend refresher training in core areas. EVIDENCE: The home benefits from a stable staff and management team. Staff interacted positively with tenants during the inspection and demonstrated a good knowledge of their needs. Records demonstrated that staff meetings take place Fontenoy Road DS0000010190.V354178.R01.S.doc Version 5.2 Page 20 regularly and are used effectively to address important issues within the service. The deputy manager said that the home had approximately one whole time equivalent vacancy at the time of inspection. On the evening shift there were two staff on duty with eleven tenants. One member of staff was to go out with two tenants, leaving one member of staff with the remaining nine tenants. The deputy manager said the home plans to use the vacant hours during the evenings to address this issue and to increase leisure opportunities for tenants. Waking night staff and sleep in staff are available at night. The inspector spoke with two staff on duty, one of whom was a permanent member of staff and one of whom is employed through an agency. Both said that communication amongst the staff team is good and that they have opportunities to attend team meetings. Staff also said that they get good support to do their jobs and that they have regular supervision. Staff records provided evidence of a robust recruitment procedure and that the organisation carries out appropriate pre-employment checks on staff, including Criminal Records Bureau disclosures. Files demonstrated that staff attend regular individual supervision and have an annual performance review. The staff training record indicated that some elements of core training need updating, including health and safety, moving and handling, fire safety and the Protection of Vulnerable Adults. See Requirement 4. Fontenoy Road DS0000010190.V354178.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run by a stable management team. There is a commitment to seeking tenants’ views and to acting on what tenants say. Standards of health and safety were generally good but the home must provide evidence of a fire risk assessment and servicing of the fire alarm and emergency lighting. EVIDENCE: Fontenoy Road DS0000010190.V354178.R01.S.doc Version 5.2 Page 22 The deputy manager was the acting manager at the time of inspection in the registered manager’s absence. The registered manager was due to return to her substantive post in November 2007. The deputy manager said that she attends regular managers’ meetings and has access to good peer support in addition to regular supervision with the area manager. There is a commitment to running the home in tenants’ best interests and to seeking their views about issues that affect them. Tenants’ meetings are held every two weeks, supported by staff. These meetings are used to seek tenants’ views about activities, menus and any other issues they wish to raise. Issues raised by tenants are discussed at staff meetings to ensure that they have received an appropriate response. Tenants said that they feel listened to and that staff act on what they say. The health and safety records checked were up to date. Portable appliances were tested for electrical safety in June 2007 and the Landlord’s Gas Safety Record was issued in September 2007. The home’s water storage system was tested in September 2007. All accidents and incidents are recorded. The home has an appropriate fire alarm system. There was evidence that staff test the system every week using different call points. The most recent fire drill took place in May 2007. The most recent test of the fire alarm and emergency lighting by an engineer was dated February 2005. This test should be carried out more frequently. There was no evidence of a fire risk assessment for the building. See Requirement 5. Fontenoy Road DS0000010190.V354178.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 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 2 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 3 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 2 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 X Fontenoy Road DS0000010190.V354178.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 YA9 Regulation 13(4) Timescale for action The registered persons must 30/12/07 ensure that all risk assessments are regularly reviewed. The registered person must ensure that all staff attend regular refresher training in the Protection of Vulnerable Adults. This Requirement was also made following the last inspection of the home in November 2006. 3 YA30 23(2) The registered person must ensure that the extractor fan hood in the kitchen is cleaned and the filter replaced. The registered person must demonstrate that all staff attend regular refresher training in health and safety, moving and handling and fire safety. The registered person demonstrate that: • must 30/12/07 30/12/07 Requirement 2 YA23 13(6) 4 YA35 18(1) 30/01/08 5 YA42 23(4) 30/12/07 The fire alarm system and emergency lighting have been serviced by a suitably Version 5.2 Page 25 Fontenoy Road DS0000010190.V354178.R01.S.doc qualified engineer. • A fire risk assessment has been carried out. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA20 Good Practice Recommendations The registered person should ensure that the signatures of all staff authorised to administer medication are recorded. 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