Inspection on 23/09/05 for Gaywood Street 24

This inspection was carried out on 23rd September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Gaywood Street 24 16/07/08

Gaywood Street 24 27/07/07

Gaywood Street 24 14/07/06

Gaywood Street 24 19/01/06

Gaywood Street 24 04/01/05

Gaywood Street 24 05/10/04

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

CARE HOME ADULTS 18-65 Gaywood Street, 24 London SE16HG Lead Inspector Mark Stroud Unannounced Inspection 23rd September 2005 3:45 DS0000007090.V252660.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 DS0000007090.V252660.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. DS0000007090.V252660.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Gaywood Street, 24 Address London SE16HG 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 7261 9210 LINC Mr Patrick Umerah Care Home 5 Category(ies) of Learning disability (0), Learning disability over registration, with number 65 years of age (0) of places DS0000007090.V252660.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 5 people with learning disabilities male or female, some of whom may be over 65 years old. 4th January 2005 Date of last inspection Brief Description of the Service: Gaywood Street is care home providing personal care and accommodation for up to 5 people with a learning disability over 65 years of age. Hyde Housing Association Limited owns the building, and the service is staffed and managed by Choice Support, a voluntary organisation. The home is located in Elephant and Castle, close to shops, pubs, the post Office, underground and buses. The home consists of a two-storey building, and is designed to be wheelchair accessible, with passenger lift, and access to a patio area. All the home’s bedrooms are single. DS0000007090.V252660.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An inspector visited the home in the afternoon, saw the service users, and spoke to staff and the deputy manager. 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. DS0000007090.V252660.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 DS0000007090.V252660.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): 5 Service users have support to agree a contract but this needs to say what help they can expect. EVIDENCE: People who live at the home agree what they are responsible for so they can live at the home. The written agreement doesn’t say anything about the help they get from staff at the moment. DS0000007090.V252660.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, 7 & 9 Staff know about service users lives. Service users need help to plan for the future. EVIDENCE: Service users have their own plans that they have agreed with staff. These include their life story and a description of who they are, that helps staff understand how they want to be helped. The plans are old now. Service users have worked with health professionals to agree what support they need with their communication and their epilepsy, and this needs to be included in their plans. Staff need to work with service users and other supporters to plan for the future. One service user is going to do this work in December. Only the manager and the deputy manager collect service users’ money. One service user has a lot of money and their plan needs to say how they are helped to use this as they want to and how they are helped to control their own money. Staff have been trained to support service users with Person Centred Planning this year. Staff have noticed that service users go to bed when staff choose to go to the sleep in room. Some service users also spend several days at a time in the home without going out. Staff need to work with service users and their DS0000007090.V252660.R01.S.doc Version 5.0 Page 9 supporters to decide what they might want to change, and include this in their plans. Staff complete written risk assessments. Service users need to be involved in this, so that plans say what service users are already doing to keep themselves safe, and say clearly exactly what staff will do when it is really necessary. DS0000007090.V252660.R01.S.doc Version 5.0 Page 10 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, 13, 15 & 16 Service users who need more help to go out are not getting the help they need. EVIDENCE: One service user goes to a day centre and takes part in lots of activities with friends and their family. Service users tidy their rooms, listen to music, and watch television. Most service users don’t take part in regular activities away from the home. Recently, for two weeks, three of the service users went out only two times. The manager is the only person who can drive a minibus owned by some of the service users. Staff say that the mini bus is not used very much. One service user missed the opportunity to go on holiday because there was no driver. The manager is speaking to social workers about what should be done. DS0000007090.V252660.R01.S.doc Version 5.0 Page 11 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, 21 Service users know they will be cared for as they wish in the day, but could be worried about the night and if they become seriously ill. Most service users need more support to be happy and occupied in the day. EVIDENCE: Staff are careful to look at service users when they are moving them, or talking to them, making sure they are happy. Because the care is good service users are comfortable and healthy. Staff spend time with one service user who spends time in the kitchen, talking with them, asking them about their day. The other service users spend time in the lounge, and staff leave them to watch television and rest, while they do the household chores like collecting medication, cleaning, and preparing for meals. Staff provide good support for service users to keep themselves clean and healthy. Staff are worried that they don’t have to stay awake at night anymore, because people feel they don’t need to. They used to make sure service users were comfortable and safe at night. They use alarms now, that are supposed to wake them if service users are in danger, but these are not working properly. Staff are worried that service users need more help at night to be comfortable and healthy. DS0000007090.V252660.R01.S.doc Version 5.0 Page 12 Service users are healthy, and eat well, but one service user has lost a lot of weight recently, and the home have arranged for them to see a doctor, and are talking to the people who arranged for them to live at the home about it. Service users are able to work with health professionals to find better ways of making themselves understood, sitting more comfortably, and being able to move around the home more easily. Staff collect medication and make sure there is always enough for service users to take. They write down when medicine is taken so everyone knows it isn’t missed. Service users haven’t been able to make plans for when they get seriously ill or die yet. Staff have some ideas about this, and need to write this down so people can talk about it and agree, and try to make sure what service users want actually happens. Service users need to know things like when they might need to leave the home if they got too ill for staff to help them. DS0000007090.V252660.R01.S.doc Version 5.0 Page 13 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 Service users know staff can keep them safe, and how to complain if they are unhappy. EVIDENCE: The home keeps a complaints record but there have been no complaints. Staff are going to be trained this month to make sure they know how to keep service users safe from harm, how to know if they might have been harmed, and what to do. One service user continues to provide the vehicle they own and maintain for the use of other service users, who pay no charge for this service. There is still no contract or agreement regarding this to protect the service user. The manager is speaking to service users social workers about what to do. The manager clarified that service users do receive their own benefits, and that these are not pooled. DS0000007090.V252660.R01.S.doc Version 5.0 Page 14 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, 26, 29 & 30 Service users live in a comfortable home, but sleep in staff are having to worry at night because alarms to keep service users safe aren’t working properly. EVIDENCE: Service users all have a large room. One service user needs a double bed and the home are planning to buy one for them. Since the staff stopped staying awake at night the service users have had bed alarms in case they need help at night. These are not working though. Service users rooms are left open at the moment. Staff say this means they get air in them, and it makes it easier for service users to get into their rooms. This means they are not very private though. Bedrooms and shared areas have been redecorated. This makes it more homely. The bathroom wall has been repaired and redecorated. Staff are trying to find more things for service users to do at home, using a room for them to use for this. One service user is waiting to work with a health professional so they can find a more comfortable chair. The home has a lift for wheelchair users. This was fixed recently. The home was clean and tidy. DS0000007090.V252660.R01.S.doc Version 5.0 Page 15 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, 33, 35 & 36 Service users know that staff know what to do and work as a team. EVIDENCE: Staff get training that helps them to support service users the way they would want, and helps staff to understand what they need to do and why. Staff learn as soon as they start working at the home using the Learning Disability Awards Framework, and go on to finish National Vocational Qualifications to Level 2. Staff stopped staying awake at night since the last inspection. They were told to stop this after a service user didn’t need it any more. Staff are worried now that other service users might need this. Alarms have been used to try to wake staff when service users need them, but these are not working properly. Staff are very worried about one service user who needs staff at night more. Staff are happy that they plan when they work to suit what service users are doing. Staff get regular supervision to talk about anything that worries them, and make sure the work is being done properly. This year staff were taught about people who need help when they can’t see, how to help people who take medication and have epilepsy, and how to help people take risks so they have more control over their lives. DS0000007090.V252660.R01.S.doc Version 5.0 Page 16 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, 39, 41 & 42 The home is run well, and safely, but service users need to know that the quality of care is getting better for them. EVIDENCE: The manager asked Commission for Social Care Inspection (CSCI) to register him. Commission for Social Care Inspection (CSCI) are still checking he is a good manager, before they do this. The home hasn’t written down a plan for work over the next 12 months. Service users need to be able to have their needs considered as part of the plans for the home. The things that need to be done to meet the needs of all service users need to be things that can be measured, so that people can see if the quality of care is getting better every year. Staff are very good at making sure visitors understand what to do if there is a fire. The fire alarm has been serviced this year. The temperature of water from the hot taps in bathrooms and basins changes a lot. The deputy manager clarified that water testing has been done. DS0000007090.V252660.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 X X X X 2 Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 X 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x x 2 3 LIFESTYLES Standard No Score 11 X 12 2 13 2 14 X 15 3 16 2 17 Standard No 31 32 33 34 35 36 Score x 3 2 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 3 2 Standard No 37 38 39 40 41 42 43 Score 3 x 2 x x 2 x DS0000007090.V252660.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. Standard 1 YA5 Regulation 5(1)(b)(c) Sch 4.1 Requirement The registered provider must ensure that each service user receives a written and costed contract/statement of terms and conditions between the home and service users (timescale of 30.12.04 not met, Requirement repeated for third time). Continued failure to comply with this requirement may lead to consideration being given to enforcement action. The Registered Provider must ensure that all service users care is regularly reviewed and up dated on time (within timescale from previous inspection) The Registered person must ensure that the purchasing authority and relatives have the opportunity to provide assessment and support for service users to have more control over the amount of time they spend outside of the home, and the collection, spending, and general management and planning of their money and DS0000007090.V252660.R01.S.doc Version 5.0 Timescale for action 28/02/06 2 YA6 15 28/02/06 3 YA18YA16YA 13YA12YA7 12(1)(a)(2) 31/05/06 Page 19 finances, and that Service User Plans describe support. 4 YA33YA29YA 18 12(1)(a) The Registered Person must ensure that plans are made and action taken to keep service users safe, comfortable and well cared for at night, agreed in the Service Users Plans. The Registered Provider must ensure that service users are supported to express their wishes and feelings and make a decision regarding death and dying, taking any action necessary in consultation with the purchasing authority and other stakeholders as necessary.(timescale of 31.03.05 not met) 31/10/05 5 YA21 12(2)(3) 28/02/06 6 YA23 13(6)20(1)&(2) The Registered Provider must ensure that 23 1. Purchases must not be made on behalf of service users without prior consultation, agreement and clear contractual arrangements. These must be evidenced. 2. A contract must be drawn up between the organisation and the service users in respect of the use of the service users vehicle. Among other things, this contract must detail ownership, and arrangements for the use of the vehicle by service users who do not own it including payment for it’s running and maintenance if any. All written information must be made accessible to service users and explained to them. Copies DS0000007090.V252660.R01.S.doc Version 5.0 30/04/05 Page 20 must be forwarded to the Commission for Social Care Inspection (CSCI). 7 YA39 24 The registered provider must 30/04/05 ensure the home has effective quality assurance and monitoring systems, based on seeking the views of service users and their advocates. The systems should be in place to measure how far the home is meeting the aims and objectives and statement of purpose (within timescale from previous inspection).(timescale of 31.01.05 not met) The Registered Person must 30/11/05 ensure that water valves are serviced to ensure a safe water temperature. 8 YA42 13 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 2 Refer to Standard YA9 YA26 Good Practice Recommendations The Registered Person should ensure that risk assessments say what service users do to keep themselves safe, then what staff and the home can do to help. The Registered Person should ensure that service users have adaptations or other support to make sure their rooms are private when they use them and when they go out. DS0000007090.V252660.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH 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 DS0000007090.V252660.R01.S.doc Version 5.0 Page 22 - 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!