Inspection on 12/04/05 for Gloucester Road (22)

This inspection was carried out on 12th April 2005.

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

The inspector 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

Gloucester Road (22) 07/01/09

Gloucester Road (22) 20/12/07

Gloucester Road (22) 08/11/05

Gloucester Road (22) 09/11/04

Gloucester Road (22) 18/05/04

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

CARE HOME ADULTS 18-65 Name Mental After Care Association 22 Gloucester Road Kingston Upon Thames, Surrey KT1 3SJ Lead Inspector Michael Williams Announced 12th April 2005 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 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 Stationary 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. Name Version 1.10 Page 3 SERVICE INFORMATION Name of service Mental After Care Association Address 22, Gloucester Road, Kingston Upon Thames, Surrey, KT1 3SJ Telephone number Fax number Email 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 8547 0610 020 8546 3832 Mental After Care Association Mr Phillip Des Wright Care Home 16 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia of places Name Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 9/11/2004 Brief Description of the Service: 22 Gloucester Road is a large, detached property situated on the outskirts of Kingston-upon-Thames. Town centre facilities are within easy reach and the home is conveniently situated for access to public transport networks. The property is owned by the Local Authority, the Royal Borough of Kingston but the project is managed by the Mental After Care Association. The home has a contract with a local Primary Care Trust. The local primary care trust also contributes to the funding of the project.The home offers six bedrooms on the ground floor of the property and a further ten bedrooms on the first floor. The home has a large garden to the rear, mostly laid to lawn with a range of mature trees and shrubs. Name Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is based on an announced inspection undertaken in the Spring of 2005. The home was full, 16 service users in all, and some service users assisted in the inspection process by writing to the CSCI, others spoke to the inspector during the course of the inspection. This is a long established care home specialising in the care of people with enduring mental health problems and does so in a caring and pleasant atmosphere. It is managed by MACA, a national charity specialising in this form of care and support. It achieved good standards in those areas assessed. 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Name Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Name Version 1.10 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 standard(s) 3 Assessments and Care Plans are in place for each service. Multidisciplinary reviews are held periodically and those reviews include the service user’s contribution; risk assessments are in place for issues such as self-medication, travelling, handling chemicals (cleaning), dealing with money, cooking and so forth. EVIDENCE: Meetings for service users are held regularly so they can contribute to the running of the home. A range of meetings, both within and outside the home, provides a forum for service users to make choices and offer opinions about the service they receive. Many of the service users have lived at No.22 for many years and regard it as their home for the foreseeable future. As a consequence of their condition some service users have limited aspirations; indeed they might argue that living in the community in a pleasant and undemanding environment that helps them to maintain a stable state of mental health is their key objective. Although assessments are in place the inspector recommends that the condition and (registration) category of certain service users is reviewed; this may lead to review of placement or a modification of the home’s conditions of (CSCI) registration. A recommendation is made to review contracts to ensure the costs of holidays and additional care costs are addressed in the contracts. Name Version 1.10 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 standard(s) 6, 7, 9 Care planning that involves the service user is in place. Arrangements have been made to ensure service user consultation takes place in an informal but regular and methodical manner. Most service users are quite active and enjoy a range of activities that pose some degree of risk and this is being suitably assessed by staff in collaboration with the service user. EVIDENCE: Case files were checked, medication records inspected. Service users, a District Nurse, staff and the manager were interviewed during the inspection. Service users have the opportunity to contribute to their care planning through the initial care planning process (on admission), by meeting with their key-worker (care staff) and meetings with their psychiatric team (Nurses and/or Care Managers and Psychiatrist). Service users are encouraged to participate in the subsequent review meetings. In order simplify the documentation a revised care plan is being devised. Service users are supported in taking appropriate risks - commensurate with their skills and capacity; this will include independent handling of their money, medication, travel and so forth. Name Version 1.10 Page 9 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 to 17 The home encourages community participation and helps service users engage in leisure activities of their choice. The home is very welcoming and personal relationships are supported. The dining room is homely and congenial setting but would be improved by removing the freezer and filing cabinet. The meals are reported to be satisfactory. EVIDENCE: Whilst service user engagement with the wider community is sometimes limited by their social skills and motivation nevertheless they are content with their lifestyle. They enjoy the freedom to make use of the home’s facilities as they wish. They are equally free to make use of community resources, leisure centres, library, shops and so forth. In practice service users vary in their amount of engagement and use of such facilities and this is inevitably a reflection of their mental health. Staff help service users to sustain personal relationships, particularly with their family. The service users commended the meals but the home hopes in future to increase their involvement in self-help catering. To this end a recommendation is made to replace the large industrial oven – which is not very efficient and not domestic in scale. There is freezer and filing cabinet in the dining room because of lack of storage space elsewhere in the home. Name Version 1.10 Page 10 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19, 20 Personal and health care is provided according to service users’ individual needs. Clinical support for specific health care is provided by the General Practitioner service, by District Nurses and by the psychiatric multi-disciplinary teams as well as other specialist services such as the continence advisor chiropody, sight and hearing services this ensures they have a good quality of live. EVIDENCE: Service users confirmed that they keep in contact with their General Practitioner and psychiatric team. Their case files record their contact with these services. Detailed documentation is in place to demonstrate that health care as well as social care needs are provided for by this home. Service users vary in their ability and wish to administer their own medication. The home actively supports service users who wish to self-medicate otherwise staff organise the ordering, storing and administration of medication. Name Version 1.10 Page 11 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 Complaints procedures are in place and records of any complaints are maintained which ensures that service users complaints are listened to and dealt with. Service users are protected through the homes venerable adults policy, procedure and staff training EVIDENCE: The inspection process included questionnaires made available to service users and visitors. These gave a mixed range of opinions (of service users) about the home and these comments were passed on to the staff team. The inspection also included interviews of and staff and manager. These interviews were all very positive and without criticism of the home. The managing organisation (MACA) assists in the process of recruitment including police checks, identity and qualification checks and references. In respect of money held by the organisation, it was noted that most service users make their own arrangements for dealing with their finances including their personal bank account. For the small number of service users who need support it is required that if a centralised account is held by the organisation then accounts must be maintained for each service user and a copy of each of the accounts is sent to the service user monthly - with copy available for CSCI Inspectors. This account to make clear the service user’s entitlements, income and expenditure and dispersment to or on behalf of the service user. If capital accrues then interest must be paid at a rate equivalent to a High Street bank account. Name Version 1.10 Page 12 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 30 This is indeed a homely, comfortable and safe environment. It is also a clean and tidy place although some cleaning and refurbishment is needed in some areas to ensure the comfort and safety of the service users. EVIDENCE: Most areas are to an acceptable and comfortable standard but some minor improvements are needed such as deep-cleaning in some bedrooms and the replacement of stained and damaged carpets. The garden whilst in a reasonable state of maintenance needs attention to the borders and flowerbeds, which are rather weed filled and overgrown at present. Name Version 1.10 Page 13 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 The staff team is clearly a well-motivated group of carers and several have already achieved National Vocational Qualification (level 3) training whilst others are embarking on such training. EVIDENCE: Typically there are four staff and the manager on duty with two carers at night. The CSCI particularly commends the employment of ancillary staff, a cook and a cleaner, to help service users prepare meals and keep the home clean. A part-time gardener would be a valuable addition to the team. Staff records were checked and the staff and manager were interviewed to confirm inspection findings. The organisation has a national reputation for providing a comprehensive training programmes including induction training as well as ongoing training and support and this appears to be a well managed home with a professional staff team. Name Version 1.10 Page 14 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39, 42 This is clearly a well managed home backed by a competent organisation. Although there are a number of requirements covering health and safety the home is nevertheless run in a safe and comfortable manner. EVIDENCE: Service users are consulted in a number of ways including service user meetings, meetings with carers, service users also meet with representatives of the organisation during the monthly visits; and there is day to day contact between service users and the care staff. The inspection CSCI process also contributes to the service contribution to the running of the home. A recommendation is made to sort and index the service users’ case files. Requirements are made to maintain all areas in a clean and well maintained sate – including bedrooms. Requirements are made in respect fire safety; that the kitchen door checked and the side gate padlock is replaced. It is also recommended that window security be reviewed. Name Version 1.10 Page 15 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 x x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 Name x 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x 3 x Version 1.10 Page 16 16 17 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 2 x Name Version 1.10 Page 17 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 23.6 Regulation 17 Requirement Money: It is required that suitable arrangemnets are made for drawing and holding money held for service users; the main account should be held centrally with an audit trail from income to dispersment to service user. These auditable accounts should be sent regularly (monthly ) to the service user and a copy made avaibale for CSCI inspections. Health & Safety: It is required that the security of the home be reviewed; particulary windows. Fire Safety: It is required that the home confirms that the kitchen door is fire safe so that the adjacent fire escape route is suitably protected. Fire safety: as some fire doors lead into the enclosed garden a means of escape from the garden must be available - such as a fire brigade padlcok on the side gate. Timescale for action 31/8/05 2. 3. 42 42 13(4)(c) 23(4) 31/8/05 31/8/05 4. 42 23(4) 31/8/05 Name Version 1.10 Page 18 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 1 Good Practice Recommendations Contracts: it is recommended that service user contracts be renegotiated to include the provision of holidays (NMS 14.4) and to make clearer arrangements for charging for extra care when and if the arises (NMS 1 (2)vii). Medication: It is recommended that the information held on case files about medication is consolidated into a medication profile and held in the medication folder. Accommodation: It is recommended that storage space be reviewed to ensure the dining room remains a congenial setting and is not used to store a freezer and a filing cabinet (NMS 17.1 and regulation 23(2)(L). Garden: it is recommended that the garden be improved by greater attention to the flower beds and borders. 2. 3. 20 17 4. 28 Name Version 1.10 Page 19 Commission for Social Care Inspection CSCI 8th Floor Grosvenor House 125 High Street, Croydon CR0 9XP 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 Name Version 1.10 Page 20 - 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. 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