Inspection on 22/09/05 for Goodman Crescent, 9

This inspection was carried out on 22nd 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 but made no statutory requirements on the home.

Other inspections for this house

Goodman Crescent, 9 21/05/07

Goodman Crescent, 9 06/02/06

Goodman Crescent, 9 18/02/05

Goodman Crescent, 9 31/08/04

Goodman Crescent, 9 26/03/04

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

CARE HOME ADULTS 18-65 Goodman Crescent, 9 9 Goodman Crescent Streatham London SW2 4NR Lead Inspector Ms Rehema Russell Unannounced Inspection 22nd September 2005 18:00 Goodman Crescent, 9 DS0000022795.V254055.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 Goodman Crescent, 9 DS0000022795.V254055.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. Goodman Crescent, 9 DS0000022795.V254055.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Goodman Crescent, 9 Address 9 Goodman Crescent Streatham London SW2 4NR 020 8671 2768 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) Mrs Jehunita Freeman Mrs Jehunita Freeman Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Goodman Crescent, 9 DS0000022795.V254055.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th February 2005 Brief Description of the Service: 9 Goodman Crescent provides residential care for 3 service users in an ordinary family house. It is situated in a small private development just off a main road. The home is in easy walking distance of a large shopping centre, which provides full community facilities and public transport (buses and trains) into central London and to other large shopping and community areas. The home provides individual personal care that is fully supportive of service user’s needs, preferences and behaviours and which encourages and supports their independence within the home and within the wider community. Goodman Crescent, 9 DS0000022795.V254055.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place during a weekday evening on 22nd September 2005. The inspector first arrived at the home during the afternoon but all of the residents were out and so the inspector returned later. The inspector spoke with a support worker, the manager and two of the residents. A tour of the building also took place as well as an examination of documents and records. 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. Goodman Crescent, 9 DS0000022795.V254055.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 Goodman Crescent, 9 DS0000022795.V254055.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): 2 and 5 Prospective residents’ individual needs and aspirations are thoroughly assessed. Each resident has an individual contract and a statement of terms and conditions. EVIDENCE: A thorough admission procedure is carried out. The application form is very detailed, including all relevant information required. There is a checklist of all documentation given to the applicant, which includes the complaints procedure and signed contract. There is a daily living needs assessment form, which includes the medical history, religious observance, dietary preferences and daily living and social activities. The home also ensures that it obtains a full assessment from the placing authority, including relevant mental health assessments as appropriate. Files demonstrated that each resident is given a contract, signed by the proprietor and the resident, and a statement of Terms and Conditions of Residency which is also signed by the resident. Both documents are clear and easy to understand. Goodman Crescent, 9 DS0000022795.V254055.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 and 9 Residents assessed and changing needs and personal goals are reflected in their individual care plans. Residents are encouraged and supported to make decisions about their lives and to take risks as part of an independent lifestyle. EVIDENCE: Care plans were seen and found to be comprehensive, detailed and well ordered. They covered every aspect of daily living, including dressing, grooming, bathing, personal hygiene, eating and drinking, mobility, communication, sleep, general health, medical, mental health, behaviour management, personal relationships, sexual health and respect for others. Each section was scored with details of how each need was to be met by staff, and each was signed by both the manager and the resident. Internal six– monthly reviews are carried out and documented by the home and all previous reviews are kept on file for reference, which is good practice. The most recent annual review by the local authority had not been carried out but there was evidence on file that the home had contacted the local authority to request that they carry out their statutory duty in this regard. Goodman Crescent, 9 DS0000022795.V254055.R01.S.doc Version 5.0 Page 9 Observation and verbal evidence from staff and residents indicated that staff encourage and support residents to make as many decisions as possible in regard to the daily activities of their lives and also their goals and aspirations. An example was given of when one resident was considering moving out of the home but was indecisive. The manager emphasised that it was entirely his decision, helped him to understand the advantages and disadvantages of the move and suggested that he discuss the decision with people at the cultural centre, the day centre, and his social worker from the mental health team. Similarly, when another resident decided he did not want to move out of the home, the manager called a review meeting with himself, his mother and his Community Psychiatric Nurse to ensure that he was well supported in the decision. All three residents have either their social worker and/or a family member as an advocate. All residents manage their own finances. Staff accompany them to the post office to collect their monies and their Disability Living Allowances are paid straight into their bank accounts with no involvement by the home. There is a general risk assessment for each resident on their care plans and also a number of specific risk assessments. The latter are comprehensive and clear and tailored to residents’ individual needs and capabilities. Observation and verbal evidence demonstrated that staff discuss all aspects of daily life with residents, in an open, honest and supportive way which gives them the opportunity to assess situations and risks for themselves. There are no current restrictions on residents’ rights and an indication of the increasing independence and responsibility achieved by residents is that they now all have their own front door key, whereas in previous years this had necessarily been restricted for two residents. Goodman Crescent, 9 DS0000022795.V254055.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 and 17 Residents are able to take part in age, peer and culturally appropriate activities. Residents are part of the local community. Residents are supported to have appropriate personal and family relationships. Residents are offered a healthy, nutritious and varied diet of their choice. EVIDENCE: Residents are supported to attend clubhouses and colleges and to take up job opportunities offered to them if this is their choice. One resident has a parttime job, which he spoke to the inspector about. He enjoys working, although he feels the job is quite easy, and is happy to be earning extra money. Another resident has held down a part-time job in the past but is not currently interested in doing so. Staff obtained information about classes from a local college but residents did not wish to go. Residents are supported to take part in culturally appropriate activities and one resident has been attending a religious place of worship for several years, where he joins in activities and meals and has made friends. Another resident visits several drop-ins that are run by the religion he is affiliated to. Goodman Crescent, 9 DS0000022795.V254055.R01.S.doc Version 5.0 Page 11 Residents take part in a range of local community activities, alone, in pairs or as a group, with or without staff and at their own individual choice. They use local pubs, shops, cafes, cinema and the library. Despite staff encouragement, none are interested in taking part in sports. Staff make sure that residents know about local events that are taking place and have made a London-wide brochure of places of interest and activities available at the home. All three residents have regular contact with family and friends. On the day of the inspection one resident was visiting his sister for the day and did not return to the home until after 9 p.m. Another has an aunt and a brother who he visits from time to time and with whom he told the inspector he was planning to spend Christmas. The third resident’s mother lives locally and he visits her regularly. Family members have also visited residents at the home. Residents have made friends privately and at the various day centres, drop-ins and other activities which they attend. Residents have also become friends with each other. One resident who used to spend all day out of the home and keep his outside activities and friendships very private recently wanted all of the staff and the other residents to come with him on a day trip that was organised by one of the drop-ins he frequents. He also now only leaves the home on a daily basis during the late morning or after lunch, rather than in the early morning as he did formerly. Residents and staff devise the weekly menu together each Sunday and residents are encouraged to help with the shopping. The weekly menu was displayed on the notice board near the dining area and indicated that residents receive varied and nutritious meals. Although residents contribute to the menu the inspector was told that they are individually asked what they want to eat each day and if they prefer something else to the menu then this is provided. The inspector’s visit coincided with the day chosen that week for a take-away. However residents had decided that they prefer to eat individually that evening and so one resident was eating out alone, another ate at the Clubhouse and the third was eating with his sister. The inspector was told that there is always food available for snacks and that residents could help themselves to food and drink whenever they wished to. The fridge contained a selection of sandwich fillings and there was a range of frozen food in the freezer. Residents confirmed that they were happy with the food arrangements at the home. Goodman Crescent, 9 DS0000022795.V254055.R01.S.doc Version 5.0 Page 12 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): 19 and 20 Residents’ physical and emotional health needs are met. Residents are protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: Verbal evidence from staff and documentary evidence in care plans demonstrated that the healthcare needs of service users are assessed and monitored and that service users are supported to access all healthcare services as appropriate, including mental health and other specialists. Evidence of regular reviews with psychiatrists and mental health teams were seen. Staff also make, or support residents to make, appointments with the full range of NHS healthcare professionals such as the dentist, optician and chiropodist. However, residents’ rights to choose whether to attend appointments is respected and they sometimes choose not to attend appointments made. Medication storage, administration and recording was seen and found to be in very good order. A spot tablet count was conducted and no errors were found. The requirement arising from the previous inspection report in regard to signatures on MAR sheets had been implemented and all administration was correctly signed for. Goodman Crescent, 9 DS0000022795.V254055.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): 23 Residents are protected from abuse, neglect and self-harm. EVIDENCE: The inspector asked the support worker on duty about his knowledge and training in abuse. The home has a clear abuse policy and the subject has been covered during the NVQ Level 3 course that he is undertaking. The support worker was able to cite many different forms of abuse that can take place, including mental abuse and institutional abuse, and was fully conversant with the procedure to be followed if abuse was suspected or reported. None of the current service users have been verbally or physically aggressive but there was verbal and documentary evidence that mental health issues are dealt with appropriately, with sensitivity and understanding. Goodman Crescent, 9 DS0000022795.V254055.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 and 30 Residents live in a homely, comfortable and safe environment. The home is clean and hygienic. EVIDENCE: Goodman Crescent, 9 DS0000022795.V254055.R01.S.doc Version 5.0 Page 15 The home is accessible, safe and well maintained with a small but pleasant rear garden. It is situated in a small private development just off a main road. It is five minutes walk from a large shopping centre that provides full community facilities and public transport (buses and trains) into central London and to other large shopping and community areas. The home is not suitable for people with severe mobility problems/wheelchair needs as it is an ordinary terraced house which is not designed for this. The communal areas of the home are well furnished, fitted and decorated and contain comfortable seating and culturally appropriate ornamentation. The kitchen had recently been repainted in consultation with residents and the furniture re-arranged in the dining area, making the whole area more spacious and brighter. All residents’ bedrooms are personalised according to their individual choices. The inspector toured the premises and found it clean and hygienic throughout. There was a slight smell from one area at the top of the house and the inspector was told that this had been noticed by staff and that replacement carpet had already been ordered by the proprietor. The kitchen was meticulously clean and well kept. Goodman Crescent, 9 DS0000022795.V254055.R01.S.doc Version 5.0 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 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): 33 and 35 Residents are supported by an effective staff team. Staff are appropriately trained. EVIDENCE: The weekly rota was displayed on the notice board. It provided evidence that there is always one member of staff on duty, which is the Manager during the day and support workers during the evening, sleep-in and early morning. As no residents require assistance with physical care and all can travel independently the home can meet their care needs by one member of staff on duty at any time. The Manager and other staff are available on call outside office hours and at weekends. As this is a very small home, the whole staff team exchanges information on a daily basis and evidence of four monthly, minuted staff meetings were seen. Additional staff meetings are also held if particular circumstances require it, such as when planning summer activities or for Christmas. Goodman Crescent, 9 DS0000022795.V254055.R01.S.doc Version 5.0 Page 17 The proprietor/manager does not employ support workers unless they have the NVQ Level 2 qualification, which ensures that they have all of the basic training required to work at the home. They are then kept abreast of current issues and changes of legislation by in-house training. For example, following a requirement arising from the previous inspection, the manager undertook inhouse training for all staff on the contra-indications and potential side effects of medications taken by residents. In addition, the proprietor obtains specialist video training for staff. The manager carries out six-monthly appraisals of individual staff and bases the training and development plans for the following six months on any indications of training need that arise from the appraisals. Goodman Crescent, 9 DS0000022795.V254055.R01.S.doc Version 5.0 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 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 and 43 Residents benefit from a well run home and from competent and accountable management of the service. EVIDENCE: The proprietor of the home is also the registered manager. She has several years experience of managing residential care for this particular client group and formerly managed a much larger residential home for people with mental health needs. She also has academic qualifications to degree and higher levels. However, she does not have the NVQ Level 4 qualification in management and care as recommended under this Standard. At the previous inspection the proprietor/manager was considering employing a manager who had this qualification but this was now being reconsidered. The proprietor/manager is now considering undertaking the NVQ Level 4 qualification herself. The previous requirement has therefore been changed to require the proprietor to make a firm decision about this issue by the end of the year. Goodman Crescent, 9 DS0000022795.V254055.R01.S.doc Version 5.0 Page 19 The home has suitable insurance cover. The previous inspection report required the manager to ensure that a business and financial plan is in place. This was discussed with the proprietor/manager and it was agreed that the financial and business report submitted annually to placing authorities to prove viability would be suitable for the purposes of this Standard. Therefore the home is required to keep a copy of this annual submission on the premises from now on. Goodman Crescent, 9 DS0000022795.V254055.R01.S.doc Version 5.0 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 x x 3 Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 4 X 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 4 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X 3 X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Goodman Crescent, 9 Score X 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 X X X X X 2 DS0000022795.V254055.R01.S.doc Version 5.0 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 37 Regulation Requirement Timescale for action 31/12/05 2 43 18(1)(c)(i) The Registered Provider must ensure that the manager of the home is suitably qualified. Previous timescale of 30/6/05 not met. 25(3) The Registered Provider must ensure that a copy of the annual business plan is kept on the premises. 30/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Goodman Crescent, 9 DS0000022795.V254055.R01.S.doc Version 5.0 Page 22 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 Goodman Crescent, 9 DS0000022795.V254055.R01.S.doc Version 5.0 Page 23 - 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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