Inspection on 13/05/05 for Gonville Road (33)

This inspection was carried out on 13th May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Gonville Road (33) 25/09/08

Gonville Road (33) 27/09/07

Gonville Road (33) 07/09/06

Gonville Road (33) 15/11/05

Gonville Road (33) 24/11/04

Gonville Road (33) 13/05/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

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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 Gonville Road(33) Bovells Lodge 33 Gonville Road Thornton Heath CR7 6DE Lead Inspector Claire Taylor Unannounced 13 May 2005, 09:30 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. Gonville Road(33) G53-G53 S28514 gonvilleroad V211026 130505 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Gonville Road(33) Address Bovells Lodge, 33 Gonville Road, Thornton Heath, Surrey, SE25 5EQ 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 8240 9228 Wilfred Bovell Mr W Bovell Care Home 3 Category(ies) of Learning disability registration, with number of places Gonville Road(33) G53-G53 S28514 gonvilleroad V211026 130505 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 24th November 2004 Brief Description of the Service: Bovell’s Lodge is a small care home registered with the Commission for Social Care Inspection to provide a service for three young adults who have learning disabilities, aged between 18 and 65 years old. The registered provider, Mr Bovell, is also registered as the manager and is therefore very involved with the home. Situated in a residential area of Thornton heath, the home is well positioned to access local transport links and amenities. The registered provider also has a car to enable service users to access their chosen activities. The premises consist of three good- sized single bedrooms on the first floor, communal lounge, open plan dining / kitchen area, laundry and office. There is a garden to the rear of the house comprising of lawn, various fruit trees and patio area. Gonville Road(33) G53-G53 S28514 gonvilleroad V211026 130505 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place during lunchtime and late afternoon. Inspection time was spent examining records, talking to service users, touring the building and meeting with the home manager / owner of Bovell’s Lodge. All three service users showed the inspector their bedrooms and are thanked for taking the time to do so. Likewise, all three service users were willing to share their experiences about life at the home and their contribution to this inspection is much appreciated. The registered manager / provider, Mr Bovell and his wife are also thanked for their time to facilitate this inspection. What the service does well: What has improved since the last inspection? The majority of the previous requirements and recommendations have been met. The registered manager / provider demonstrates a commitment to meet the National Minimum Standards and Regulations and continues to explore ways of improving the services provided. The manager and staff team have undertaken further training to keep their knowledge up to date and ensure the needs of the service users are met. Quality assurance monitoring has begun and the manager’s efforts to improve the quality of care are progressing well. Improvements have been made to the décor internally creating a homely but safe environment for the people who live and work there. Flooring has been replaced in one service user’s room; double glazed windows have been installed as well as a new alarmed front door. A detailed maintenance schedule for further planned refurbishments has been put in place. Record keeping has much improved for which the owner is commended. Gonville Road(33) G53-G53 S28514 gonvilleroad V211026 130505 stage 4.doc Version 1.30 Page 6 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. Gonville Road(33) G53-G53 S28514 gonvilleroad V211026 130505 stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Gonville Road(33) G53-G53 S28514 gonvilleroad V211026 130505 stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,3,4 and 5 The Home staff when agreeing to admit or undertaking service users pre admission assessment must ensure that the home is registered and that staff are trained to support and meet the care needs of the service user. The necessary information and opportunity to visit the home is being made available to service users, enabling an informed choice regarding the suitability of the home to be made. Written contracts are provided, ensuring that service users are aware of their rights and responsibilities to live in the home and likewise, the home’s duty of care (its terms and conditions). EVIDENCE: The home ‘s needs assessment plan is detailed and covers all areas to ensure that any new service user’s needs are fully assessed prior to their admission. The home is currently registered to provide care for younger adults with learning disabilities. Two service users have been admitted to the home who both have additional mental health needs. The registered provider has undertaken training in this field together with his wife and there are plans for the other staff employed to receive appropriate training on mental health issues. The registered provider is still required to submit an application for a variance in category of registration. The two new service users were admitted under emergency circumstances due to the closure of their former placement. They confirmed that they had Gonville Road(33) G53-G53 S28514 gonvilleroad V211026 130505 stage 4.doc Version 1.30 Page 9 received appropriate support to settle in to the home and that their respective families were involved throughout the process. Daily notes and other records seen also showed that service users were well supported to familiarise themselves with the home and review meetings were arranged accordingly. The service users’ contracts are well written and specific to the information required in the standard. Gonville Road(33) G53-G53 S28514 gonvilleroad V211026 130505 stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7 and 9 Individual plans of care are reviewed and revised regularly and service users are fully involved. Service users are provided with the necessary support to take risks so that independence is maximised as far as possible. EVIDENCE: Service user plans are developed from needs assessments and also refer to likes/dislikes, personal strengths, and aspirations. Pictures and symbols are included to make them more accessible for one service user who has limited verbal communication. As required at the last inspection, records confirmed that care plans were being reviewed at six monthly intervals. Service users are supported to take ‘responsible’ risks as appropriate. Relevant risk assessments, matched to individual needs are in place for all the service users. e.g. personal hygiene, use of the kitchen and accessing the home / wider community. Records of financial transactions on behalf of service users are well managed. Service users meetings are regularly held and discussions are geared towards their views. E.g. choice of activities, food and resolving any concerns raised amongst fellow peers. Staff appeared committed to ensure that service users are fully involved with the operation of the home and encourage them to contribute. Two service users confirmed that they felt their views were valued and that they can discuss issues about the home freely with staff. Gonville Road(33) G53-G53 S28514 gonvilleroad V211026 130505 stage 4.doc Version 1.30 Page 11 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, 13, 14 and 15 The home promotes service users independence; service users are encouraged to become part of the local community. Service users are supported to continue education and appropriate activities, so that they can maximise fulfilment and achievement in their lives. Appropriate contact between service users and their families and friends is encouraged to help them maintain relationships. EVIDENCE: Two service users spoke of their jobs at “Crosslinks” centre and both work for four and a half days per week. The other service user attends a day centre two days each week were he socialises and participates in activities such as bowling and swimming. The home offers opportunities for service users to access college education courses and one is due to commence a course in pottery. Care plans demonstrate that the service users have opportunities to take part in a variety of stimulating activities both inside the home and in the wider community. The two newest service users are very independent, have an established relationship and often go out together on community activities. Both spoke of their hobbies including walks, shopping in nearby Croydon or car boot sales. The other service user is unable to travel without supervision and is Gonville Road(33) G53-G53 S28514 gonvilleroad V211026 130505 stage 4.doc Version 1.30 Page 12 fully supported by the registered provider to access community activities of his choice such as shopping, eating out and discos. Posted flyers and leaflets advertising local events such as discos and theatre shows are displayed for service users. A pictorial timetable has been developed for the service user who cannot read. Indoor entertainment includes television, videos, music system and games such as dominoes. Other leisure activities include local social clubs and discos. One service user attends a regular karate group and proudly showed a certificate for recently attaining his “orange belt”. All three service users are involved with planning an annual holiday. Gonville Road(33) G53-G53 S28514 gonvilleroad V211026 130505 stage 4.doc Version 1.30 Page 13 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) 19 and 20 Promotion of health is well observed. Service users welfare is closely monitored to ensure that their physical and emotional needs are met. Although medication is generally well managed, not all staff appear to have received accredited training and this could compromise service users welfare. EVIDENCE: All service users are registered with a local GP and two service users have kept their original G.P. since moving to the home. Clear records are kept of healthcare monitoring with outcomes recorded. The service users are supported to access other NHS services regularly, including dentist, consultant psychiatrist and an optician on a yearly basis. One service user has epilepsy that is well controlled with medication and is currently in good health with no requirement for specialist health care services. The registered manager / provider demonstrated a good understanding of this condition and information about epilepsy was available in the home for staff to access. Another service user has diabetes and again the registered manager / provider was able to describe the condition and how her healthcare needs are met. Records for the receipt and safe disposal of medication and administration records were being accurately maintained. Evidence was available that the relevant doctor or consultant undertakes reviews of medication on a regular basis. The provider explained that he was still awaiting a date for accredited medication training from the local pharmacy and this requirement still stands from the last inspection. Gonville Road(33) G53-G53 S28514 gonvilleroad V211026 130505 stage 4.doc Version 1.30 Page 14 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 and 23 The home operates a clear and effective complaints procedure that is available to all the homes service users in a suitable language/format. There are procedures and systems in place regarding the protection of vulnerable adults and prevention of abuse although staff need formal training to maximise protection for the service users. EVIDENCE: A clear complaints procedure is included in the service users guide and conspicuously displayed in the home. The version has been formatted with symbols and pictures to make it more accessible to the service user who cannot read. No formal complaints have been made about the homes operation in the past twelve months. One service user has limited contact with his family and as previously recommended, arrangements have been made for him to access an advocate. There are systems in place regarding the protection of vulnerable adults. I.e. legislative checks, such as completed CRB disclosures and numerous policies to safeguard the service users welfare. e.g. management of their finances, dealing with aggression and conflict and a whistle blowing policy to state what action to take should staff suspect anything untoward. The registered manager / provider confirmed that staff are yet to receive formal training on adult protection as he was awaiting course availability. As an interim measure, the registered provider needs to organise an in house training event on abuse awareness using video resources and discussion. Gonville Road(33) G53-G53 S28514 gonvilleroad V211026 130505 stage 4.doc Version 1.30 Page 15 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, 26 and 30 The home is clean, hygienic and in a good state of repair which enables service users to live in a safe environment. Bedrooms are designed and furnished to meet the personal preferences and individual lifestyles of the service users. EVIDENCE: The home is well positioned in Thornton Heath to access local transport, amenities and relevant support services. The layout of this family type house appears to suit the personal and lifestyle needs of the service users who live there. All three service users showed the inspector their bedrooms and commented that they were happy with them. Service users are encouraged to personalise their bedrooms with their chosen possessions and furniture as appropriate. Individual rooms are lockable and service users are provided with a key unless indicated in their individual care plans. Communal rooms are well furnished, bright, clean and decorated to a good standard. The owner is vigilant over general maintenance of the premises and ensures that repairs and upkeep of the building are undertaken. Some redecoration work has been completed since the last inspection including replacement windows / front door and new flooring for one service user’s bedroom. A plan has been put in place for the ongoing maintenance and redecoration of the premises. Gonville Road(33) G53-G53 S28514 gonvilleroad V211026 130505 stage 4.doc Version 1.30 Page 16 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) 32, 33,34, 35 and 36 This family type home has a small staff team who have had relevant training to meet the needs of the service users living there. Although staff receive informal supervision which ensures that they are given the information about what is expected of them and how to do their work properly, formal supervision needs to be implemented to ensure that service users care is consistent and not compromised. Recruitment practices are securely managed to maximise protection for the service users. EVIDENCE: Several requirements related to this set of standards were set at the previous inspection and the owner is commended for meeting all but one of them. I.e. concerns were raised that staff had not received training on mental health issues and the home had admitted two service users who have such additional needs. Positively, the registered provider and his wife have since undertaken some training and the third staff is due to attend a course. CRB checks were seen for all the employees and formal staff meetings are now being held and documented. Likewise, training records are being maintained and a duty rota has been developed to show that the home is adequately staffed. The registered manager / provider, his wife and one part time care assistant currently provide all staffing in the home. Mr. Bovell confirmed that he or his wife sleep over at the home each night and in the event of an emergency for Gonville Road(33) G53-G53 S28514 gonvilleroad V211026 130505 stage 4.doc Version 1.30 Page 17 staff cover, he would contact an agency, namely “Working Links”. It is acknowledged that this service is a small home and staff supervision is mostly informal and undertaken by the registered manager / provider on a day-to-day basis to discuss concerns, monitor job performance and offer guidance. Formal records of supervision and an annual appraisal for all staff need to be maintained however in accordance with the elements of standard 36.4. Gonville Road(33) G53-G53 S28514 gonvilleroad V211026 130505 stage 4.doc Version 1.30 Page 18 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, 40 and 42 The home has good plans in place to show how they intend to make positive changes and monitor quality of care. Policies and procedures and codes of practice are in place to ensure that service users rights and best interests are safeguarded. Staff must receive fire training and risk assessments relating to the environment must be carried out to ensure that service users health, safety and welfare is maintained. EVIDENCE: The home has an annual quality assurance plan that outlines a system for planning-action-review of the home’s aims and objectives. The home has formal systems in place for ascertaining the views of the service users including satisfaction questionnaires and most recent ones all indicated positive feedback. The provider explained that he plans to extend these to relatives and other relevant professionals e.g. care managers and GP’s with regard to the home’s achievement in meeting its stated aims and goals. There was good evidence that Mr Bovell continues to improve the quality of the service and care provided for the service users and maintains compliance with the National Gonville Road(33) G53-G53 S28514 gonvilleroad V211026 130505 stage 4.doc Version 1.30 Page 19 Minimum Standards. Significant work has been undertaken to address and meet previous inspection requirements. Policies, procedures and expected codes of practice are in place that is appropriate to the home setting. They are clearly written and accessible and serve as a means of protecting the rights and best interests of the service users. Record keeping concerning health and safety is in good order. Staff were fully up to date in most areas of health and safety training i.e. moving and handling, food hygiene and first aid. The provider must arrange for staff to receive appropriate fire training however. Accurate records are kept for accident and incident reporting. Fire drills, fire equipment and hot water temperature checks are carried out at appropriate intervals and cleaning products are stored safely. Of significant improvement is that the home keeps the Commission well informed of any incidents that affect the service users well being. The provider must ensure that environmental hazards around the home have been risk assessed to safeguard the welfare of the service users and minimise the risk of injury. Aside from this, the home was found to be safe, and the welfare of service users and staff promoted. Gonville Road(33) G53-G53 S28514 gonvilleroad V211026 130505 stage 4.doc Version 1.30 Page 20 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 3 2 3 3 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 3 x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 x x Standard No 31 32 33 34 35 36 Score x 3 3 3 x 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Gonville Road(33) Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 3 3 x 2 x G53-G53 S28514 gonvilleroad V211026 130505 stage 4.doc Version 1.30 Page 21 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 3 Regulation 12(1)(a) Requirement Timescale for action 31.8.05 2. 20 3. 23 4. 36 5. 6. 42 42 The registered provider is required to submit an application for a variance in category of registration as two service users have associated mental health needs. 13(2) & The registered provider must 18(1), demonstrate that staff have Sch 2.4 received accredited medication training. (timescale of 31.3.05 not met) 13(6) All staff must receive training on 18(1 a & the Protection of Vulnerable c)19(5 b) Adults, with records to evidence this kept in the home. (timescale of 31.3.05 not met) 17(2)sch. Formal records of supervision for 4(6 f all staff must be maintained in )18(2) accordance with the requirements of standard 36.4(timescale of 31.3.05 not met). 23(4)(d) All staff must receive training on fire safety, with records to evidence this kept in the home. ) 13(4)15(1 The home must ensure that risk ) Sch.3,3q assessments are completed for all safe working practices as listed in standards 42.2 and 42.3. G53-G53 S28514 gonvilleroad V211026 130505 stage 4.doc 30.9.05 30.9.05 13.5.05 and henceforth 31.8.05 31.8.05 Gonville Road(33) Version 1.30 Page 22 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 23 Good Practice Recommendations The registered provider organises an in house training event on abuse awareness using video resources and discussion. Gonville Road(33) G53-G53 S28514 gonvilleroad V211026 130505 stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 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 Gonville Road(33) G53-G53 S28514 gonvilleroad V211026 130505 stage 4.doc Version 1.30 Page 24 - 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. 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