Inspection on 14/09/05 for Grantham Road, 57

This inspection was carried out on 14th September 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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Grantham Road, 57 16/04/07

Grantham Road, 57 12/01/06

Grantham Road, 57 16/03/05

Grantham Road, 57 08/09/04

Grantham Road, 57 31/03/04

Grantham Road, 57 25/11/03

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

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 Grantham Road, 57 57 Grantham Road Brixton London SW9 9ED Lead Inspector Lynne Field Announced Inspection 14th September 2005 10:00 DS0000022733.V251587.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 DS0000022733.V251587.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. DS0000022733.V251587.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Grantham Road, 57 Address 57 Grantham Road Brixton London SW9 9ED 0207 326 0498 020 7326 0498 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) Southside Partnership Mr Edward Clifford Yeboah Care Home 5 Category(ies) of Learning disability (5) registration, with number of places DS0000022733.V251587.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th March 2005 Brief Description of the Service: 57 Grantham Road is a Victorian terraced property in a quiet residential side street close to shops and public transport networks. The ground floor has the lounge, dining room and kitchen, two single bedrooms and a bathroom with toilet. The mezzanine has a bathroom with toilet, a separate toilet and the laundry room. The second floor has three single bedrooms and the staff office/sleep-in room. There is a small garden at the rear of the property. Parking near the home is restricted to resident permit holders only, although there is limited metered parking a few streets away. Grantham Road provides care and support for three men and two women who have autism, learning difficulties, challenging behaviour and communication problems. The staff team are a balanced mix of men and women reflecting the service user’s support needs. DS0000022733.V251587.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and was carried out on the 14th September 2005. The registered manager was present. The inspector met all the service users who live at the home. The inspection included a tour of the home and examination of records of the care plans, staff records and building maintenance records. During the inspection staff interaction with service users was observed to be knowledgeable and conducted in a respectful manner. The inspector noted the positive way in which the incidents of challenging behaviour displayed by the service users during the inspection were dealt with by the registered manager and staff of the home. 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. DS0000022733.V251587.R01.S.doc Version 5.0 Page 6 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. DS0000022733.V251587.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection DS0000022733.V251587.R01.S.doc Version 5.0 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 the following standard(s): 1-5 Prospective service users’ needs and aspirations are assessed, so that a service tailored to their needs could be provided. EVIDENCE: The inspector was shown the statement of purpose and a service user’s guide, which includes the complaints procedure in the service users’ guide. The Statement of Purpose and Service users’ guide are being updated to reflect the changes in the management of the service. There have been no recent admissions to the home. Should a vacancy arise, the manager said the home would follow the homes admissions procedure and the prospective service user would be invited to visit the home with family members or friends to help them decide if the home could meet their needs. A complete assessment based on personal history, care management assessment and a full needs assessment would be completed to ensure the home could meet the prospective service users needs before a place in the home was offered. DS0000022733.V251587.R01.S.doc Version 5.0 Page 9 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): 6,7,8,9, The service users are involved in planning their care with their key worker, the registered manager, appropriate professionals and family members. Potential risks are identified and service users are supported to take risks within a risk management framework. EVIDENCE: Three service user files were inspected. Care plans give a thorough description of service users’ individual behaviours, reactions and preferences and how the service user was to be treated. Care plans are reviewed six monthly or earlier if the need arises. Several service users have very challenging behaviour and there were detailed guidelines and risk assessments on file of how the service users behaviour could be managed and supported safely. The inspector viewed individual risk assessments, which had been carried out, monitored and reviewed by the staff with service users every six months or when the need arises. Details of any changes to the risks are recorded in the service users care plans, with details of how to manage the risk. DS0000022733.V251587.R01.S.doc Version 5.0 Page 10 On the day of the inspection the inspector observed service users being supported by staff to make decisions about what daily activities they wanted to do that day. This included verbal prompts and using objects of reference. DS0000022733.V251587.R01.S.doc Version 5.0 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 the following standard(s): 12,13,14,16 Service users are encouraged to take part in age, peer and culturally appropriate activities. The service users are actively encouraged and supported to develop daily living and social skills by the manager and staff of the home. They are able to maintain relationships with friends and family. EVIDENCE: The registered manager told the inspector that service users are supported to make decisions concerning their daily activities. During the inspection the inspector observed staff interacting with service users in a positive way, enabling service users to deal with situations that they found upsetting. Such as when one service user remembered that she had lost or broken her earrings the previous day. DS0000022733.V251587.R01.S.doc Version 5.0 Page 12 Service users have an individual activities programme, which includes developing independent living skills within the range of the service users abilities. The inspector saw that service users are offered opportunities to participate in the day-to-day running of the home as far as their abilities allow. One service user has no family but the home has applied for an advocate to support him. At the present time they have no one assigned to them because of the lack of advocates. The home has been told if an issue arises where an advocate is needed they will become involved. Other service users have relatives who are more actively involved with the home and act as advocates in decisions relating to social and health care needs of their relatives placed there. One service user goes to their family’s home for weekends if there is a special family occasion. The registered manager has contacted the job centre for advice on service users having an appointee and clarification on DSS benefits in consultation with each service user and /or their representatives. This was the subject of a previous requirement that has been met. The inspector was told the service had met with service users and staff to discuss the practice of service users not holding their own front door keys. This has been risk assessed, with skills teaching and guidelines in place for those who might want to have a key. This was the subject of a previous requirement that has been met. DS0000022733.V251587.R01.S.doc Version 5.0 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 the following standard(s): 18,19,21 Service users receive personal support, in the way they prefer. Ageing, illness and ascertaining service users wishes in the event of the death is being handled with sensitivity and respect by the registered manager at a time appropriate to the service user. EVIDENCE: Care files contain information for staff on service users who need personal support with their preferred personal care routines A key worker system is in operation, with each service user having two members of staff from within the team to co-ordinate their support and care planning. The record of health appointments attended indicated that each service user is supported by staff if this is what the service user requires, to attend an appropriate range of healthcare appointments in line with their individual healthcare needs. The inspector was told service users sometimes go on holiday but they have to pay for staff accommodation. As the service users receive limited funds the DS0000022733.V251587.R01.S.doc Version 5.0 Page 14 inspector discussed with the manager the possibility of the organisation paying for staff accommodation when taking service users on holiday. The registered manager told the inspector the service users and their families have been consulted and supported to draw up formal documents to describe the arrangements for the service users in the event of aging, illness and death. Two service users have agreed and a letter has been written to parents. DS0000022733.V251587.R01.S.doc Version 5.0 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): 22,23 There are safeguards in place to protect the service user from abuse, neglect and self harm. EVIDENCE: There is a complaints policy and the complaints book was seen by the inspector. No complaints have been recorded since the last inspection. The inspector was shown a copy of the home’s Adult Protection and Whistle Blowing policy, which conforms to Local Authority requirements. The organisation now refers staff to POVA as appropriate. None of the staff in the home have been referred for inclusion on the POVA list. There is a policy regarding the protection of the service user’s finances; personal money and valuables are checked twice daily as part of the handover system. The home safeguards service user finances with appropriate recording systems. The inspector was told each service user has a finance book in which all financial transactions are recorded and signed by two members of staff. DS0000022733.V251587.R01.S.doc Version 5.0 Page 16 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): 24,25,27,28,30 The home is bright and comfortable. The accommodation for both individual and shared use is furnished appropriately and maintained as well as possible given the nature of the high level of challenging behaviour in the home. Work has been done to make the premises more suitable to service users needs. Service users rooms are comfortable and are decorated to reflect their personalities. The inspector was told one service users bedroom had recently been redecorated. The standard of hygiene was very good with no unpleasant odours. EVIDENCE: DS0000022733.V251587.R01.S.doc Version 5.0 Page 17 The home’s premises are suitable for the current service users, being accessible, safe and generally well maintained. At this inspection it was found that the manager and staff had continued to make efforts to improve the decor, furniture and fittings at the home. Most of the areas were attractive, comfortable and homely, despite the very challenging behaviours, and subsequent damage and wear and tear that service users present. For instance, on the day of the inspection one service user became distressed and during an episode of challenging behaviour, pulled the curtains in the lounge down. This type of behaviour is all part of the every day behaviour of the service users whom live at the home. The registered manager and staff all responded in a positive way prevent the behaviour from escalating further. The home has a lounge, diner and kitchen, which together with a paved back garden form the communal space in the home. The lounge is separated from the dining and kitchen area by a sliding door, which can be opened to make the three areas into one continuous space. This also gives the home the facility for staff to sit in the dining area when service users are in the lounge and provide non-intrusive care. The garden is on two levels and completely paved over but staff have made it attractive by planting lots of tubs of flowers and hanging baskets and by providing a table and chairs so that service users can eat outside and otherwise enjoy the space. All five bedrooms shown to the inspector by each of the service users, were decorated according to service users’ choice, and four of the bedrooms were attractive and comfortable with good quality decor, furniture and fittings and personalised according to the individual service users’ preferences, choices and cultural interests. One bedroom had only very basic furniture and fittings because of the very challenging behaviours that the service user presents. The home has two bathrooms with toilet, and an additional separate toilet between five service users. These facilities are located within easy reach of service users’ bedrooms and both bathrooms have hand-held shower facilities and both have recently been redecorated. Laundry facilities were adequate and well sited, and the home has thorough policies and procedures in place to control infection. The premises were found to be clean, hygienic and free from offensive odours throughout. DS0000022733.V251587.R01.S.doc Version 5.0 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): 31,32,33,35,36 There are appropriately trained, supported and supervised staff. The organisations training programme provides staff with wide ranging induction and foundation learning. NVQ Training for all staff including bank staff must be identified and formally planned to ensure that 50 of the homes staff achieve NVQ level 2 or 3. EVIDENCE: The inspector was given copies of the staff rotas, which showed that there are three staff on each early shift and two on each late shift. With the regular attendance of most service users at colleges, this is sufficient to meet the daily needs of service users, including escorting and the one to one care required by one service user outside the home. The inspector was told that there is a key worker system and the registered manager said he discusses care plans, risk assessments and reviews at team meetings so all staff are kept informed of changes to individual service users. The manager said all staff receive monthly supervision, which is recorded and staff spoken to said that they feel adequately supported by the home management team. DS0000022733.V251587.R01.S.doc Version 5.0 Page 19 Three members of staff were spoken to and showed an understanding of when it was appropriate to get advice on care and other issues and to refer to other professionals/specialists. The inspector observed several incidents of service user behaviour during the course of the inspection and witnessed how staff dealt with and had an understanding of service users cognitive limitations, challenging behaviours and care needs. Staff files are kept at the organisations head office so it was not possible to inspect individual training and development assessments for individual team members or for the staff team as a whole. The inspector was told by the registered manager that the recruitment procedure is based on equal opportunities and ensuring the protection of service users. Each new member of staff must supply all of the required documentation to meet this standard. The organisation has a training and development plan in place. All new staff undergo LDAF foundation training that covers learning disability, health and safety, risk assessment, challenging needs, inclusion, medication, mental health issues, manual handling, first aid and fire safety. All staff have, also undertaken training in Restraint Relevant to the Service Users needs. This was a previous requirement that has been met. The manager told the inspector one support worker had completed their NVQ and one was due to complete it in February 2006. At the previous inspection, a requirement was made that the home’s manager must ensure that care staff complete NVQ training, to ensure that 50 of the homes staff achieve NVQ level 2 or 3 by end of September 2005. This has been reinstated. DS0000022733.V251587.R01.S.doc Version 5.0 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): 37,38,39,40,41,42,43 The home is being well managed by a manager of good character, long standing experience in care, who is open and supportive in his management approach. There are systems in place to measure the satisfaction of service user and other stakeholders about care provided by the home. Working practices and associated records ensure that the health and safety of service users is promoted. EVIDENCE: Staff told the inspector that the registered manager is approachable and well respected by staff and service users families and made it clear that the home is managed in a positive and open way. Staff said they felt they are able to influence the way the home is run via staff meetings and supervision. DS0000022733.V251587.R01.S.doc Version 5.0 Page 21 The inspector was shown records that show a quality assurance monitoring system in place to systematically gather feedback from service users, relatives and other professionals and enable their views to continually influence service development. There are written policies and arrangements for maintaining safe working practices in place, including appropriate risk assessments. The company updates these on a regular basis. The fire system is subject to regular tests and equipment is suitably checked. Service users records are held appropriately. Regulation 26 visits had been carried out and copies of the reports have been sent to CSCI each month. DS0000022733.V251587.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 X 3 3 X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score 3 2 3 X 3 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 DS0000022733.V251587.R01.S.doc Version 5.0 Page 23 No 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 YA32 Regulation 18 (c) (i) Requirement The registered person must have a clear policy on how it will achieve the 50 NVQ Level 2 training target. The registered manager must ensure that he completes NVQ level 4 in order to meet the requirements of the Sector Skills Councils workforce targets. Timescale for action 31/12/05 2 YA37 18 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA19 Good Practice Recommendations The registered person should review the policy of service users paying for staff accommodation when they go on holiday. 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