Inspection on 26/01/06 for Gibraltar Crescent (36a)

This inspection was carried out on 26th January 2006.

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

Other inspections for this house

Gibraltar Crescent (36a) 20/02/07

Gibraltar Crescent (36a) 08/08/05

Gibraltar Crescent (36a) 17/11/04

Gibraltar Crescent (36a) 10/06/04

Similar services:

The Royal School for Deaf Children - Westgate College

89 Hastings Avenue

39 Westway

24-26 St John`s Road

David Gresham House

Denecroft

4 Malham Drive

7 - 8 Hawthorn Way (RNIB)

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

CARE HOME ADULTS 18-65 Gibraltar Crescent (36a) 36a Gibraltar Crescent Epsom Surrey KT19 9BT Lead Inspector Sandra Holland Unannounced Inspection 26th January 2006 14:30 Gibraltar Crescent (36a) DS0000013491.V277434.R01.S.doc Version 5.1 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 Gibraltar Crescent (36a) DS0000013491.V277434.R01.S.doc Version 5.1 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. Gibraltar Crescent (36a) DS0000013491.V277434.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Gibraltar Crescent (36a) Address 36a Gibraltar Crescent Epsom Surrey KT19 9BT 020 8393 0865 0208 393 8649 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) RNID Care Services South West and Wales Mrs Christine Ann Downing Care Home 6 Category(ies) of Learning disability (6), Sensory impairment (6) registration, with number of places Gibraltar Crescent (36a) DS0000013491.V277434.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The age/age range of the persons to be accommodated will be: 18-65 YEARS The gender of those accommodated will be MALE and FEMALE Date of last inspection 8th August 2005 Brief Description of the Service: Gibraltar Crescent is a purpose built detached home offering accommodation for up to six people with a learning disability, who may have a hearing impairment. It is situated in a quiet residential area on the outskirts of Epsom. A number of local shops are close by and Epsom town centre, with a larger variety of shops and facilities is a short distance away. The area is well served by public transport. The service is managed and staffed by the Royal National Institute for the Deaf (RNID) a registered charity. The property is maintained by CDHA (Chichester Diocese Housing Association) – formerly Hyde Housing. Service users have individual bedrooms, one of which has an en-suite bathroom. The communal areas are well appointed and the home is in very good decorative order. The home is wheelchair accessible and service users have access to a large rear garden with patio area. The service has its own vehicle, a people carrier. Gibraltar Crescent (36a) DS0000013491.V277434.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the second inspection to be carried out in the Commission for Social Care Inspection year April 2005 to March 2006. As this was an unannounced inspection, no one at the home knew that it was to take place. Mrs Sandra Holland, Lead Inspector carried out the inspection over a period of four hours. Mrs Christine Downing, Registered Manager was present representing the service. Areas of the home were seen and a number of records and documents were examined, including the statement of purpose, policies and procedures and residents’ financial records. All five of the residents and five members of staff were met or spoken with. The inspector thanks the residents and staff for their hospitality, time and assistance. The people living at the home prefer to be known as residents and that is the term that will be used throughout the report. As the inspector does not share the communication methods of some of the residents, their responses were assessed by observing their facial expression, their body language and their interaction with staff. Staff also supported residents by signing introductions and questions to residents and conveying responses to the inspector. To fully assess how the home is meeting the requirements of the National Minimum Standards (NMS), it will be necessary to read the reports of both inspections. What the service does well: Residents are actively encouraged to develop their independence and living skills. There is a high level of communication between the residents and staff, with most staff able to use British Sign Language (BSL) and or the Makaton symbol forms of communication. To ensure these are accessible to residents, the service provides all documents, signs and instructions in a Makaton or pictorial format throughout the home. Gibraltar Crescent (36a) DS0000013491.V277434.R01.S.doc Version 5.1 Page 6 The service has a Makaton computer programme that enables residents and staff to produce letters and documents in a combined written and Makaton format. Staff support residents to have fulfilling activities and to enjoy busy and active social lives. 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. Gibraltar Crescent (36a) DS0000013491.V277434.R01.S.doc Version 5.1 Page 7 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Gibraltar Crescent (36a) DS0000013491.V277434.R01.S.doc Version 5.1 Page 8 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 Gibraltar Crescent (36a) DS0000013491.V277434.R01.S.doc Version 5.1 Page 9 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 and 5. A statement of purpose containing the required information is available in a suitable format. Contracts for residents do not contain all the required information and are being reviewed. EVIDENCE: The statement of purpose was seen to be up to date and to contain all the required information. It was pleasing to see that this has been produced in written, pictorial and Makaton formats to ensure it meets the needs of all residents and their representatives. A requirement was made at the last two inspections, carried out on 17th November 2004 and 8th August 2005, that residents must be supplied with a statement of the terms and conditions regarding accommodation to be provided, including the details of payment of fees. The requirement also stated that a standard form of contract of the services and facilities to be provided to residents must be supplied and must be specific to each individual resident. This requirement has still not been met. The manager stated that she and other home managers have asked the RNID for these to be reviewed and that a draft contract was currently being approved, although this was not available for inspection. A requirement has been made. Gibraltar Crescent (36a) DS0000013491.V277434.R01.S.doc Version 5.1 Page 10 Gibraltar Crescent (36a) DS0000013491.V277434.R01.S.doc Version 5.1 Page 11 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): 10. Residents’ know that information about them is handled appropriately and that confidentiality is respected. EVIDENCE: The manager stated that the need for confidentiality and how staff will handle information, is explained to residents using their individual communication method. During their induction, staff are introduced to the issue of handling information about residents in a sensitive manner and to respect confidentiality, the manager stated. This is discussed at staff meetings to ensure that staff do not become complacent about confidentiality and two examples were given to highlight how confidentiality may be breached. The manager and staff have reviewed the use of scrap paper in the home, to ensure that it does not contain any names or personal information that may identify an individual. Staff had also recently reported to the manager that confidentiality may have been breached at a signing class. Staff advised that they were aware not to discuss residents in front of other residents or visitors. Gibraltar Crescent (36a) DS0000013491.V277434.R01.S.doc Version 5.1 Page 12 A comprehensive policy regarding confidentiality is in place in the home. This has been drawn up by RNID and refers to the Data Protection Act 1998, the National Minimum Standards (NMS), codes of practice for social care staff and the RNID’s terms and conditions of employment handbook. It was pleasing to see that the home had also drawn up a local policy which gave details as to how information would be handled and confidentiality be maintained within the home. Gibraltar Crescent (36a) DS0000013491.V277434.R01.S.doc Version 5.1 Page 13 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): 17. Residents are offered a well balanced and nutritious diet in pleasant surroundings. EVIDENCE: Residents were met with whilst enjoying their evening meal and this was seen to be well balanced and appetising. The main meal of the day is usually served in the evening, staff advised, as residents attend a number of different activities during the day. Most meals are eaten family style in the dining area of the spacious kitchen and residents were actively supported to be independent and to make their own choices. The dining table was attractively laid with a colourful cloth and table mats. Residents are encouraged and supported to be involved in choosing the meals to be served and to participate in cooking if they wish and are able, staff advised. One resident regularly shops and cooks for herself one day each week, with a view to moving to an independent living household. Gibraltar Crescent (36a) DS0000013491.V277434.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed at this inspection. EVIDENCE: Gibraltar Crescent (36a) DS0000013491.V277434.R01.S.doc Version 5.1 Page 15 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 and 23. Each resident has been supplied with a copy of the complaints procedure in a format suited to their needs. Staff are aware of their responsibilities in the protection of residents. EVIDENCE: The complaints procedure has been given to each resident as part of their service user guide, which was kept in their bedrooms. These were seen in appropriate formats (usually makaton symbols) and it was pleasing to see that residents had signed their copies to indicate that staff had gone through it with them, to ensure their understanding. A detailed complaints policy has been drawn up by RNID and supplied to the home to guide staff in the handling and management of any complaints. It was noted that although the policy refers to contacting CSCI, the full name, address and telephone numbers of the local office were not included. It is required that these are included in the policy. Similarly, the name, address or telephone number of RNID were not included in the complaints procedure and it is recommended that this be added. A comprehensive policy regarding the protection of vulnerable adults is in place in the home. This refers to the Surrey Multi-Agency procedure for the protection of vulnerable adults, an updated copy of which is held in the home. These policies and procedure guide staff in the event that they have concerns that a resident may be being abused or at risk of abuse and the appropriate actions to be taken. The policy also refers staff to the Whistle-blowing policy, to CSCI and to their line management process. Staff spoken to said they would report any concerns to the manager or area manager and would not hesitate to do so. Gibraltar Crescent (36a) DS0000013491.V277434.R01.S.doc Version 5.1 Page 16 A requirement and a recommendation have been made. Gibraltar Crescent (36a) DS0000013491.V277434.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed at this inspection. EVIDENCE: Gibraltar Crescent (36a) DS0000013491.V277434.R01.S.doc Version 5.1 Page 18 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): 31 and 34. Residents are supported by an effective staff team under the leadership of the manager. EVIDENCE: The residents are supported by a small team of support staff under the leadership of the manager and her deputy. Staff advised that they all share the support tasks within the home, including shopping, cooking, laundry and assisting with personal care. It was clear from speaking to staff that they were aware of their responsibilities, that they were enthusiastic about their role and that they enjoyed the interaction and activities with residents. Two members of staff had accompanied two residents to visit a football ground on the day of inspection, as one of the residents is an avid supporter of the team. The staff and residents returned to the home in a very animated mood, having had a successful and enjoyable day out. A requirement was made at the last inspection carried out on 8th August 2005, that all members of staff must be supplied with a statement of the terms and conditions of their employment and that a record of these must be maintained in the home. This requirement has not been met. Gibraltar Crescent (36a) DS0000013491.V277434.R01.S.doc Version 5.1 Page 19 The manager stated that she had been advised that copies of these were held at the RNID regional office, and that although she had requested these from RNID, these have not been supplied to be held in the home, as is required. A requirement has been made. Gibraltar Crescent (36a) DS0000013491.V277434.R01.S.doc Version 5.1 Page 20 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, 40 and 43. Residents benefit from a well run home with an open, positive and inclusive management. EVIDENCE: Since the last inspection the manager has successfully completed the process to be registered by CSCI and she stated that she is about to undertake the National Vocational Qualification (NVQ), Registered Managers Award and a certificate in management training. It is clear from observing the interaction between the manager, residents and staff that an open and inclusive atmosphere is promoted, in which everyone is valued and supported. The manager stated that quality assurance questionnaires had recently been supplied to resident’s families, friends or representatives and that four responses had been received so far. Very positive comments indicated a high level of satisfaction with the service offered. Each respondent stated that they thought their relative was very happy living at the home, that they were kept Gibraltar Crescent (36a) DS0000013491.V277434.R01.S.doc Version 5.1 Page 21 informed about events and changes and that they are made welcome when they visit. It was pleasing to see that when asked if living at the home had made a difference to the lives of the residents, all four respondents made additional written comments. These included that residents had matured, had achieved new skills and had much improved communication. Other comments were very complimentary about the dedicated efforts that staff make and expressed confidence in and appreciation of the support provided to residents. A number of policies and procedures were seen and were up to date, accessible to staff and comprehensive in content. The manager stated that as policies and procedures are updated they are supplied on the RNID intranet, to enable the home to access them and print them out. Where necessary, the manager and staff have drawn up local policies to detail how the organisation’s policies are specifically carried out in the home. The arrangements regarding the management of the home’s budget were discussed. The manager stated that she oversees expenditure in the home and that a monthly report is produced to enable her to monitor this. To monitor regular spending, a weekly petty cash return is completed and is forwarded to RNID headquarters. A senior support worker was being trained to complete the return on the day of inspection, overseen by the manager. The petty cash record was checked with the amount held and was found to be different by a small amount, which may indicate a weakness in the system that needs to be managed more effectively. It is advised that the system of recording is strengthened to ensure that an accurate record is maintained and to ensure the system is safeguarded from abuse. A recommendation has been made. Gibraltar Crescent (36a) DS0000013491.V277434.R01.S.doc Version 5.1 Page 22 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 x 3 x 4 x 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 x 25 x 26 x 27 x 28 x 29 x 30 x STAFFING Standard No Score 31 3 32 x 33 x 34 2 35 x 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score x x x x 3 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 x 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x x x 3 x 3 3 x x 2 Gibraltar Crescent (36a) DS0000013491.V277434.R01.S.doc Version 5.1 Page 23 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 YA5 Regulation Requirement Timescale for action 28/04/06 2 YA22 3 YA34 5(1)(b)& The registered person must 17(2)Sch4(8 produce a statement of the terms and conditions in respect of accommodation to be provided for residents, including as to the amount and method of payment of fees; and a standard form of contract for the provision of services and facilities by the registered provider to residents; this statement/contract to be specific to each individual resident. REQUIREMENT CARRIED FORWARD FROM 10/11/04 and 08/08/05. 22 (7) (a) The complaints procedure must 28/04/06 state the name, address and telephone number of the CSCI local office (Surrey). 17 (2) The registered person must 28/04/06 Schedule 4 maintain a record in the care home, of all persons employed at the care home, including in respect of each person employed, records in relation to his employment. Specifically, all persons employed must be supplied with a statement of DS0000013491.V277434.R01.S.doc Version 5.1 Gibraltar Crescent (36a) Page 24 the terms and conditions of their employment. 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 YA22 YA43 Good Practice Recommendations It is recommended that the complaints policy should include the name, address and telephone number of RNID personnel to whom a complaint can be referred. It is recommended that the petty cash system in the home is reviewed and strengthened to ensure an accurate record is maintained. Gibraltar Crescent (36a) DS0000013491.V277434.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Gibraltar Crescent (36a) DS0000013491.V277434.R01.S.doc Version 5.1 Page 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!